97-249 • CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 29 19 97
• This is to certify that work requested to be done as shown by Permit No. Cr7") ,:4
has been completed.
MOBILE HOME
This structure may be occupied as a
32 LAWTON RD.
Location
o„ner DU POUR, JUDY ANN
By Order Town Board
TAX MAP NO. 70. -2-14
TOWN OF QUEENSBURY
• V
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 Na
97249
TAX MAP NO. 70. -2-14 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to DU FOUR, JU-DY ANN
OWNER of property located at 9 LAWTON RD. Street, Road or Ave.
in the Town of Queensbury,To Construct or place a MMOBILE 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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
P . O. BOX 108
GLENS FALLS , NY 12801
2. CONTRACTOR or BUILDERS Name
DUFOUR, JUDY ANN
3. CONTRACTOR or BUILDERS Address
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( 1 Masonry ( )Steel
ffQBILE HOME
7. PLANS and Specifications
706°•SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
MOBILE HOME
$ 17 PERMIT FEE PAID —THIS PERMIT EXPIRES June 5 19 99
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 5 Day of June 19 97
SIGNED BY 3/1 for the Town of Queensbury
Building and ZoningInspector
nector
i
•
fra • TOWN OF Q ULENS I3 Utz X
REVIEWED BY:
FEE PAID: $ 0 0
PERMIT NO. q
APPLICATION FOR PERMIT
MOBILE HOME OR MODULAR
A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE HOME.
NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT HAS BEEN ISSUED.
The owner of this property is: aj
P.O. Address: /p : Phone Number 7c'3-7a&
Property Location 3) ./
��w� �.��e- Tax Map N o./0 /� / / (,
NAME OF APPLICANT:
Address of Applicant: a • •
All applicants spaces on this application MUST be cimpRreOGWRID
signature of the applicant MUST appear on the reverse side of tics application.
PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUI ' DING' COD NI: 1997
INN OF Q EEN 3URY
BUILDING AND CODE
MOBILE HOME INFORMATION �Da so
�
oh APPROXIMATE VALUE OF HOME: $ Pgi
New Home Yes ZONING INFORMATION:
Replacement Home No 97- )Kf
Size of Property: ; t x ft
Size of mobile home .5-Oftxi9 ft Existing Buildings:
,c2e2_,/,,,, 79 .'7_ ,Jy9
Singlewide i/Doublewide
No. of rooms (exclude baths) Proposed building-distance from property line:
y Front Yard ft Rear Yard ft.
No. bedrooms Side Yards ft and ft.
• Occupancy Information:No. of bathrooms /
Primary dwelling: Yes (o)
Fireplace Woodstove
Accessory Building(s) :
Foundation style and size: Detached garage (one car /two car car)
Attached garage (one car /two car car)
Piers-No. of Size ft x ft Storage building fie. /, , �--, - �ccs
Other
l""'"`
• Depth below grade ft
* * * * * * * * * * * *
Foundation-Footing size,cU ". x "
Proposed date of placement:
Wall material
Wall thickness € " Height . " Water Supply: Well Municipal
Total depth below grade ft. Septic permit required? )/O
Grade to home floor, level ft.
•
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
6=— -=i,
NAME OF INSTALLER/MOBILE HOME DEALER: p awt, t°z. 4ia--
ADDRESS/PHONE NUMBER
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE
. 1. Insignia serial number pi q7
2. Name of Manufacturer
3. Plan Approval Number •
4. Model or Component Designation �` I
le ••
5. Date of Manufacture
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 information.
Town of Queensbury State of New York
County' o:f Warre'n t
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 bq. done on the
described premises and that all provisions of the BUILDING 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.
Signature
Owner, owner' s agent, architect,
contractor
SPECIAL CONDITIONS OF PERMIT:
By
Code Enforcement Officer
DECLARATION: Please sign below after you have carefully read the statement.
