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98-744 c"%ERTIFICATE OF OCCIMAN CY TOWN OF QUEENSSURY WARREN COUNTY, NEW YORK December 30 98 Date 19 . r 98744 This is to certify that work requested to be done as shaven by Permit No* i has been completed. MOBILE HOME 17ais structure may be occupied as a LOT 109 NC3MESTEAD VILLAGE Location VALUED MOBILE H014£ BROKERAGE Clwrr�er TAX MAP NO . 9 3 . - 2 - 1 1 . 1 By Order Town Board To'ww OF QUEE14SOURY Director of Bldg. do Cade Enforcement BUILDING PERMIT VALUE $ 15e0jTOWN OF QUEEN5BURY No. JL � TAX MAP NO . 93 . — 2 - 11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Street, Road or Ave. OWNER of property located at In the Town of Oueensburl To Construct or place a 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 iQueensbury Building end Zoning Ordinance. Mill IIIIIIII I. OtNNER'S Address is 4294 ROUTE 5 CALEDONIA . NY 14423 2. CONTRACTOR or Iltll LDE R S Name VALUED MOBILE HOMES 3. CONTRACTOR or SUILOER'S Address 36 ,SACKSON RD EXT sow GLENS FALLS , NY 12803 4. ARCHITECT'S Name ATLANTIC INLAND s. ARCRD BOX S2 60 GREENWICH , NY 12834 6. TYPE of conseruction — IPtaase indicate by xi MOBILE HOME l I Wood Frame t l Masonry I I Steel I I T. PLANS and Sp�lcmi g524*.Sg FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS B. ProWNW use MOBILE HOME 35 December 9lfl 2000 S PERMIT FEE PAID -- THIS pER MIT EXPIRES (it a kvnitee period Is racwl► w an appiicalion for an extension wouet be +made to the Building and Zoning irrtpaetor of the sow++ of Civaemtwry before the expiration date.k 9 Day of December 1998 Dated at ttw Town of GuftaLburiv this t9 for the Town of Queensbury SIGNED BY 8uitdirMl rtd nirq trgkracter ti 'i WOWN CAI { QUE NSBURY 1r7� REVIEWED BY : FEE PAID : $ d:3 PERMIT NO . APPLICATION FOR PERMIT MOBILE IIUME OR MODULAR A BUILDING PERMIT MUST BE OBTAINED BEFORE PLACEMENT OF MOBILE #TOME . NO INSPECTIONS WILL BE MADE UNTIL A VALID BUILDING PERMIT 11AS BEEN ISSUED . The owner of this property is : a!! A w ecaez P . O . Address : J (� 'Ci Phone umbe rr ''� Property Location /�' ` / max Map No . ` [ >/ / Ile NAME OF APPLICANT : / Address of Ilppl icant : , u •�S r '� �'�� ?r /� S;�' 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 110ME INFORMATION �. APPROX I MACE VALUE OF IIUME : New #tome Yes No ONING INFORMATION : Replacement #come Yes o t �� size of Property : Jft x ft Size of mobile name ftx ft Existing Buildings : Singlewide 7X_ Doublewide --- Proposed building-distance from property line . No . of rooms ( exclude baths ) M:5 Front Yard _ /' ft Rear Yard ft . Side Yards ft and r� ft . No . bedrooms Occupancy Informatio No . of bathrooms I Primary dwelling : YC�g No Fireplace �Woodstove r� AcreSsory Try Foundation style and size : De tailtsecl ,gars _ _wee car / two car car ) y Attached gar a ( one car '/ two car car ) Storage bwflding Piers--No . of Size ft x ft Other Depth below grade ft 4eo � Foundation- Footing size of x " Proposed date of placement : eAP Wall material . . �►� _� Wall thickness 4 " #leightir7e 11 Water Supply . We] I Muiiicipa1 Total depth below grade p ft , Septic permit required ? IV6 Grade to home floor. Tevel ft . FURT11ER INFORMATION REQUESTED ON T11E REVERSE SIDE OF T11IS S11EET NAME OF INSTALLER/MOBILE 110ME DEALER : , 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 � ;z �(]_ 3 2 . Name of Manufacturer 3 . Plan Approval Number 4 . Model or Component Designation 5 . Date of Manufacture r , st All the above information is toj "be- found on a plate or sticker which should be affixed to the Mobile Ilome , Complete above with 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 bg 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 , anti that such work is authorized by the owner . ------------- Signature ► Q Owner , owner ' s agent , architect , contractor- SPECIAL CONDITIONS OF PERMIT : . By To�de 'Enforcenwent Officer DECLARA770N.