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97-528 CERTIFICATE OF COMPLIANCE • TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date October 1 19 97 7140 \ 97528 This is to certify that work requested to be done as shown by Permit No. has been completed. MOBILE' HOME • This structure may be used as a Location LOT 1TIMBER LANE Owner CHEM R, W:CLLIAiM By Order of Town Board fAX HAP O . 125 1 9 13 TOWN OF QU ENSBURY Director of Building & Code Enforcement BUILDING PERMIT VALUE $ 43000 TOWN OF QUEENSBURY No, 97528 TAX MAP NO. 125 . -1-29 . 13WARREN COUNTY, NEW YORK PERMISSION is hereby granted to CHENIER, WILLIAM LOT 1 TIMBER LANE Street,Road or Ave. OWNER of property located at 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 Town of Queensbury Building and Zoning Ordinance. 1. 9_,WFRT AlICTIVER LANE QUEENSBURY, NYNY 12804 2. CONTRACTOR or BUILDERS Name SHO MOBILE HOME BROKERS 3. SfiATTA iftBU�l1DERS Address SARATOGA SPRINGS ,I NY 12866 4. ARCHITECTS Name NEW YORK BOARD 5.IMPITFORA fit SRD OF FIRE UNDERWRITERS 6. TYPE of Construction—(Please indicate by X) MOBILE HOME ( I Wood Frame ( 1 Masonry ( )Steel 1 1 7. PLANS and Specifications 1104 Nsoq ft MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use MOBILE HOME 41 September 15 19 99 $ PERMIT FEE PAID -THIS PERMIT EXPIRES (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.) 15 September 19 97 Dated at the Town of Queensbury this Day of SIGNED BY 00(AieWa---tiAn for the Town of Queensbury Building and Zoning Inspector ECEIVE'P — 7°) SEP 10..1997 ®F QuE,'ea�aV l I►lb TOWN OF Q ULENS J3 UPI ul�ir�G .r4D ®r• REVIEWED BY: • Gj FEE PAID: PERMIT NO. 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 i s: frcif‘k i��i l l o • s- P.O. Address: = 1c aArc,t A1J . G �n,g Q..� Phone Number -5/ 8 l99 L Property Location Fori5 fy-L iixjaoc Lek A Tax Map No. / / NAME OF APPLICANT: �( `^s -' ' `,cad idtr- - Address of Applicant: . All applicants spaces on this application MUST be completed and the signature of the applicant MUST appear on the reverse. side of this application. PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES: • Rio MOBILE HOME INFORMATION 1 tG • APPROXIMATE VALUE OF HOME: $• _. New Home MO No ZONING INFORMATION: Replacement Home Ye• No Size of Property:p y: 60 ft x ) 00 ft Size of mobile home2 '1-J"ftx4-8..ft Existing Buildings:• Singlewide Doublewide No. of rooms Proposed building-distance from property line: (exclude baths) Front Yard . ft Rear Yard ft. No. bedrooms Side Yards ft and ft. No. of bathrooms — Occupancy Information: Primary dwelling: `alab No Fireplace 11.6 Woodstove fk..O 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 Other Mt— Depth below grade ft * * * * * * * * .* * * * Foundation-Footing size ". x• + Proposed date of placement: Wall material Wall thickness " Height17'6 " Water Supply: Well Municipal ` , Total depth below grade ft. Septic permit required? no Grade to home floor level ft. FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET NAME OF INSTALLER/MOBILE HOME DEALER: 1 ke ADDRESS/PHONE NUMBER aLt% RA- ArA ���?'r p''L jj , 1,T6tt STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL • INSIGNIA OF APPROVAL OF THE STATE BUILDING CODE 1. Insignia serial number QtaVLV-45-A i1 5 13 2. Name of Manufacturer \.a� ne1 (. Plan Approval Number . 4. Model or Component Designation tit‘L; r3-Y-8S S • 5. Date of Manufacture • All the above information is to be found on a plate or sticker which should be affixed to the Mob Ile Home. Complete above with tha t information. • 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 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. Si gna Lure Owner, owner' s agent, architect, contractor SPECIAL CONDITIONS OF PERMIT: By Code Enforcement Officer DECLARATION: Please sign below after you have carefidly 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 surve . • drawn to scale, showing actual location of project on premises. Signature: � __ri (o 'ner, owner's agen: arc ' ect, contractor) p NAL I PECTION REPORT MO1ilLE / MODULAR UC 1 ' Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:./VDEPART INSP: V �� DATE INSPECTION REQUEST RECEIVED: (� � � l ' 1 l l 1 NAME: -'--\�T\iC)V 1 l.