1999-646 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 40000 Building Permit No. 99646
TAX MAP NO. 125 . -1-29 . 13
D� MOWRY, MARY
Permission is hereby granted to
Owner of property located at LOT 10 FOREST MOBILE HOME PARK
in the Town of Queensbury,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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
LOT 10 FOREST PARK
QUEENSBURY, NY 12804
Contractor or Builder's Name:
GLENS FALLS MOBILE HOME INC.
Contractor or Builder's Address:
39 SARATOGA RD
GANSEVOORT., NY 12831
Electrical Inspection Agency:
NEW YORK BOARD
NEW YORK BOARD OF FIRE UNDERWRITERS
Type of Construction:
MOBILE HOME
Plans and Specifications:
1280 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
MOBILE HOME
53 - October 15. 2001
$ PERMIT FEE PAID-THIS PERMIT EXPIRES
(If a longer period is required,an application for an extension must be made to the Code Enforcement
Officer of the Town of Queensbury before the expiration date.)
15 October 1999
Dated at the wn of Queensbury 's Day of
SIG Y l?�- for the Town of Queensbury
• Code Enforcement Officer
. . ' ' - "19 -
OCT 12 7999
TC.) WN 01.. QV 1 1 N,s:,i3 C11Zr
in INC Lr,Ee'C ot1RY '
ItEVIEWED BY:
d �c�
r
FEE PAID: $ 5� ®
�` (°
PERMIT NO.
APPLICATION FOR :PERMIT
MOB'i.f: HOME OR ,MODULAR
A .BUILDING PERMIT MUST DE 0lrrhINED'AIlf:_row PLACEMI NT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID IlL)lIDING PERMIT HAS IIEEN ISSUED.
The owner or this property is: 47244/6k. : eel if
P.O. Address: a Ub ►V . s / Phone Number
Property Locatn ► )�o i
T s E"AAK Tax Map No. /�S/ / / a9. 43
NAME OF APPLICANT: Imay ktuo Ay 9ce-3- 3 U 14-
Address of Oppl lcant: V - w�2.4 ay-e_ G
All. appl !can is spaces on tirI s appl .Ica t Ion MUST be coinpl a Led and the
signature of the applicant MUST appear on the reverse side of Lill appl lcation.
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES:
MOBILE HOME INFORMATION ✓ � :�, Pi
. ��t . �,�` nPPRUX-1 Mn'TI_ VALUE of I IUML": $ �Q jJ"� -�
New Rollie No =l
'ZONING INFORMATION:
Replacement Ilome, Ye,s �. : , iia $6
Size of Property: ft x fI
Slze of (�
mobile home ft1
Existing Buildings:
SinglewIde )c Doublew1de - . _. ;'
No. o f rooms (exclude baths) 4 Proposed bO l d l ng-distance _ from property l l ne•
I�ran t Yard =-' ft. Re_i;rv_Y_a,rd_/ ft
No. bedrooms A S�I`ile Yards _ ft and J ) f
No. of bathrooms Occupancy In forma Lion: i:,�
_ga
Primary dwell lily: Yes No
Fireplace Woods Love
Accessory Build anj(s) :
Detached garage (one car /two car car)style and size:
Attached garage (one car_____
care car)
Piers-Noe of Size ft x ft
Storage building
—Other
Depth below grade` ft .
-Foundation-Fooling size — "x - -_ _
Wall maLerla': Proposed date of placement:
Wall thickness " Height " • Water Supply: Well Municipal
Total depth below grade fL• Septic permit required?
Grade to home floor•, level ft.
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
NAME OF INSTALLER/MOBILE HOME DEALER: ,tal,t4 ._.(416-- _
ADDRESS/PHONE NUMBER2c'( SuAriet ledP 79 g 'a ( 1
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF TUE STATE BUILDING CODE '
1. Insignia serial number I21�' , - 19-5'q 48— [ -� Y- 0
__C.2. Name of Manufacturer .
3. Plan Approval Number
__ ___„ _ ,A.,_ Model or Component Designa,l:ion .__1:::)1:17 .
5. Date of Manufaclure / — 2- —9?
All the above information is. to be .found .on a plate or sticker which
should be affixed to Lhe:.Mo.bI1a home. 6)MP:tote. above with that information. •
Town of gtteensbury 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, t:ogether•__ with. the plans_�and specifications submitted,
- - =ail ai -Li(lip -hiii-d--cOiiip101.e --sLalemonI. a an I pr000sfil work to bp, dune on the
descrI bed . ,p.remises and Opal.. all provisions of the BUILDING CODE ,_ . t.he 7ONINIi
ORDINANCE ,' and all other laws pertaining to the proposed work shall., be comps led
wl th, whether spec) fled or not, and that: such work I s authorized by the. own r.
Signature - - 1112.11--
Ow e • caner' agent, architect,
contractor
•
•
SPECIAL CONDITIONS OF PERMIT:
•
BY
. Code f'riforcomentOIlicer .
DECLARATION: Please sign below after you have carefully read the statement.