- Please sig�t below after you leave carefully read the staterrrent. 1'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 that all previsions of the Building Code, the Zoning Ordinance and all other laws pertaining to the proposed work shall be complied with , whether specified or rioted, and that such work is authorized by the owner. Further, it is understood that 1/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, 7 Signature: (owner, owner's agent, architect, contractor) down of Queensburll 9ulwing M' Code EntOMOmeM ay Ftoad Queensb uw'YI N 28+04 (518) 7601.825 DEPART, gECE.IVED: DATE 1NSPECnoN REQU D+ti� A I..DCATtON' G �' pgri.� viol" � VpAMING -- Focn'r�rs � �,ourmr+Tiox � '`�' .` -- - NlA yvS NO 1, lcavnslat'c�n supper, per si?R .. . per rnauuf. .... __- Pr nuanuf. �. axticlnor'ng .• . . . . . •. . ____ 3 water line shut,off . ... .. . su A a 4 few a. Is fiver oblevwide) _ outside 7. skirting `ten valve piping g, hot water relief 9. deck, Pdrelles' steps, _ - 10. furnace!'tloot "Hater opem . . file proo It 1. S�aP . .. . •. . . . • • .'� closers •• —� 1x. doo! . .. _-- 13. plumbing l.). .•... Lion ['f •. .�r�.�/c, J �--- ___- smal e .. . . . . +H al electni —� 17. ce required 18. data p'iftte okay 19. mile RUB seal okay . . . .. Serial # Mrxlel # Manufeaurer Late of lylatuufacttiu'er No OK TO lssTm Cf0 YES Covarpents: f I �� ��wG U S tiN BP awricarA *4t P+a -f if fr"1pp1L.E M�a�LAR Town dt C)UeenabUN 8ulkiin9 Gaie Eni'orcemer►t Clue +'sr°'�"y Nyj�a (518) 761.8256 r)EPART: "Te iNSPBcrn0N REQ.UF'.L' gECELVL'L]= - V oErMA l PBRMTT �i ^6� DATA: , /" HQ,.�►.R Hp1iR� ._------ WGS ,O,N,pATION � _ NIA YES NO pies —` 1. fvur�t"Qr' ._. .. . • ' " .�--- ._--- per rnasnuf. 2. anchoring Per' of . .. . water lice shut'o . . .. ... _- ,ewer lisle SXM?Port ) off Vd" --- heating erossover ( „ ... . .. ,. . . -- �— 6. clrYes " .. .. ... .. outside 7 s�ry re efv Ve10 �- g, hot 9. furnace lhot water I'L. garage fire & ' w*.. : . . . . . . . .. .. . --- cle�rs .. . `~ 12. l�iurthsn8 fixes ., ... .. ... .. � �-- I3. p tsars (if appx•). . . .. . _ - 1 Rios+ iesi'ls toss —� 1 smoke . . .. . .. ... . . .. . . fia n eatri . .... . .. .. ... 18. okay �- 1.9. mobile HUD seal akaY . Serial is __�------__"'_.--- Mocfel # M Date of Maxsixfa'ct►uer NO pKAY TO ISSUE C/O "_`- Co��ts: RI'IVA►Iw IIVSPaCiTic3ra irtFc7 MOBILE / MC3C3ULw^R Town of Quee"sbury Building & Code Enforcement 742 Bay Road ©ueensbury, NY 12804 (518) 761-8256 ARRIVE /DEPART: [:AMP: DATE INSPECnC)N Rj.EQUEST RECEIVED: NAME: } � VIee . LOCATION: f�`j.^ ' `�"'�'�M"7 DATE: r 9£� PERMIT �+ '_l .= f'"— HOBSLE HO [8 !i[OD>SJL t�A H01l�L F[]Cn1NGS ATION EA FRAMING N/A YES NO 1, foundati Pie' spasc per 2. anchorit►$ p� uf. 3 water line sh ,off -- e¢ sewer lines a rt a 4 feet "5. heating c er (dblewide) off $rd, — -- 6, dryer vented tsids ` 7. skirting vM .. .. ..... .. ..tautside S. hot water re valve piping 9. deck, porebes, steps, railing . .. ..,., -- .10. furnacelhot water operating _11. garage fire proofing ... .. .. .. ... . . .. .. -- 12. door closers 14: plumbing fixture foundation insulation (if appl•}. ., ., . 1yfinasmlce detectors -- l electrical 17, variance required . ... .. .... ... . . . 18. data plate okay ..... ., .. 19. ,mobile HUD seal okay . .. .. .. . . . .. .. Model # nal # lMlanufacturer pate of Manufacturer OKAY TO ISSUE ClE7 YES NO Comnnents: ajr� AA f` Y COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. Main Office 357 Elwyn Terrace — Manheim, PA 17545 14 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Panel Board No. ........ ... . .. ... Cert. �q59837 Cut-in Card No. .. ......,..,,.. . . . . . . .... Owner .._..._ ....C:. r1f .....