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2006-555 TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20060555 Date Issued: Wednesday, August 22, 2007 This is to certify that work requested to be done as shown by Permit Number P20060555 has been completed. Location: 200 LUZERNE Rd Tax Map Number. 523400-309-009-0002-001-000-0000 Owner. HOMESTEAD VILLAGE L P Applicant: HOMESTEAD VILLAGE L P This structure may be oc14010NsPASCO Mobile Home In Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Co•e Enfoement Planning Board or Zoning Board of Appeals. 016` TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20060555 Application Number. A20060555 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: LARRY PASCO HOMESTEAD VILLAGE L P For property located at: 200 LUZERNE Rd in the Town of Queensbury,to construct or place at the above location in accordance with 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. Type of Construction Value Owner Address: HOMESTEAD VILLAGE L P 4294 ROUTE 5 Mobile Home In Park $2,000.00 CALEDONIA, NY 14423 Total Value $2,000.00 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2006-555 980 SQ FT MOBILE HOME/ EXISTING SEPTIC TO BE PLACED AT 115 ADIRONDACK ST $33.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday, August 21, 2007 (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.) Dated at the Town Que bury ,Mond.y,August 21, 2006 SIGNED BY4 / - for the Town of Queensbury. Director of Building&Co.e Enf. ement /' r' _ p OFFICE USE ONLY , TAX MAP NO. ti� PERMIT NO. 06•— J,) DATE ISSUED: i e • PERMI• crf E3 APPROVALS: ZONING TOWN CLERK ; r MOBILE HOME -APPLICATION FOR PERMIT: A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Property Owner Information Name: Z-•,1tiY i"y OvP Lr. G d Name: / fIr Ca Address: /.7-- 3 Ni i r0,,,(4.c1 lA r/ Address: L/ 2 , LJ /-41//47(0, /edt,m ti (:::::?L r e f- 5.. Az., t" y Lir-/C./,/2? e:41 66 �i 11 e 1.1 C1 C;'l ) C^' /27 V ! 11,; fici Phone No. 1--- --e-------1-71- 32 ' 2,//3 Phone No. 'j � 2-2.- 6 3 2 6 0 Parcel Information �� // 4c 49 /17 - f Proposed Date of Placement: Property Location: � d'/ ra'. `y 4- /L CY-- Road,Street,Avenue Name of Mobile Home Park: \--\OmF c J c VI Li FY F. (if applicable) Tax Map Number: an .G-a- 1 Mobile Home Information Zoning Information Approximate Value of Home: $ Zoning Classification: New Home: Yes No Size of Property: ft. by ft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: I'- ft. by - b ft. Setbacks: front yard ft. rear yard ft. side yards_ ft.and ft. Singlewide: X Doublewide: Number of Rooms: (exclude baths) il Accessory Building(s): circle Number of Bedrooms: ? Number of Bathrooms:J Detached garage: 1-car 2-car car Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: Storage building: Yes ` No ) Type Size & Depth Other: Piers Runners Water Supply: well or municipal Slab Is Septic Permit Required? Yes or No Continued on back Town of QueensIrury• Community Development Office • 742 Bay Road, Queensoury, iv r 1LOU'1 s� l ark) / „ J Name of Installer or Mobile Home Dealer: L_.5 IL 1` I'k ', .c noRe I f o yv'�, `re-`' /ice., Address:cri- 11i4 ,J.-r / 4 �f7 ple,�,,-1O, Phone: 7 6 Z 2- //y / I 1 J ?). cl Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: / Insignia serial number: n1 ' (-)cis-? `151 y l-\Ufl (S—l7 c )4'4 ✓ Name of manufacturer: Rh\/A1'Tlm hi ✓ Plan Approval Number: ✓ Model or Component Designation: (New home only) ✓ Date of Manufacture: G/5?/7(v Y.lt!'w•L_L_._._��..................�._._�.:_...._._._.�f f::_«._....._..�..•L_.S._iL1:..•L]i_•...._._..._._....._w._..._.::r r. AFFIDAVIT V Y Town of Queensbury State of New York County of Warren c J rJ x I swear that to the best of my knowledge and belief the5.4 ▪ statements contained in this application, together with the plans 5 and specifications submitted, are a true and complete statement ii of all proposed work to be done on the described premises and il that all provisions of the BUILDING CODE, the ZONING J ▪ ORDINANCE, and all other laws pertaining to the proposed work c shall be complied with, whether specified or n t, and that such s z work is authorized by the owner. y 7 y Signature: ,,>� l.�Y r 0 er,Ov ref er's Agent,Architect, Contractor J J J .� J J .r.a.r.J.l.r.J..rJ.�.�.1.r..sus.r.li.r.f.t.�.s.�.1..s.�.�.�.i.Xi..'.��.1.1✓.�.�.�..tir.�.�.J.�.�.�.i.�.�.xr.a.i.r.r.r.�.�.