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98-103 CIFEIR IFICATE OF OCCUPANCY TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK L]atc Apr 1 1 13 19 _ 98 98103 This is to certify that work requested to be done as shown by Permit No. has been completed. MOBILE HOME This structure may be occupied as a Location LOT 149 ELM HU12ST DRIVE �'L Loe%%_l Owner HOU SEWOR'TH . RONALD TAX MAP" NO . 93 . 2 - 11 . 1 By Order Town Board TOWN OF QUEENSBURY Director�"of Bldg. do Code Enforcement BUILDING PERMIT VALUE g 28000 TOWN OF QUEENSBURY No . 98103 TAX MAP NO . 93 . — 2 - 11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to HOUSEWORTHe 10 OWNER of property located at LOT 149 LUZER14E RD . Street, Road or Ave. in the Town of Queentsbury, To Construct or place a MOBILE HOME at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. 1, OWNER'S Addreu is LOT 149 HOMESTEAD VILLAGE QUEENSBURYr MY 12804 2. CONTRACTOR or SUILDER'S Narne GLENS FALLS MOBILE HOME INC . 3_ CONTRACTOR or SUILDEWS Address 39 SARATOGA RD GANSEVOORT , NY 4. ARCHITECT'S Name NEW YORK BOARD S. ARCHITECTS Address NEW PORK BOARD OF FIRE UNDERWRITERS 6. TYPE of Construction — (Please indicate by X) MOBILE HOME f i wood Frame f ) Masonry i i Steel I I 7_ PLANS end Specification% 14r Ro. 80r MOBILE HOME AS PER PLOT PLAN SPECIFICATION'S 8, Proposed Use MOBILE HOME 41 April 3 2000 $ PERMIT FEE PAID — THIS PERMIT 'EXPIRES 19 (If a longer period is required an application for an er.tension must be made w the Suilding and Zoning inspector of the town of Queensbuny before the expiration date.) 3 April 19 Dated at the Town of +Oueensbury this Day of S9 SIGNED BY -��A C" _ -- for the Town of Queensbury Building and Zoning Inspector c . � v REVIEWED BY : kw FEE PA I Il : ` PERMIT NO . � �- APPLICATION FOR PERMIT MOBILE IIUME Oil MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME , NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT IIAS BEEN ISSUED . . . ♦ . , . . . . , • . . . • • .,,. a • • • • . . w . • r r • . r The owner of this property is . , � p �� "i p � T� P . O . Address : -e o eje 'p hone Numberq ). 249" C40 Property Location Tax Map No . / / NAME OF APPLICANT : Ar Address of lIpI711catrt : t1 — j All applicants spaces on I its application !'BUST be completed and the signature of the applicant MUST appear on the revers cation . PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES : -TOWN OF MOBILE HOME INFORMATION APPROXIMACE VALUE OF HOME : New home Yes � ZONING INFORMATION : Replacement Hom Yes No Size of Property : ft x _ _ft Size of mobile home jLftx p(3ft Existing Buildings : Singlewide V, DoubTewide No , of rooms ( exclude baths '" ' Proposed building-distance from property line : Front Yard ft Rear Yard ft . No , bedrooms �`J Side Yards ft an6 ft . Occupancy Information : No . of bath7Woodstove s � Primary dwelling : Yes No Fireplace Accessory Building ( s ) • Detached garage ( one car / two car car ) Foundation style and size : Attached garage ( one car / two car car ) ` Storage building Piers-No . of Size ft x ft Other Depth below grade ft * * * * * * * * # Foundation- Footing size x Proposed to f lacernertt Wall material � /p Wall thickness " Height "" Water Supply : Well Municipal Total depth below grade f t . Septic permit required ? w� _1 f2 Grade to home floor. level ft , FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SIIEET NAME OF INSTALLER/MOBILE HOME DEALER : ADDRESS/PIIONE NtJMBER �TTi'j,tl; y-- STATE OF NEW YORK DIVISION OF IIOUS I NG AND COMMt1N I TY RENE14AL INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1 , Insignia serial nuniber D7 2 . Name of Manufacturer 3 , Plan Approval Number Ckl � - ���� � � � � 4 . Model or Component Designation 451� 5 . Date of Manufacture �^ � �I3 All the above information is to be found on a plate or sticker which should be affixed to the Mobile home . Complete above with that informaLion , Town of Queensbury State of New York County of Warren AFFIDAVIT I swear that to the best of my knowledge and belief the statements contained in this application , together with the plans and specifications submitted , are a true and complete statement of all proposed work to be,_ done on the described premises and that all provisions of the IW ILDING CODE , the ZONING ORDINANCE , and all other laws pertaining to the proposed work shall be complied with , whether specified or not , and that such work is authorized by the owner. - <7; , 4afu i4-G S i g n a L i i re c_.G�-< Owner , owner ' s agent , architect , conLrac. Lor SPECIAL CONDITIONS OF PERMITO By Code Enforcement Officer DECLARATION.* Please sigh helosv after ymr have carefully read the stateyneru: To the hest of my knowledge the statements contained in this application , together with the plans and specifications submitted , are a true and complete statement of all proposed work to be done on the described premises and that all provisions of [lie Building Cade, the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied with, whether specified or noted, and that such work is authorized by the owner. Further, it is understood that I/we shall submit prior to a Certificate of Occupancy or Certificate of Compliance being issued, an AS BUILT PLOT PLAN by a licensed surveyor; drawn to scale, showing actual location of project on premises, Signature: (owner, owner's agent, architect, contractor) k TOWN OF Q UEENSBURY � 742 Bay Rd., Queensbury , NY 12804 APPLICATION FOR SOLID FUEL BURNING APPLIANCES AND CHIMNEYS qg� Date ` , 19 Permit No. APPLICATION IS HEREBY MADE to the Building Dept. for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. Please fill oUt additional form if more than tthan+ one appliance andfor chimney, Applicant , %. f �,��', wzr .� 1 - '- APPLIANCE (check appropriate boxes) Address ;�y' j /.MiV 5"{t" t STOVE: ❑ Wood ❑ Coal ❑ Pellet 0Gas ❑ FIREPLACE INSERT Zip jelFIREPLACE, F�TORY-BUILT: ood ❑ Gas Phone � i ,S • 7 © FIREPLACE, MASONRY : ❑ Wood o Gas Owner �'=,`% T Y- rl %'f t r-r . - ❑ FURNACE: ❑ Wood ❑ Gas p Oil Address IF NON-MASONRY APPLIANCE: Manufacturer: Zip Model: Phone CHIMNEY (check appropriate boxes) EE;:T ADDRESS of proposed construe ion ❑ MASONRY : ❑ Block ❑ Brick ❑ Stone Ca�],S?, �1 ' C� G�4 y ► � � ' FLUE : ❑ Tile ❑ Steel Size: _ inches CONSTRUCTION / INSTALLATION MUST /FACTO ManuRY�facturer:erLT: Model : CONFORM TO .NYS FIRE PREVENTION & M Number: BUILDING COt)E, CONSULT AVAILABLE Listed By : TOWN OF +QVEEENSBURY HANDOUTS ❑ Double Wail ❑ Triple Wall REGARDING R.EQUIREI" 4SPE'CTIONS. ❑ Insulated coney Liner❑ Direct Venting Chia Cashier's Department Town of Queensbur y, New York Amount Collected Amount Refunded Dept: Fire Marshal Code Number 'Title w � A 173 3389 ( 190 ) Public Safety ,Ai 233 2655 (230) Minor Sales .. Fee 'Collected FromorAefunded to: Address-. Dated : Town Clerk or Dep y: Rite: Applicant Green: Fire Marshal yellow: Bldg. Dept. Fink do Goldenrod: Cashier's Dept. g T1C3iV WR0Pp T rmjjV4JX1_ 11,ioP p ` MC3151LOW I AC3="L.A Taown of pueensbury Building & oodo Enforcemem 742 Clueensburyy W 1 2804 (51$ 7i51$256 . A1iRl " - i7EPAR'tq NSP !