�J 1 I t\an LOCATION:G' ?- 1 / --rilnhP4r 2_ DATE: J 0 — 1 —"17 PERMIT#9-/—yak I?�OISIILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A YES NO 1. foundation support, pier pac per manuf. 2. anchori\ _ _ _rt per manuf 3. water lines i ut,off 4. sewer line supo,•rt a 4 feet 5. heating crossove •blewide) off grd. . dryer vented ou ide ... ). skirting ventil��t'ed _ ____1_, hot water reli¢f valve piping outside 9. deck, porches, steps, railing 10. furnace/hot/(vater operating 11. garage fir/ proofing 12. door closers _ 13. plumbing fixture 14. foundation insulation (if appl.) _ — ,15. smoke detectors / 416. final electrical /.17/1 f(7 �C l5 _ •_/ 17. variance required 18. data plate okay 19. mobile HUD seal okay — Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. y� Main Office 357 Elwyn Terrace — Manheim,PA 17545 /MUNICIPAL CERTIFICATE c-r�ELECTRICAL APPROVAL S p� j Panel Board No. Cert. 5 2 6 2 7 Cut-in Card No... o Owner X r ' C G 4/( G2' Occupant Location T/ o1.f Installation Consisting of %Y/G)4/C— /�60i?C C/ZGI%c-c 'Gf/C/ Installed By. / e ' CO4J� / L Lie.# The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:— This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations, application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of mak" g in .ns at any time,and if its rules are vi ated,the Companyshall have the right to revo e ex- I .tea Date +�r7 INSPECTO Member N.F.P.A.,I.A.E.I. FINAL INSPECTION RePownr MOBILE / MODULAR Town of Queensbury "C: V CA1 Building &Code Enforcement 742 Bay Road s ► .30 Queensbury, NY 12804 (518) 761-8256 I ARRIVg,3Z3CPEPART&L)INS' i• DATE INSPECTION REQUEST RECEIVE • NAME: a 1n a _ _ LOCATION: 1 Tt I B U\ s F DATE: 131 '- — PERMIT# q-1"h5-22) MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation support, p -r s. s g per manuf. ... _ V 2. anchoring per manuf. ... _ _ 3. water line shut,off 4. sewer line support ®4 f-t 5. heating crossover (dble, de) off grd. 6. dryer vented • •g ventila dew � I 'U. -.� - ve i ing outside' 1- 9. deck, porches, steps, railin — 10. furnace/hot water operating 11. garage fire proofing _ 12. door closers • _ 13. plumbing fixture 14, foundation insulation (if appl.) _ 15. smoke detectors 1 t tncar 17. variance required 18. data plate okay 19. mobile HUD seal okay — �C Model #<%- 3S • Serial#FL2412zAvtl3SiZ j —5Ke3 Manufacturer FLEFTf CO k'lc \F 5 Date of Manufacturer a-1 1 ` t OKAY TO ISSUE C/O YES NO Comments: VELIEE 'iNLve_ ?RI , &L Tb t3E Fill:6E T FS/0 A Ott F 1,10 J0) 1 Q,. • u \ R.Ast<. 5 a ‘X- 9° FINAL INSPECTION I=et_Piam MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 4111/40 ARRIVE: EPART: DATE INSPECTION REQUEST RECEIVE►: NAME: C\A Ar-.WiNtA LOCATION: lr C C - DATE: a —11 PERMIT# SZQ j MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A YES NO 1. foundation support, pier sp. ing Pe r manuf. — — 2. anchoring per manu`. — — 3. water line shut,off ... —4. sewer line support @ • --t — — 5. heating crossover (di ewide) off grd. _ — 6. dryer vented outsi' 7.• skirting ventilated 1 ___St.\ ' - -8. hot water relief valve 'ping outside _ • l 9. deck, porches, steps, g — V 10. furnace/hot water operating V 11. garage fire proofing Yf — — 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 # c3 �_!7 • Serial#Pi\av7,.zAGgJ: z- �ki3. Manufacturer FL Tc l X ) Date of Manufacturer 9—I 1-97 OKAY TO ISSUE C/O YES NO Comments: li,1,1E,IED k--11\:t3P \Z.! riZNI r �� FLEE7VtIcOD® Stone Creek Series H, 0 • M E • S Model 3483E it I a' , y o� ae • -,F.',, o J. d IL t o b a •1 a try% g,, i 4_,.0 o' -. 6 .@ o.�%j , a 'A 1 /' o k _�,.� p per.. �: - ,� Y 9� '' ' 1 .' ,, . :.:4-,-"..,1r77-113----,•- . ..1_ , , ,.. _ "'se.Cet 61% 0. 4. , - , ' ' s^'`r �a•S Li ��i AJL El c1L _ Ira - -- ^ r_i®p® milif „Iit --,,--. jpEEE .-_i_.....,..... #d Pd e p a9 3 Bedrooms •• 2 Baths •• 1 , 119 Square Feet - -c, °mob 0.4 O U 8 `gyp 1 . 