97-511 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
November 18 97
Date 19 _
;Poct ��
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This is to certify that work requested to be done as shown by Permit No. 9751
has been completed.
MOBILE HOME
•
This structure may be occupied as a
LOT 169 HOMESTEAD VILLAGE
Location
FLEMING. GARY/JOHNS, JACQUE
Owner
TAX MAP NO. 93. -2-11. 1 By Order Town Board
TOWN OF QUEE B Y
Director of Bldg. do Code Enforcement
BUILDING PERMIT
VALUE $ 32000 TOWN OF QUEENSBURY 97511
TAX MAP NO. 93. -2-11 . 1 No.
WARREN COUNTY, NEW YORK
FLEMING, GARY/JOHNS , JACQUE
PERMISSION is hereby granted to
LOT 169 HOMESTEAD VILLAGE
OWNER of property located at Street, Road or Ave.
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. +lEln5ddretibMESTEAD VILLAGE
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
GLENS FALLS MOBILE HOME INC .
33g3N 'mapp ABUSERS Address
GANSEVOORT, NY
4. ARCHITECTS Name
NEW YORK BOARD
5NEKEtrIficKS$tiI-fI?D OF FIRE UNDERWRITERS
6. TYPE of Construction—(Please indicate by X) MOBILE HOME
( 1 Wood Frame ( )Masonry ( )Steel ( 1 -
7. PLANS and Specifications
1152 SNoO. FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
MOBILE HOME
47 September 16 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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.)
16 September 97
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
' CFNED
TOWN WN OF Q ULENS J UJ °3 1997
•
TOWN OF QUE S8URY
REVIEWED. B UILDINGANDCODE
FEE PAID: $
PERMIT NO. 1— 1
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: PICI-V-4; coilAN) t` l
P.O. Address: Lt(`ZCat'ocp Phone Number —A 2 D
Property .Location L <3 Yt. a1C Tax Map No.923 / c / /i. /
NAME OF APPLICAN .� tq 1eVVl.l Y1) `- , �("f��l -66Z>
�r
Address of Applicant: r �s(�, fwy� f
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:
MOBILE HOME INFORMATION APPROXIMATE VALUE OF IIOM : $ .)-.
New Home
No 1 5) WCZONING INFORMATION:
Replacement Home Yes No ------ Size of Property: ft x ft
Size of mobile come 17ftx l6ft 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 �i Occupancy Information:
Primary dwelling: Yes No
Fireplace Woodstove Accessory Building(s) :
Foundation style and size: Detached garage (one car /two car car)
Attached garage (one car/two"tar car)
Piers-No. of Size ft x ft
Depth Storage building
Other
Depth below grade . ft
* * * * * * * * * * * * * * * * *
Foundation-Footing size " x
Proposed date of placement:
Wall material
Wall thickness " Height Water Supply: Well Municipal ✓�
Total depth below grade ft. Septic permit required? Al c)
Grade to home floor level ft.
FURTHER INFORMATION REQUESTED ON THE REVERSE SIDE OF THIS SHEET
NAME OF INSTALLER/MOBILE HOME DEALER: ildleJAA..-
.11/6-64P
ADDRESS/PHONE NUMBER C( / 1'fLL /jJ_A3 D'i / V X
•
•
STATE OF NEW YORK DIVISION OF HOUSING AND COMMUNITY RENEWAL
' 'INSIGNIA OF APPROVAL OF THEE� �'S�QTATE BUILDING CQEJE
1. Insignia' serial number Ne_ Go 1 �� 6elyoc �"�(�
u I ,
J
2. Name of Manufacturer
3. Plan Approval Number
4. Model or Component Designation
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 wiLh that 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.
Signature -1
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)
,-P.J/:J",(4ti)!la./'A��J.� 1J.<.:",��,Jd1a...pp,p_n.).,.11,� 1./::\.AA,,p,..4.,p,y.-l'J..IX..1,!s�('J_�psto_.._l'�..Ca�.)_.v...„0.1 71,,,,s.1.,l'x.1. e.C).._C .:CJ�.0,,Ce.i.:7d_C7.._l..,,.:s.:1s.".7.spy,,$.\�.l'J.�._la.Sl,.A��.C:
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THE NEW YORK BOARD OF FIRE UNDERWRITERS �'i�,c�-1', l r
BUREAU OF ELECTRICITY
111 WASHINGTON AVE., SUITE 704, ALBANY, NY 12210 ,g'�
-t• S l.''ITI.1'31iR :30, 1.`-�97 41:7.',a'WY..?1,i'9 1 T4, 1211339.7 r
' Date Application No.on file l6
! THIS CERTIFIES THAT ! '1 .L� 3'1r1. 3" . l.,l. IT
lac: only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of :r
t.k. :
•C• ,AW1 FI.J i2.1I G, 169 FIC IEEME 1t} �J:4.1.:3�?�GUG '.:ICil l'�13�aBUP , 1�4.'s'. Ir
.t_ in the following location; ❑ Basement ,{'`1� r
f q Cl❑ Ist Fl. ❑ 2nd Fl. Section Block Lot
• was examined on and found to be in compliance with the National Electrical Code. ,�!