� CEN REQvTCLIVFD: 'DATE 1NSPRCn rloll rt!1Y "`Q [�C7 pypME: p,ERMrl' ` _ 3 DATE ¢ a, H#1!r[E 140,511L Np11R� ERASING WINGS ON N!A YES NO . pier spacing _ -- 1. foundation per �n f. .. .. . .. .. . . 1 water line shut,Off �- 4 feet 4. se+ver line support ewide) a '~ 5. hearin8 crossover ide 64 dryer ventedti �- S. �W v valve pn 01AS7 0 f ~- relief Iaw _ 1. furnacelh+ ater -- 11. garage fire proo • • '~ 12. door closers . .. . .. .. 14. foul'" ) (if aw.. ... .. .. �- I5* smdke detectors ' 16* final electrical -- �- 17 . vsru►nce okay .. . .. .. . Is. data p I �,y .. ... .. .. . .. .. lg. mobile HU'D serial # Model p Manufatturer t*W of M DIES NO C1KAY To ISSUE CIO g Ups 1�?n- 1N�p�MppV AR MpBfv'� f T°'H S.°fie E o(COment Bui4diri9 742 Bay Falcsad Quewsburl, NY III (51 a) 761-8256 PART: 4_�`_�ll3 DATE i,,S,EC7' ON PmQuEsr P*EC'! iV jL'OCATIaN: PURMIT DA'[L: ma H Id8 ---- moss" +alarm ` raut� ON FoCnI1G5 131a► Es No vy, Pig .5•pacir. . , --- ation support, _ 1. cver MI rin Per ittanu . . .. 2 Strut,off �- 3, water liM 4 feet . . . » �- grd- 4. sewer tine support ,a�icle) off t tin8 crossover (db 5 outside . . .. . » vy 6. dryer vented ... .. . . . .. .. . .. .. . �- 7.8. h irtingt v relief valve s, stee(ss= 4. deck, P'� water oPe�` ' l0. furnaaellu � . . garage fire proofutg . . . . . .. - - k2 ttcior closers .. . -- �- 33. plum kag f'xture c�n (if . .. . .. f 1S• s y�eltrical • .. . '..•s: 1,7 . variance required . . 18. data platy clay 19. mobile HUD seal y . .. .. . ..; Serial 14odol # �apufacpirer .pate of MwaIcturer YES NOptr,AY To IS CIO Cornnoen'ts: i TOWN OF: QUEENSBURY FIRE tAARSHAL QUE 51817 8p4 61 _g205 FIRE MARSHAL. INSPECTION REPORT REQUEST FOR INSPECTION RECEIVED NAME '�t�-�SZ1rY-�'�-A►„�'�1 �� LOCATION -�- _ ,� �0, �7 DATE. PERMIT APPROVED N!A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTINO FIRE EXTINGUISHERS . AUTO. EXTINGUISHING SYSTEM HOOD INSTALLATION '' -- AUTO. SPRINKLER SYSTEM �--- ALARM SYSTEM F INTERIOR FINISHES P. STORAGE: Pi CLEARANCE TO SPRINKLERS h CLEARANCE To HEATING UN S REQUIRED SIGNAGE i' CHIMNEY _ \NOODSTOVE FIREPLACE - MASONRY FIREPLACE - FACT R BU �] QK TO THIS DATE REMARKS: 1 i S R 4NSPSBF? PUB 1�f1VAL IIVll3PEGTlE71V maim v t N10B1LE f 11AOCiUL-AR Town of Queensbury Building & Code Enforcement r 742 Bay Road QueensburY, NY 12804 (518) 761-8256 ARRIVE-.2j',DDEPART_ 7, 1NSP_ [ DATE ENSPECrnON Py-QUEST RECE V NAME: i l}ATE: PEltM1T # - � MoOlLE lions 0�,� ROMB w•t•taN CKFn.L r�MING �grt•tNos -- F° _ NIA YES NO 1 . foutudation pier spacing per nwauf. I. .1 .. .. . . . . . .. .. .». 2. anchoring per uf. ». .. . .. .. . .. 3. water line shut, o ® 4 Beet . . . 4, sewer line super 5» heating crossover lewide) o -- 6. dryer vented outsi 71 skirting ventilated . .. .I. .. .. . utside 8» hot water relief valy �pmg -- 9. deck, porches, steps, 10. furnaoe/hot water ll» garage fire proofing 12, door closers .. ... .. .. .. . 