0 o FLEETWOOD , Stone Creek Series H o M E S Model 3483S 3 Bedrooms • 2 Baths • 1 119 Square Feet ''--. .,'!-:1VED SEP 1 0.1997 TOWN OF OUEENSBURY 1 BUILDING AND CODE • ` A OPT.CHEN"+ o1 pr. ' 1-.111-H1 _ 0,311 *.'"•••OPT. \ --1—"Fr ri- 0,,Tp 1_11_1 —.7*n PHONE JACK dm FIREPLACE II NM IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII I I Z I 1 1 2 i I I i r I I i t, \ \ ' IN 111111111111111111111111111 IIIIIITh !UTILITY, t 1 I L_•tt • [ . ta t MI • Ell IIIIIIIIIINNIIIIIIIIIII IMO 1111111111111111111111 11111111M1111111111111111 MIMI ,___•<---1.- BEDROOM#2 0 IZI I UNIALIMMEMOR NEN .................Eur N.PIN IN I IMIIIUIIIIIIIIIIIIIIIIIIIIIIIW . 0 _..74......—til— 6-9"x 11'-2" EN I" IIIIIIIIIIIIIIINNIIIIIIIIIP i .Q.J.L1 up,I, 7 C mom Nu ARE.mommumms, 14 IL", I .. ., _ Entili um ansimunimmor kr) minumn sinimmimmirnininar ni-iiii--. ,11.,?,•.•-i.opr.--DININ ! ! WALK-1N 11 EASEMENT 23 4 1 WALK-1N— I+ t •1.-,.-El5:1-E,REC.' R=A ! . N CLOOE illa GREAT ROOM —I: • a Fri CLOSET— oh-7h . .- " ENTRY IMP 100 iy D9 "<-OPT. • opr.-C------4 MASTER 7-1/JACK BEDROOM 134"X 9,9" • , . M. OPTIONAL BASEMENT ENTRANCE 0 BATH \ MASTER BEDROOM#3 ! BEDROOM 10-4"x 11"-0" / 134"X1V-2" OPT.GARDEN TLID ,- OPT PHONE JACK V • * )1 ..1 =• • ENTRANCE- • 4) . V.'". 7,,g 7 7',)'`...,•:. • . li ,'-'r,'%1 i.. r,,,r; o-r •: " C,72° Ci., r, ,--. ,,,,,I.i..-;t1,,,;,,,,,a•:..,. u , ... pi i.,,,.. r.,,: ,,,,:r: ,,r,. ,.A.,..„ fc, ., „, . . • t,„.L....:L. — Irv) Fr, Vi I, v.o;t.,y..9 .1,-,, .,_,.-,...,,r..,, I—• F ,..__,,,.. li-,..: , • • L *Exterior rendering shown with optional shutters:11:7-1-1--Y ----------' — STANDARD LIVING FEATURES Exterior Kitchen • 4'/�' vinyl lap siding with lifetime - 100% nylon to prevent fuzzing • Magic Chef appliances give you Twarranty stands up to the worst of and shedding name brand confidence and 1his smaller home packs a weather hassle-free service - Multi-colored dye technique • 22 yr. composition shingle roof for minimizes tracking and spotting - Includes: 30" free standing range punch with its versatile living lasting maintenance-free • %" rebond step carpet pad for and a 15 cu. ft. frost-free performance better cushioning and longer life for refrigerator space. With a large great room • 10"front and rear vented eaves for your carpet • 30" Broan power range hood rain protection and greater air flow • Brass door knobs to endure the • Laminate countertop for easy care in roof cavity acid dining aria,°the possibilities ' use and time plastic knobs can't and endurance • 2" x 6" (16" o.c.) exterior wall • Designer color coordinated drapes • 71/2" stainless steel sink and are endless. Cathedral sprayed frameruction provides a sturdy and valances to enhance your gooseneck faucet for larger decor cookware accessibility • Transverse floors with 2" x 6" •,,ceilings create:a light, open (16" o.c.)floor joists for better Glass light fixtures in walk-in • Bank of 4 drawers for your storage support closets for a better view of your needs clothing, shoes and other storage environment;for all°kinds of No-wax vinyl flooringfor easy • •Front and rear porch lights for your needs maintenance safety • Linoleumfloor at front door to gatherings. An overhead cabinet • Adjustable center shelves and • White finish windows with storms handle wear and tear from feet as white lined overhead cabinets give and grids to add architectural well as the weather versatility and added value to and bar make entertaining a dimension • Decorative white panel box cover storage space • 30 lb. roof load to handle the complements decor • Overhead refrigerator shelf breeze. : winter weather • Hardwood countertop edging adds provides added storage • Removable hitches for better richness and quality to cabinetry Utility, Safetyand ! home appearance • Mini-blinds throughout the home for _ • Heavy duty steel I-beam to privacy and safety Energy Features With versatility this a ordable, stabilize home in transport and Baths ff set-up • Smoke detectors and built-in interior electrical panel box for your you can relax in comfort and