'i'o the best 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 Ihat all provisions of the !Wilding Code, 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, n ractor) '
. \ / •
,
S J_!1 .ti _l !l' ti e_l.l_�_ ..0. 6_l)_,_l) .)...' !l')_._l'J_�_lJ��_l'J_�_l'J_�_l � �,1'.1�_lJ_.�1 �_l,_li_l' �_l'AV'AV AkvAsop..mtm.,1 �_l`��J_:....1' •_l�..1X� ,,,A ._l' ..2.l�..lA�_l'J.,_l'J_i_l' pcl':I
•
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE I •
• 80807 79
BUREAU OF ELECTRICITY Ir
g,• I- 111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210
6 NOVEMBER 02,1999 46039399/99 H 456950
i
�e Date Application No. on fi . �r
lk+ THIS CERTIFIES THAT I
only the electrical equipment as described below and introduced by the.applica t�I,afne one a e application number is in the premises of ki
it 15:
WI MARY !'MOWRY, 10 BRI6uOOD CIRCLE, QUEENSBURY, NY Fe
Vii
in the following location; ❑ Basement ❑ Ist Fl. ❑ 2nd Fl.;<i OUTSection Block Lot
was examined on OCZ'O�3FI� 29t999 and found to be in compliance with the National Electrical Code., ii>i
1
,• I FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS •
t}
OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. >•,
DRYERS FURNACE MOTORS FUTURE.APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS :ri
BELL iy
1i AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. MI H.P. NO.OSYSTF FEET AMT. WATTS 1
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SERVICE DISCONNECT NO:OF S E R' V 1 C.. E
METER NO.OF CC COND. A.W.G. A.W.G. A.W.G. 1yE
+• AMT. AMP. TYPE EQUIP. 1 0 2WECM 3 0 3W 3 0 4W PER 0 OF CC.COND. NO.OF HI-LEG OF HI-LEG NO.OF NEUTRALS OF NEUTRAL Iy:
III
1i OTHER APPARATUS: .
FEEDER:#2 #4 FROM DISC TO MH
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•
RANDY O. HITCHCOCK ii
�( i :.'4:iF .' l._. a..rL
-{I SAL , ., r . .r'iS S# r',=`i.: - GENERAL MANAGER iiri
j; ,''• a e�• a , ''39
- - -. - . . Per ii
• This certificate must not be altered In any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. r
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RESIDENTIAL FINAL INSPECTION REPORT
Office No. (518)761-8256 Date inspection request received:
Building& Code Enforcement
Dept. of Community Development Arriv ML m Depa
Town of Queensbury spector's Ini •
742 Bay Road
Queensbury,C\C -N.--- -)•••-..
New York 12804 (- I
NAME � 1O )- \ r� n PERMIT# �_�-(C11"`Q
LOCATION , I � ) Y i�l^A ! ) \ err X Q DATE \\
TYPE OF STRICTURE V 1 e
N/A YES NO COMMENTS
r
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent through roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30"to 36"
Exterior Handrails,balconies,landing 18 . o , ore
Interior Handrails stairs both sides 3 or ore ris
Grade 2%away from foundation
8"clearance to sill plate
Gas Valve shut-off exposed/regulator 1 t"above e
Gas Furnace shut-off within 30 feet or 'thin line o site
Oil Furnace shut-off at entrance to :ce area
Furnace/Hot Water Heater-operating
Relief Valve(s)installed
Headroom,6 ft. 6 in. on stairs /
Basement stairs,6 ft.4 in.
Handrail exterior stairs both sides ore than 3 risers
Interior privacy/trim/doors/main trance 36"
Floor Finish
Bathroom/Kitchen watertight
Interior Handrails Balconies/L ding 18 in. or more
Railing across window in staff ells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom fans
Plumbing fixtures
Foundation insulation
3/4 hour fire door/door closer j 0
Garage fireproofing
• Garage penetrations sealed 1 -- ��
Furnace in separate room protected(in garage) �—
Light ventilation per room
Safety glazing 18"or less from floor
Final Electrical
Site Plan/Variance required
Final Survey Plot Plan
As Built Septic System layout required
Okay to issue C/C(Certif. of Compliance)
Okay to issue temp. C/O(Certif. of Occupancy)
Okay to issue permanent C/O(Certif. of Occupancy)
FINAL INSPECTION REPORT
MOBILE / MODULAR Jr>
Town of Queensbury
Building & Code Enforcement
)V
742 Bay Road •
[:k , (�tr�
Queensbury, NY 12804 Jl �-
(518) 761-8256 , ���, 1
ARRIVE: °u,C�DEPART: "'1_c '`NS jCk 4,
DATE INSPECTION REQUEST RECEIVE I it 1t4'rt `�'7`sy
^ b
O
NAME: a- / ' Ott
r� 11 1 0a Ate,'
LOCATION:,,r I d�t '��► ��
DATE: 1V U. I, 11c H PERMIT/I 311,0-
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION _ BACKFILL_ FRAMING
N/A . YES NO
1. foundation support, pier spacing
per manuf. ._ ✓J
2. anchoring per manuf. — -
4
3. water line shut off \ — 4 -
4. sewer line support 4 feet — —
5. heating crossover (dplewide off grd.6. dryer vented outside .. —
7. skirting ventilated .. — ✓ —
8. hot water relief valve aping outsi.• — / _
9. deck, porches, step railing — V —
10. furnace/hot water perating
11. garage fire prop g ✓ — —
12. door closers — —
13. plumbing fix re 4
14. foundation ' sulation (if appl.) — i
15. smoke det tors —
‘/_.
16. final elec 'cal 17. variant required ._
if_
18. data plate okay —
19. mobile HUD seal okay — —
Model # ` • Serial # Et- q t 77&A '
Manufacturer E.t`-\\--)t t\r 7
Date of Manufacturer \b`Ik {9
OKAY TO ISSUE C/O YES NO
Comments•(D F .. - t cv�O L-A- t oft; tot 4 t:J - u Alae..
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§ I TOWN L,l d L Q L E 'i�C
1 y Y'ry U RY
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REVIEWED B
DATE - W . _ oc 7
I
NOTICE
ANCHORING OF MOBILE HOME
FRAME IS REQUIRED PER
MANUFACTURERS SPECIFICATIONS
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2:::) 0
TOWN 0: t.2G,L.,7,_BURt BUILDING DEPARTMENT
i::_i:;ed1 limited examination
,
on our,,,uiTed e, ,
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full
compliance with the code. b?
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