136 plumbing fixture -- 14. fourOatian insu 15, smoke detectors 16* final electrical 17. variance req �[ _- 18. data plate 19, mobile seal okay .. ... .. . .. Lam- rrti� +Z►�PvC�G' Mat1e1 # / S Manufasoer Date. of Manufacturer OKAY TO ISSUE CIO YES NO Comments F�1�7 ► rJ Z 01iJ�G- THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY III WASHINGTON AVE ., SUITE 704, ALBANY, NY 12210 date �}Yf{ S fA i _: . L`+ li Applioation on E THIS CERTIFIES THAT i'EI€ ITT 14 'aLils' .a Only the electrical equip K named on the above application number in the preOKisee al meat as described below and introduced by appl' "t;'1'i1S" llk;kt ►T�}I{"f ; , f1x3LI1 ,E"I'l�?f' 1_] f�J Section Black Lot f y , in thefoltoLcing location: Bosco"ent Int Fi. 2nd Ft. eras examined an 1AV: l I €}>' , I `}'+ ' and,f`ound to he in compliance with the National Flectricai Code. Fa%T1lRE RXTURES RANGES COOKING DECKS OVENS DISM WASHERS EXHAUST FANS OUTLETS ACLES Ti�Y11ITCHES NCANGESCENT FLLIORE34FNT OTHER AMT. K- W. AMT. 9. W. AMT. K.W. AMT. K- W. AMT. H- P, DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CWCKS RELL UNIT MEATERS MULTI-OUTUET DIMMEIRS SYSTEMS AMT. WATTS AMT, K. W. OIL H. P. OAS N. }. AMT. NO- A. W. G• AMT. AMP. AMT. AWS. TRANS- AMT. H. P No. OF FEET V t C E SERVI CE DISCONNECT NO.of S E R A. W. G- P40. OF NEUTRALS A. W. G. AMT. AMP. TYPE EMETEROLRP. T .X zw 1 0 3w 3 X 3w 3 X 'IW �" �PER!'C4N0. � CC COI!ID- NO- 6F H4LEG OF HI-LEG Or NEUTRAL OTHER APPARATUS; F"s`i'ii', t3F;kf L€�t7{'1 MANAtiiR f„ IfFikSf#: ;t!Ili,'; Tip" . f :'.t'•L14 :_ r., ;wL PCr This certificate must not be offered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials- COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY -MANNER . COPY FOR BUILDING DEPARTMENT . THIS - F11VAL. 1NSPEGTtGh1 ii�l�F•c�rr�-r �' + Town of Queensbury Building & Code Enforcement 742 Bay Road Qu+eensbury o NY 12804 (S18) ? 108256 F ARC Ge?sPART: . " INSP: �Ct DATE INSPECTION REQUEST R1✓Cixli�D: i NAME; i&DX k-�" I,OCAMON: DATE: i PERMIT p �163 MOBILE HOME MR1iD�TLAR OM8 I FOOTINGS FOUNDATION BACKFR3. FRAMING N/A YES NO 1 . foqubdatson support, Pier spacing i Per manuf. 2 anchoring per manuf. -- water line shut, off . ... .. .. .» .. . _ . .. .. . 4. sewer line support (W 4 feet . . .. .. . - -�/� 5. luting crossover (dblewide) off grd. . ✓ 6# dryer vented outside . .. ....... .. .. . ... ... . -- 7. � skirting ventilated .. .. .. .. ..... .. .. ... S. hot water relief valve piping outside � — -- 9. deck, Porches, steps" railing .. .. ...» — -- 110. fiunacelltot water operating . ._x. .. 11, garage fire proofing ... I' ,* . . .. .. -- 124 door closers fixture 13, plumbing . .. ... . . .. ». .. : 1. .. .. . 14. foundation insulation (if apP1.). . 15» smoke detectors .. ... .. .. .. ..... .. .. .. . `.. 16, final electrical 17. variance required . ... .. . . .. . . . .. .. . . — 1$, data plate okay 19. mobile MD seal okay .. .. .. ..... ... Model # Serial # Manufactuxer S Date of Manufac r OKAY TO ISSUE Gl0 YES NO FiNAiL IN�ptlstti^,.TIOIV t�I1F.t�t7llFeT" MCfi81LE / M=EMUL.AR I'� + 3 Town of Queensbury c7� Building & Code 'Enforcement 742 Bay Road pueensbury, NY 12W4 (518) 761-8256 clltRlvE� ,6 c3 2 DEPART: ,, ®y INSP: Q---r DATE INSPECTION REQUEST RECEIVED: EDATE: C?� IV: PERMIT # MSl81CLK HOUK MOEKI1<.