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2011-538 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20110538 Date Issued: Tuesday, January 24, 2012 This is to certify that work requested to be done as shown by Permit Number P20110538 has been completed. Location: III AVIATION Rd Tax Map Number: 523400-295-018-0002-004-000-0000 Owner: IVAN & JANE BARSUKOFF Applicant: NICKIE LOCKE This structure may be occupied as a: 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 Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20110538 Application Number: A20110538 Tax Map No: 523400-295-018-0002-004-000-0000 Permission is hereby granted to: NICKIE LOCKE For property located at: 111 AVIATION 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. TVc of Construction Value Owner Address: IVAN&JANE BARSUKOFF Mobile Home In Park $10,000.00 82 ROCK CITY Rd Total Value HUDSON FALLS,NY 12839 $io,000.00 Contractor or Builders Name/Address Electrical Inspection Agency Plans&Specifications 2011-538 LOT 20-NICKIE LOCKE- 700 sq. ft. (14 ft.by 50 ft.)mobile home in park: Serial No.my8865829 Fairmont Year 1987 $84.20 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,December 29,2012 (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 ToT"of Queensbury; Th#rsft ecember 29,2011 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement r .0 t2 9 5/1 --C) 17 ` , • OFFICE USE •NLY•i • • • /' iv TAX MAP NO. PERMIT N•!�• DATE ISSUED: i • • G • • PERMIT FEE APPROVALS:• ZONING TOWN CLERK # L tamp i , , • , , . 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 LOC/CC U Name: JtdLQ LOC/CC Name: MO- j ri Yi'e-- Address: f Ot „r) V t' 0' Z,,lia,'K--Address: III ' ft 1) FEZ q0 Iii -Pv� an P � ► ' . .A-?..-_ v\Y _ C-- Phone No. rigs=S.M./ / - Phone No. ?t?'7 O SO O Avearce nfo� 1 _ 73')2 - Proposed Date of Placement: ‘C .2., 1` Property Location: 'r IC'kj.f &r" 1 t6 �r � 1 Road,Street,Avenue )÷z Name of Mobile Home Park: M.w -i- ttt \)% :k, (if applicable) Tax Map Number: Z'i L_ A 4.2'"x-4 Mobile Home Information Zoning Information Approximate Value of Home:$ b _ti ab,,,, Zoning Classification: New Home: El Yes ❑N 10 0 S Size of Property: ft.by ft. Replacement Home: es ❑No I 424 5° 7100 Existing buildings: 6 tkE.c) 4t,.$ Size of Mobile Home: I "-s ft. bSetbacks: front yard ft. rear yard ft. \ side yards ft.and ft. Singlewide: v7 Doublewide: Number of Rooms:(exclude baths) lQ Accessory Building(s): Number of Bedrooms: 7._ Number of Bathrooms: Z. Detached garage:01-car 0 2-car ❑ car 0 Gas Fireplace 0 Woodstove 0 Wood Fireplace Attached garage: ❑1-car ❑2-car ❑ car Foundation Support: Storage building: ❑Yes 0 No /4ype Size & Depth Other: Piers Runners Water Supply: ❑Well Municipal Slab Is Septic Permit Required? ❑Yes No Continued on page 2 ;Town of Queensbury/• Community Development Office • 742 Bay Road, Queensvury, iv r IZrsu4 Or • Name of Installer or Mobile Home Dealer: IA iNv VA L.. CO}{(7, Address: \j P c))5 E->‘) 7_.. Phone: '744—q©4 1 S-itJ' Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: "�I ���� Lal $V } ✓ Insignia serial number: M v ✓ Name of manufacturer: eSreipMgregPI FA(K mot-)1 L i`Y? I Plan Approval Number: ik AO li t, (11,1--)(Q I Model or Component Designation: iNAw --„� �ome only) ✓ Date of Manufacture: �i y!i!iK!ii!'.!i_R_._i!i!i.•:R!SR!i!:!i!i!i_K!1,1 i_:!'i!i•:_i!SRH.11,4!ii!i!i^.R!:_^.!L•i!i!i!i!iSi.1"...4_i!1,11,,._R_•ii!iK{, 5. AFFIDAVIT c J J t G J 3 Town of Queensbury State of New York x r County of Warren c r. J w v v c I swear that to the best of my knowledge and belief the .. statements contained in this application, together with the plans c and specifications submitted, are a true and complete statement 5 of all proposed work to be done on the described premises and x c that all provisions of the BUILDING CODE, the ZONING ORDINANCE, and all other laws pertaining to the proposed work s y shall be complied with, whether specified or not, and that such y r work is authorized by the owneF. C�////yid y i A V L Signature: , may' •5 Owner,Owner's Agent,Architect,Contractor s y r. 4 :4 y SPECIAL CONDITIONS OF PERMIT // By: ✓ ` I C •e nforc= -nt Officer ;` `, Town of Queensbury• Community Developmen Office" 742 Bay Ro',, Queensbury, NY 12804 k OC). mar: Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No.