�3�! c!u r� . ......................... . .. . . .. ...... ..... ........... .... .. .. t Oeeupant .....................r„r, r,r .)..//................., .. .. .... ............................ . .. . . ... . .... Location Xv.� ��'?,,. r� '..`.".�'.' L"�. / • . ... � .' Installation Consisting of ../ G. !' .. .... ' ' G Q C 4`.....:... ............................. .... .. .. iL/C y/ ............ .... . . . ........... ........ ...... installedBy ... f3 ......... ... . ... .. . .... ... ............ Lic_ *.. .................. .,., .,, . . .. . . ... . 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 or 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 r kip ins tons t any time, and if its rules are violated, the Comppany sh i have the right to revokeIn eru �" Date .�...�.........�.....�..........< INSPECTOR;". ....... ... ..... Member N,F.P.A., i if=IIVAL 1lVSPECTIO<hI REP�iE=sue' ""' " MOBILE / M==UL^R Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART '" ANSP: DATE INSPECTION REQUEST RECEIVED: NAME: U6 C C LOCATION: Lerr los LW j DATE: PERMIT o ' 7 MOBILE HOME ENLYLAR HOME FOOTINGS FOUNDATION RACN.F L; FRAAUNG NIA YES /r NO 1 , foundation support, pier spacing per numuf. — 2. anchoring per . .. ... . . 3. water line shut off 4. sewer line rt (� t . . ... J — 5. heatin c er (dbiewide) off grd. 6. dryer outside ....... .. .. .. .. .. .. ..4 — _ 7. skirting ventilated . .. .. .. . . . .. .» ». .. .. S. hot water relief valve piping outside _ — 9. deck, porches, steps, railing . .. .. .. . — — 11. garage furnace/hot water operating .. .. � = 11. garage fire proofing . .. .I 'll ». .. .. .. f — 12. door closers . .. .. .. . . ... .. .. .. . . .. . . . . . 13. plumbing fixture . ..... . . .. .... .. . .... . v/ — 14. foundation insulation (if - 15. smoke detectors .. .. .. .. ..... .. .. .. .. .. / 16, final electrical 17. variance required ..... .. .. .. I . . . . .. .. . _ I$* daft plate dray .. .. .. . .. .. .. .. .. .. .... 19. mobile I-LUI! seal okay . .. .. .. .. .. .. .j Model # ��— Serial # CID I.S Q 7., Manufacturer P)b Date of Manufacturer OKAY To LSS[TE CIO YES NO Comments: dmC, d`s I u �IIVAL IIVBiRf�f1 TIG11V �[I�r�+caFt Y' M088111 W ! MOC3UL^ FI Town of Queensbury Building & Cade Enforcement 742 Bay Road Queensbury, NY 12804 (518) 7614MW e , ARRIVE: DEPART: L��TSP DATE INSPECTION REQUEST RECEIV ! c NAME: It L OCATIOM t DATE: r �Z _ y PERMIT # MOBILE HOME MODRJLAA HOME f300TngGS _ FOUNDATION _ BACKFHL _ FRAMING NIA YES NO 1 . foundation support, pier spec. per rnanuf. ..... .. .. .. . .. .. . .. .. . . — 2, anchoring per uf.. . .. .. ... .. .. . 3, water line shut _- 4. sewer line support 4 t . .. . ... — — S6 heating crossover ( de) Off — — — G. dryer vented outside . .. _ 7. skirting ventilated 8. hot water relief valve 'ping outside — — 9, deck, porches, steps, railing , ., ., ., . 10. fuil]acell7ot water ring .. . . .. , . _ — 11. garage fire pmofin . ... .. .. .. .. . . ... . 12, door closers .. .. .. — 13, plumbing fixture ... .. .. .. ....4 .. .. .. .. 14, foundation msu 'on (if appl.).. . ... — 15. smoke detectors .. 16. final electrical .. .. ... .. ... .. .. . .. . . .. 17. variance required . . .. .. .... ... . . .. .. .. — — 18o data plate okay 14. mobile HUD seat wok/ay . . . .. .4 .. . . ... — — — Model # �T� _`t Serial # I) Z:22 �J Iq Manufacturer LAC) 'l'' \ n l CAa .,"J3 Date of Manufacturer JS l i OKAY TO ISSUE C/O YES 'NO Comments: 'Z. , N �5 /✓c- t= o �� ALPINE AVE FMOM e. 36 FT .. 36 FT � eoar►-- TOWN OF Q E ENS$URY �I BUILDING & 0 PTO a � REVIEWED BY DATE I 4 TOWN OF QUEENSBLRY SUILOI aG I)IEP Based an afar knited exammauorcOmPionce not AR� ENT tru d as cornmefu sho be Pans and Spedricatim a the rug camPiiarice with the Vie. r� NOTICE ANCHORING OF MOBILE HOME FRAME IS REQUIRED PER MANUFACTURERS SPECIFICATIONS