&R HOUR F41nINGS FOUNQATION BACIMLL FRAMING N/A YES f NO 1. foundation support, er s1cInS per tnanuf. nr3,;,__lrnin@ per ti7alulf. -- -- 3. water line shut.Off ., .» .. . . 4, sewer line support 4 5» heating crossover (dblewi o 6. dryer vented outside . .... .. .. 7 skirting Arm ilated j S. hot water relief valve piping ide 9, deck, porches, steps, tailing . .. .» .. . lo. furnace/hot water operating _ — 11. garage fire proofing ... .. .. . . ... . . .. -- 12. door closers . .. ... . . .. .. .. . . . . . .. .. .. .. 13. plumbing fixture .. .. . .,». .. .. .. . . . .. .. 14. foundation insulation (if aPPI.)». .. .. 15. smoke detectors .. .. .. ....III *. .. . . ...», . 16. final electrical .. »» ... .. .. .. ... .. .. . . .. 17. variance required .. ....... .. .. . . »., .. . 1S. data plate okay ..,.. .. .. .. .» ... .. .. — -- -- 19. mobile HUD seal okay Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C!O? "YES NO Comments- hl101S11�E / mcmc:I .ILWAfA Town of ©uesnsburY Building &. Code Bnforcernent 0AWj 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: \t1 EPART:1at[ 1 DATE INSPECTION REQUEST RECEIVED: 1 NAME: LOCATION: � HATE: .r PERMIT MrpSILE #�gltlE M004ILAR Ho Fr N(�g FOUNDATION � IIACICFSLL � FRAMING NIA YES NO i. "mutation support, Pier" spacmg per manuf» .. .. .. ... .. ..� . . .. . ., ., -- 2. anchoring per manuf. -- 3. water line shut, off , .. , . . » . . —+ — — 4. sewer line support t:W 4 fee . .. . g, heating crossover (dblewide o gam» 6. dryer vented outside .. .. .. ..... 7. skirting ventilated , .. .. .. .. ... -- — -- g, hot water relief valve piping trtside , �- 9, deck, POmhes, steps, ram — -t 1104 ftumce/hot water opera II, garage fire proofing .. .. ... .. .. .. .. .» . 12, door closers 13. phm*ing fixture .. ..... .. .. -- -- -- 14. foam Ution insulatim (if appl.), .. ... -- 15. smoke detectors .. .., .. ., ». ... .. .. . 16. rural electrical — -- 17. variance required . .. .. . .. . . ... .. 1C -- Is# data plate okay ...., ..,. » 19. mobile HUD seal okay . .. .. ... . — z Modal # serial t � Manufacturer � 3;,Date of Marzufac __�... 1 YES NO j Cl1GAY TO i Comments: i h f) "� REcoFIVED APR 01 im -rOVVN wp o:lp�E�NlRURY aUit�OING CODE q <6 .................... ....4;1;;:: I FILE D AT TMW OF OEM=" ON h* a hldkoft Meda Ph= low 41111111015collim " in fam CNRP%nm oft tho coft fIJ OPTIONAL PANTRY ' ry rx On0[fnS[ M Y _ L — 4Fl Y Y1 Y Y7Y.N MR - ' - - - - - - - - ROOM l I - L - , iy L ! riYau wwr - - - - - --^^ - .-.•._.. Yr lrl CATHEDRAL ROUGGHOUT 'wUAR� l LwIltiS'f SEOOND BEDROOM BEDROOMI '. .Id i l-- 1 . L _- .- L - LINNG l - I a -a 1 ,•-r ,a-, r . ,t —Y I 36R, 28A, ISLAND KITCHEN, LUXURY MASTER BATH JT168081 OF ,.D - ER BEDROOML L L +L� UVI,IG SECOND Y ROOM BEDROOM ,r--- . ,+•-r ,a•-a' r sw-r CATNEDRV. CEILING 5TAFI0ARO tr ++�• �' .Id oo. _ . •. �. THROUGHOUT DINING a'—a' • Rd—r .. rYtr � I 2BR, 2BAs ISLAND KITCHEN, FOYER JT168096 I ! I r YYY.Y 3 a.r Yrmcr[L_y `. L L i ROOM rSE00t CATHEDRAL CEIuNC STANn,aouGNGuT L i . iBEDROOM _ _ THI D _ L L - L . L_ L i_ 1_ L sr BEDROOM ! to-r v -r j 3BR, 2BA, FRONT DINING, LUXURY BATH JT168097 1 1 v+A�A 1 LMING _ L- L'S BEDROOM ROOM INIf 1 I.._ . . , MO C47NEURAL CEILING STAfiLlAR7} L. SECOND _ I ! I L . L iv-srL L- , -a' . ,a'-to' L _ L L L. TIo•-r . 4•-X h . 2BR. 2BA, FRONT DINING, LUXURY BATH JT168098 + k'