To 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 that all provisions of the Building 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, contractor)
7.4"..1../....1".. .,"a!Ca9/:l_..1a,41S!;•..-...0 EI'J,,!C;I....9/:4�A>:9.1"7_.9,7,"A n.,In"..e'.4. ..0 ._l').AP-,10-,A.:.)-'...),..14-9A')_...'P,P-),.. ..l'X.A',In)..9l'J.k cll.,gn.J.,,kJ.e1V).. J_..c0.,t_C'S.,.l'J.",(:)YcC 4.:.) l ...k).1._L' el'
• 4r�'tfet].9.*t-,
THE NEW YORK BOARD OF FIRE UNDERWRITERS g'1 ''
�, BUREAU OF ELECTRICITY 0,1
' 111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210 y
il: Date Application No.on file y
�, THIS CERTIFIES THAT 7— Ir
-e only the electrical equipment as described below and introduced bytheapplicant named on tf e oboeA appl cation number in the premises of :r_
e4 PP PBP
1/4. 0!
UD'_Y l I.ti:AOI R, :.32 lAI?a.,Cl 3 AVE, {}iiEENSBE3Ii?a N.Y,
c in the following locatio{1n}• 77 yy.❑ Basement ❑ 1st Fl. ❑ 2nd Fl. ' Section Block Lot Y
A, was examined on and found to be in compliance with the National Electrical Code. ;T_
�; FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
. "ECEPTACLES SWITCHES r
�
�_ OUTLETS INCANDESCENT•FLUORESCENTS OTHER AMT. K.W. AMT. K.W. AMT, K.W. AMT. K.W. AMT. �
OA
�' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 'r
1 !Y
j' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS.En H.P. NO.OF FEET AA11. WATTS T
III N-
, SERVICE DISCONNECT NO.OF S E R. V -. . -I;, C, __ _..E -. --_ . . . -. - ,r
•�i MAT. AMP. TYPE METER L�,2W 7,el 3W 3 sr 3W NO.OF CC.COND. A.W.G, NO.OF HI-LEG A.W.G` NO.OF NEUTRALS A.W.G.
./' EOUIP. PER.B' OF CC.COND. OF HI-LEG OF NEUTRAL a
s: OTHER APPARATUS:
a-.
(f A t7' WIRE Y' S 7'S TO
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in t i,i:.�°i 1 s L;cr9'P C CO r-0 '}►s` 4 .PI L ;Y
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s� j. 53 i:�.J�� .LYE k.�1...7:Yn 4��)�q 1.G�.i 1C} •1;,a,,.L .-f. „1. '
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clij14 ': GENERAL MANAGER r
-t •w "� sue.i
r:(Jr R 1 LL
( T.
Per
:: 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. :
- - ---- -- -- -
'('i�1'iic:r.f'i�t iss lit:i4 74?"i�f)si'/At Y�Y'i4fY�i Y�6 i��'/w"iAi YAfYiiir)sf,/�Y'i�i:'i�Y,Yif Y.t�7ii'yiY.'�.fY.f)At'YLC.Y�Y'%eG7�YYAY Y�Y7(YYAYYAi'YiYYiYYAY,:70Y.Y�`7.Y�FY�Y,Y�Y.Y�Y.Y�Y`/of,%Y.YaY Ye,1'"
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST-NOT BE ALTERED-IN ANY MANNER.
3-c)
FINAL INi5PECTION II CII�If�!iGl1 Y.
MOBILE / MODULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE ad DEPART: /`�"INSP �
DATE INSPECTION REQUEST RECEIVED:
1
NAME: cover eU/e- 'I
LOCATION: '3'Z L j /�(X'
DATE: M Q 7 PERMIT#
L J
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION BACKFILL FRAMING
N/A YES NO
1. foundation su....rt, pier spacing
• per manu . .... — _
2. anchoring pe manu _
3. water line shu',off . r
4. sewer :.e su•y• C� 4 feet _
5. heating crossover blewide) off grd. ✓/ —
6. dryer vented outside
7._skirting ventilated
8. hot water relief valve piping outside — —
9. deck, porches, steps, railing — —
10. furnace/hot water operating _
11. garage fire proofing -
12. door closers
13. plumbing.fixture
14. foundation insulation (if appl.) _
15. smoke detectors _ . —
16. final electrical
17. variance required —
18. data plate okay — —
19. mobile HUD seal okay
Model # Serial# •
ManufacturerDate of Manufacturer
OKAY TO ISSUE C/O. [—YES NO
Comments:
INII PECTIONI REPORT
V.:.111SILE A IMODULAR
Town of Queensbury 0///
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(51j,31 761-8256 ARRIVE: DEPART:Vt iNSP: ,�(
DATE INSPECTION REQUEST RECEIVED:
NAME: (i tO Ci C
LOCATION: 7 4 'V"6
DATE: '6/1/ 5 PERMIT# %/'27/
MOBILE fkaoitaE M®I;ULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A YES NO
1. foundation support, pier spacin
per manuf.