�.i.s.1.'i SPECIAL CONDITIONS OF PERMIT I By: ode Enforce `-nt Officer j rwk Town of Queenshury• Community Development fce • 742 Bay Road,/Queensbury, NY 12804 I eCf) (/Z /07 FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: aid LOCATION: AI, A . DATE: 0 10 PERMIT # 11/4 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A , 'YES NO 1. foundation support, pier spacing permanuf. 2. anchoring per manuf. 3. water line shut off 4. sewer line support 4 feet 5. heating crossover (dblewide) 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 appi.) 15. smoke detectors — 16. final electrical — — 17. variance required — — 18. data plate okay — 19. mobile HUD seal okay — — Model 11 Serial # Manufacturer Date of Manufacturer OKAY TO I SUE C/O YES NO Comments: 801)0 (. 6/(70) 4 ( 0-7 m1/49 FINAL INSPECTION REPORT MOBILE / MODULAR r��� Town of Queensbury V1/ Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 f ) ARRIVE: DEPART: • INSP: DATE INSPECTION REQUEST RECEIVED: NAME: W(i /Vy � LOCATIONN:: 115— 1-4-1-)K {�1_ DATE: V Z Z I PERMIT# L/Ki 11 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A . YES NO 1. foundation support, pier spacing per manuf. 2. anchoring per manuf. • 3. water line shut off 4. sewer line support @ 4 feet 5. heating crossover (dblewide) 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 app..) 15. smoke detectors 16. final electrical tilt It t�. • — — 17_ variance required — 18. data plate okay 19. mobile HUD seal okay Model # Serial # ©(O '?#(4– Manufacturer R01i/ 1 iDate of Manufacturer 9 I lU OKAY TO ISSUE C/O YES NO Comments- > o FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building 8, Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART ` INSP: ,) DATE INSPECTION REQUEST RECEIVED: NAME: /� p LOCATION: DATE: 2Z- 5 ( PERMIT N 42^3—cr MOBILE HOME - MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A _ YES O 1. foundation support, pier spacing per manuf. — 2. anchoring per manuf. — 3. water line shut off 4. sewer line support ©4 feet 5. heating crossover(dblewide) off grd. f— 6. dryer vented outside 7. skirting ventilated A 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 pi/- 19. mobile HUD seal okay Model # Serial # Manufacturer • Date of Manufacturer OKAY TO ISSUE C/O St----YES NO Comments: cS 8-!D '7 --sD ,7 _ a2' FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 (� ARRIVE: DEPAR 1\-1 ) INSP: DATE INSPECTION REQUEST RECEIVED: <k2.� Z1 1 NAME: idOrher -• - LOCATION: /15 Adic 57 . DATE: '17) PERMIT U 06�- _J. MOBILE HOME .4k--- MODULAR HOME FOOTINGS FOUNDATION BACKFILL _ FRAMING N/A YES NO 1. foundation support, pier spacing per manuf. — — 2. anchoring per manuf. 3. water line shut off — l 4. sewer line support ®4 feet 5. heating crossover(dblewide) off grd. j — — 6. dryer vented outside ... — 7. skirting ventilated _ — 8. hot water relief valve piping outside — v 9. deck, porches, steps, railing — 10. furnace/hot water operating — 11. garage fire proofing xf — — 12. door closers 13. plumbing fixture — 14. foundation insulation (if appl.) — 15. smoke detectors — Y 16. final electrical f I a\_C1 17. variance required — 18. data plate okay — — 19. mobile HUD seal okay — �_'� Model # Serial# l) (A Manufacturer f 1 /1- `r Date of Manufacturer 9 W.s2 OKAY TO ISSUE C/O YES *NO Comments:0'- ADNN -atci= �-zc8 4` - sil•Aty,ka- 105%-c--eco-a. 04 vxi>floawi 1- ob& tJ g t ,.. FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Budding & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 f ARRIVE: DEPART: . C INSP: DATE INSPECTION REQUEST� RECEIVED: NAME: [40-me�'a�-441 0' V��U"�� 1 LOCATION: I I t DATE: 7i2 D PERMIT# 0(o"-K ') \ • J MOBILE HOME / MODULAR HOME FOOTINGS POUNDATIO BACKFILL FRAMING N/A YES NO 1_ foundation support, pier spacing per manuf. — — — 2. anchoring per manuf. _ — — 3. water line shut off _ — — 4. sewer line support ®4 feet _ _ — 5. heating crossover (dblewide) 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 appi.) _ _ — 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 NO Comments: fl,--t.7012 vi,...„.„ • A 1 Pyri_ 4,,, sus NOTICE ANCHORING OF MOBILE HOME • FRAME IS REQUIRED PER ;— --- MANUFACTURERS SPECIFICATION• _!IE Q 51 3�JRLIfPJ�° . :'S j ,'r. Z1pa all ° 14 -miles Sc 0!! ' - '.�1I I ieq auasaid�� n.,� TON OF QUE NSB RY �,)ua"ki '''ICS. I G,1611Cq iu BUILDING & CODES DEPT. --- TOWN OF DUEENSBURy BUILDING Ona ARTMEN' ,94`71 ,o /47.-r cc; ,, _ / Based on our limited / / cemPlia,;, ,, our comments shall not be construed as Indic tn^ tbe plans and spec:;ic-'',):'s are in full Cedes of compliance with the � w York State. 1 7 ____, / , „ 5. liLi 03 e__3 ti _ $ r..- " 37 -47-1- --.. "-----1 ... 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