Interior • 54" tub with shower head and vinyl safety surround for added protection • Acoustical vaulted ceilings against water damage • Shut-off valves at all plumbing host special gatherings in your throughout, for a more open and fixtures for your convenience airy feeling • Laminate countertops for easy care and endurance • 100 AMP electrical panel box own home. • Sprayed ceiling for a more ga• llon allon electric water heater residential stately appearance Bath mirror with tulip-type lights • add a decorative accent provides more hot water • Decorative vinyl gypsum wall • Laminate shelf over master bath • Zone Ill insulation to meet the panels are easy to clean sink for additional space needs of the climate where you live • Picture frame cabinet doors with • Water saver porcelain toilets and - Zone Ill includes: white self brass finish pulls add elegance tanks save you money on water storing storm windows with grids • Glass ceiling fixtures throughout bills and R-22-19-14 insulation illuminate more than acrylic lights Note: The higher the R-value number, •do Broanexhaust fan for better air the better the resistance and circulation effectiveness of the material. • Ventilatedvinyl coated wire shelving won'tcollect. dust • Plastic shower curtain with shower/tub combinations to help • 18 oz. sculptured carpet in all living prevent water from splashing out areas for high performance 1_ _ _PILQ N A LL I V I NG FEATURES' A TtI R E5�____.__.... • • • Half moon window front door and nine-lite rear • Single lever faucets for greater ease and • 40 gallon electric water heater provides more door with deadbolt, viewer and knocker along operation hot water with full view storm door for your family's safety • Ceiling fan provides air circulation for a spring • Laminated backsplash in kitchen sink area to breeze feeling all year long protect wall from water • Dishwasher and garbage disposal for easy kitchen clean-up • Dual glazed thermal windows for increased • Vinyl sliding glass door in selected areas to efficiency brighten your home with sunshine • Skylight for added natural light • Phone, cable, and electric receptacles • 40 lb. roof load for those areas where winter • Beautiful 5-arm dining room chandelier adds available to save you time and hassle can be intense elegance to your formal entertaining • Roof dormer available to supplement a more • Brass lever door handles for easy grip • Deluxe 25 oz. carpet selections for increased residential look performance and selection • Box bay window in the living area for exterior • Upgraded exterior porch light for your safety eye appeal (dormer required) • Refrigerator and range upgrades to meet your culinary needs • Exterior water faucet to refresh landscape or • Woodgrain 6-panel interior doors for a more rinse off vehicle residential look • Rock and wood fireplace selections to add warmth to your home • Vinyl shutters to accent the windows • 200 AMP service for your special electrical needs • All electric home -to meet the needs of your • Decorative chair rails in the living area adds community and the environment flair to your home • • FLEETlNG17D. FLEETIl1/00D® ONE YEAR® Note that square footage is measured from exterior wall to exterior wall,and is an approximate figure.Length indicated in H O M E S • • floorplansis floor length only.Renderings and diagrams are meant to be representative and,in keeping with Fleetwood's FLEETWOOD HOMES of PENNSYLVANIA, INC. policy of constant updating and improvement,may vary from the actual home.All dimensions are nominal.Ask,your retailer for specifics.(Add four feet to arrive at transportable length.) a subsidiary of Fleetwood Enterprises,Inc. PRICES AND SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE OR OBLIGATION. 48 Industrial Road,P.O.Box 530 Elizabethtown,Pennsylvania 17022 LIMITED WARRANTY � ©1996 (717)367-8222(800)366-8221 SC/22/JUN97 m w r '�! 1. 31 m W 1111111 S7 ys. `i3 Yt 34 SZ 3.f -,I cn o`V00 - G:iW UI 47 .T'� t 3 el- W Oa d. 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