2. anchoring per manuf.
3. water line shut,off •
4. sewer line support ®4 feet
5. heating crossover (dblewi ...off rd.
6. dryer vented outside
7.• skirting ventilated
8. hot water relief valve pipin outside _
9. deck, porches, steps, rail'
10. furnace/hot water operatin
11. garage fire proofing
12. door closers .
13. plumbing fixture
14. foundation insulation (if appl.)
15. smoke detectors
16. final electrical
17. variance required
18. data plate okay
19. mobile HUD seal okay
Model # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES . F ' NO
Comments: 410
1 �L�
•��� -ri lJ /`z ui gerb
FINAL INSPECTION tl=tiEllociaiitc-r
.10BILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 •
ARRIVE - DEPART:11 1INSPJP
DATE INSPECCTIION REQUEST RECEIVED:
NAME: DO O(4 /�
LOCATION: 4 'ra d / Eck
DATE: PERMIT# `1 7--)2 9
J
MOBILE HOME MODULAR HOME
FOOTINGS ' FOUNDATION _ BACKFILL_ FRAMING
y N/A YES NO
1. foundation support, pier spaci g i per manuf. 1 _
2. anchoring per manuf. \ _
3. water line shut,off 4. sewer line support @ 4\ t
5. heating crossover (dble grd. ,_ _ _
6. dryer vented outside
7.• skirting ventilated
8. hot water relief valve piping outside
9. deck, porches, steps, railing
10. furnace/hot water operating
11. garage fire proofing —
12. door closers f _
13. plumbing fixture iv- u_/
14. foundation insulation (if appl.)
15. smoke detectors //ss
16. final electrical 7 t??f(:1.1...4.✓.{.6 _ v
17. variance required _ _ _
18. data plate okay
19. mobile HUD seal okay _ —
Model # Serial# 0
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O. YES 1 NO
Co ents: /26jg-ip_ Q
�'tr5reL�
A,b- /24tc.5 � 'Y �5 ors
71 (/5
FINAL INESPECTIDN { ti poic im r 3 ,,6
MOBILE BILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
n
ARRIVE)- '4 EPART:7-''INSP: j
DATE INSPECTION`'REQUEST RECEIVED:
a
NAME: tit/ 'd lI R
LOCATION: . \'\ L4-t4.1 7-0 4(J
� t
DATE: 9 \4�1 • 7ERMIT#c17 — �11
.„
q!
MOBILE HOME 'A MODULAR HOME
FOOTINGS _ _�FOUNDATION 4.BACKFILL FRAMING
N/A YES NO
t' et. _
1. foundation support, pier s�lcmg /
per manuf. —
2. anchoring per manuf. Ti'�' — —
3. water line shut,off 1 _ '
4. sewer line support ®4ffeet'.., _ ___--- /
5. heating crossover (dble videoff grd. — /
6. dryer vented outside (1 !' — — �//
7.• skirting ventilated r — V/
8. hot water relief valy piping outside — V
9. deck, porches, steps{ railing �' — — ✓/
10. furnace/hot water operating \°' — ✓
11. garage fire proofs \, — —
12. door closers \�' — . — /
13. plumbing fixture/ _�/ — ✓
14, foundation insulation (if appl.) t,.. v/ —
15. smoke detectors ' _ —
16. final electrical/7
`� — —
17. variance required 4 _ —
18. data plate okay t` _ —
19. mobile HUD.seal okay \— — —
Model # I Serial # 'r
Manufacturer
Date of Manufacturer
r
OKAY TO ISSUE C/O YES .,, NO
• Commen :
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT „` •.