• FIXTURE RECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ;is
�, OUTLETS INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
{ iY
IT
K' DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS it
�' AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. H.P. NO.OF FEET AMT. WATTS '
is
i'
is
it' SERVICE DISCONNECT NO.OF S E R V I C E '�
f' AMT. AMP, TYPE -METER 1�B'2W 1.B 3W 3 0 3W 3,@'AW NO.OPER�COND. OF CC.COND. NO.OF HI-LEG OF HI-L G NO.OF NEUTRALS OF NEUTRAL Y
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w IY
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�C' OTHER APPARATUS: ;I;
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:1'PNOFP- r) ;t4. C Pi° Tr 111-1 6Jr-
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1' GL,1,1'dS €'i;],l.,.. l.7CJB I.i.E rQ Y �f el• [ . . L e...>t. ,}
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�' •'c S; c�'Is f l •tii- .g..- . ,� GENERAL MANAGER y
s_' t11tF7I{.., +, Lt ...�;: :' ate.
:, - •I _ . SS Per
is 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�'7'fY Cr-f i�'/Y.Y f'i�'i Y7 f'fAi'i�Y'rAfY�C%Ai`i��'YA?'i�fY�f YAiYA\7Af l�C./AY'rA\"/4CYik?YAf•YAK''Ye.7"A(Y4kf'iA\-re Yee;/ACyAYYAYYif YAYYAYYe\-Ye Y'Cr .'(\'Y'<5°CY YY`C.Y`Cie`C'%Y'%YY YYYh'
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FINAL INSPECTION tgiiElFiIG] 1 tD GO
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 4e0
ARRIVE::00 DEPART: 11'16-- INSP: •
DATE INSPECTION REQUEST RECEIVED4
NAME: 0 N •i )
LOCATION: c * P • '•>A''
DATE: \V\----11 -o1 7 PERMIT# {7—S I
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A YES O
1. foundation support, pier spacing
•
• per manuf. _ —
2. anchoring per manuf. _ i/ _
3. water line shut,off
4. sewer line support ®4 feet
5. heating crossover (dblewide) off grd.
6. dryer vented outside
7.• skirting ventilated _ _ i _
8. hot water relief valve piping outs
9. deck, porches, steps, railing . ... _ —
,10. furnace/hot water operating .
11. garage fire proofing ✓ _ —
12. door closers _ . _/ _
13. plumbing fixture _ �//
14, foundation insulation (if ppl.) — —
15. smoke detectors /
16. final electrical
17. variance required
18. data plate okay ____ i _
19. mobile HUD seal okay
Model # Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
FINAL INI3FDEOTION Ii teraciPicr / ,
MOBILE / MODULAR ., 0
Town of Queensbury 1 T
Building & Code Enforcement 30
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: = DEPART:\'_%()INS'
DATE INSPECTION REQUEST RECEIVE,
NAME: ���► k L�
r
LOCATION:• / ..l ��r. .L_f 4) ./ ac
DATE: / , PERMIT# { 7- /
MOBILE HOME 1 MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING_
N/A YES NO
1. foundation support, pier spacing
per manuf. — �
2. anchoring per .• f.
3. water line shut,off • (/ d
4. sewer line support t 4 f•.-t ... ... (' / 06
5. heating crossover (dble a de) o grd. .
6. dryer vented outside ..
7.• skirting ventilated_ — '. .
8. hot water relief valy piping outsid ,
9. deck, porches, / . , railing —
10. furnace/hot water operating -
11. garage fire proofing
12. door closers 1/
13. plumbing fixture —
14. foundation insulation (if appl.) -
15. smoke detectors
16. final electrical `.i.-ate'Gt 7 — —
17. variance required
18. data plate okay — —
19. mobile HUD seal okay " — —
Model # \ Serial# Oc6t,;(sic,.qQ71
Manufacturer
Date of Manufacturer C`97
OKAY TO ISSUE C/O YES NO
Comments: � '�
ti
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 518-761-8201
October 15, 1996
All Mobile/Manufactured Housing Dealers
At a recent seminar regarding reference standards for the New
York State Uniform Building Code, it was pointed out by the
sponsors of that seminar that all mobile/manufactured housing must
be anchored to the ground upon which they are sited. This is
required by Section 1223 .2, Reference Standard 35-3..
Therefore from this day forward, any mobile homes which
require building permits through this office will be required to
provide anchoring before the issuance of a Certificate of
Occupancy. We're asking that the installation manual for these
mobile homes be available to the building inspector upon final
inspection, and anchoring be installed in accordance to the
requirement of themanufacturer.
Should you have any questions regarding this issue, please
don't hesitate to contact us . This Department will not be issuing
Certificates of Occupancy or temporary Certificates of Occupancy
until such time as the mobile home is anchored properly.
Your anticipated cooperation is greatly appreciated.
Sinc ly,
David Hatin, Director
Building and Code
DH/mg
"HOME OF NATURAL BEAUTY. ..A GOCO PLACE TO LIVE"
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Based on our limited examination.
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full
compliance with the code.
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BUILDING AND CODE