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: AREI—'' DEPART--
IN' TJ
REQUEST F INSPi ION RECEIVED: ♦lill �('(� �Y I�
l / / v4
NAME 1 0�1 �( �
� �k
LOCATION �c
a a ka� )-t-t';7is\
DATE PERMIT /
TYPE OF STRUCTURE: MOV: 1 UI Q_
RECHECK ,A,;' APPROVE
1 N/A YE NO
TINGS/PIERS &; I1
MONOLITHIC POUR FORM tg "
REINFORCEMENT IN PLACE#
THE CONTRACTOR IS RESPONSIBLE FhOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE—
MENT OF THE CONCRETE. ?; I „
MATERIALS FOR THIS PURPOSE O/SITE
1 FOUNDATION/WALLPOUR • �::•
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING r' 1;:
o
BACKFILL APPROVAL R' 1'
PLUMBING VENT/VENTS IN PLACE `$
ROUGH PLUMBING F�F
PLUMBING UNDER SLAB a Y•
FRAMING: •
JACK STUDS/HEADERS c. _
BRACING/BRIDGING b
JOIST HANGERS! �.
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER }`u
HEATING ROUGH—IN I
INSULATION: t
FOUNDATION WALLS INTERIOR R—
FOUNDATION WALLS EXTERIOR R— \' _
FLOORS I R—
WALLS F R—
CEILING R—
DUCT WORK OR{'PIPING IN �.V
UNHEATED SPACES R— �•
PPh
I
1y'
1 rt
•
•
•
C� -
(518) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARRIf (' DEPART INT
_ � r
REQUEST FQR�INSPE ION RECEIVED:
NAME �'�� � ,7 C )
C-�
LOCATI N a ^-�
DATE {� ll 1 PERMI A 1;77 ��
TYPE OF STRUCTURE: 11 f` `` �� ^
RECHECK TVt APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT PLA
THE CONTRACTOR IS RE. '• :LE FOR
PROVIDING PROTE TION F ,OM FREEZING
FOR 48 HOURS FOLLOWING :HE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPO•E ON SITE
FOUNDATION/WALLPOUR __
REINFORCEMENT IN PLACE
FOUNDATION/DAMPPROOFING _
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM _
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIOR R-
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
FINAL INEPEOTION REPORT
MILE / MODULAR /J•�
Town of Queensbury /`
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: fbri DEPART: INSP: ?ik
DATE INSPECTION REQUEST RECEIVED:
NAME: /v y cl.4J�
LOCATION: 7 4/.12
DATE: PERMIT#
Pal BILE 1II1OME MODULAR HOME
FOOTINGS FOUNDATION BACKFILL FRAMING
•
N/A YES NO
1. foundation support, pier acin
Pe
r manuf.
2. anchoring per manuf. ...... ... .. —_
3. water line shut,off
4. sewer line support a 4 feet ..
5. heating crossover (dblewide) grd.
6. dryer vented outside _
7. skirting ventilated
S. hot water relief valve piping outside
9. deck, porches, steps, railing
10. furnace/hot water operating
11. garage fire proofing
12. door closers
13. plumbing fixture
14. foundation insulation (if appl.)
15. smoke detectors
16. final electrical
17. variance required _
18. data plate okay
19. mobile HUD seal okay _
Model # Serial #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE CIO YES NO
Comments: / /�
�6
en
W z
o
= a n
W111" TOWN OF QUEENSBURY J a
o r4,..,
ad
ca
Bay at Haviland Road, Queensbury, NY 12804-9725-518-792-5832 W v o cn
TOWN OF QUEENSBURY BUILDING DEPT. ® o a w
PROPER METHOD FOR SUPPORTING A MOBILE HOME ' a
w
FC r
_ CD Q 4 U u.,.
• Z =
1C 4
SHOWN FOR USE WITH A SINGLE WIDE MOBILE HOME ONLY
FOR USE WITH'•A DOUBLE WIDE USE SAME METHOD UNDER EACH SIDE .,.
TRAILER BODY
TRAILER 1 UAW 1.1 TRAILER FRAME
WOOD BLOCKING
♦_, CEMENT BLOCKS
_OAiCK MAR I -_—
1\ FINISH GRADE III L_T - --•
giNt---
\ •
• I
-,, ..2*-------...„,,,....,
REINFORCEMENT ROD 6-6-10 WIRE MESH
re ' REINFORCEMENT ROD AND MESH AS PER CONDITIONS
SLAB TO RUN FULL LENGTH OF THE TRAILER AS SHOWN
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TOWN. OF Q • URY. • NOTICE
. • BUILDING � ` ! -:, gP g.e � �997 :bL
1,.-�ez;:�;3URY, .(• AND CODE . • MANUFACTURERS SPECIFICATIONS
DATE /AIM `