(518)761-8256 �1� rr ; Arrive: i- '(/,a _.,,u/ � dart Date Inspection request received: Inspector's initia : �J NAME: L C \ E PERMIT 1 5:Ac6 LOCATION: _ & I' • UQDATE: - 2i - \Z Manufactured Home Modular Home Footings_ Foundation_ Backfill— Framing_ Comments: Ygs No WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends \// Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide}off grd. Dryer vented outside ✓ Skirting ventilated 1 so.ft.oer 1.500 so.ft. Hot water relief valve piping outside vjV Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing ✓ Fire Door/Door dosers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected ( .� Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Attee Warranty Seal after January 1,2006 Installers Warranty Seal r 5 18"x 24"access or 22"x 30"attic access Vapor retarder under home 6 mil poly or �� 911 Street number Okay to issue CIC or C/O[Tem,./Perm Model# Serial# Manufacturer Date of Manufacturer L:\Pam Whiting12010\Building Codes Forms1Manufac Lured Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement— Manufactured / M• • • 1r 'nal Inspection Office No.(518)761-8256 /1 i Jc�/ Arrive: i'Z _ % a., 07- Date Inspection request received: Inspector's In-i-- -. .. , die NAME: /4,G.✓i c.-Q C�4.3 PERMIT / (2 0//-�1-3,1 LOCATION: �-- ' /t ' c.,f 41 4 19 A-t-1T DATE: f 3/t '/1 Manufactured Home V c°... ,b1-'c)-6 Modular Home /1/ 141A;.;k4--A'Y // p""I ‘.!-C M`/Pe e,'S e . Footings_ Foundation_ Backfill_ Framing_ �l.d.r-rvw n / /42 k-7 E ,� ,, Comments: Yes No WA I"l >L`1_ z Foundation support,pier spacing, y Per manufacturer /Q'/ 61..�S t/ r Anchoring per manufacturer 2'from ends G C Water line shut off Sewer line support©4 feet J ^ / Heating Crossover[doublewide}off grd. 8/Vik' l�-�'4,1C C i Dryer vented outside V7 —7 ) Skirting ventilated 1 sq.ft.per 1.500 sa.ft. 7 Hot water relief valve piping outside hf- , , y /",', - Deck,porches,steps,railing Cif )0:GfLt G- Furnace/hot water operating Garage Fire proofing Fire Door/Door closersy. �` A / � Plumbing Fixture/3-Vent through roof[Modular] �=( '),v„1114 " J( Z�^c //' �c,.`,-L Foundation insulation[if applicable] 4iv`�RC1 l l4'u'l� L Smoke/Carbon Monoxide Detectors/Interconnected 1 cj 0, Lc t -1-d Final Electrical Variance required Data Plate okay /7/ flIC2,—.---Manufactured HUD seal okay , 1 (9�6 I Warranty Seal after January 1,2006` /"----- Installers /`Installers Warranty Seal — C ‘. 18"x 24'access or 22'x 30'attic access _ {� 4 � Vapor retarder under home 6 mil poly or other , , /O Y� 911 Street number (��i Okay t• - t _ -. Model# Serial# M' cS _ Manufacturer FA A t��_Mo Date of Manufacturer \tl1 TpC1 L:\Pam Whiting12010\Building Codes FonriManufactured Modular Fatal Inspection 03 0410.doc 7'/ ./U-e -�-��� Q nsbury Building & Code Enforcement- Manufactured / 'nal Inspection • Office No.(518)761-8256 Arrive: .y ir a • De - . lb: am/ m Date Inspection request received: Inspector's In' �Q NAME: jr5() AO PER # —63' /7-// LOCATION: ill hi i CI(Q Ii ) ,( /--'DAT• : / � Manufactured Home Modular Home Footings_ Foundation_ Backfill Framing_ Comments: Yes No WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide)off grd. Dryer vented outside Skirting ventilated 1 so.ft.Der 1,500 so.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door losers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18"x 24"access or 22"x 30'attic access Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue C/C or C/O[Temp./Perm.] J/ OD O I E_ D�� L $ VID‘4E 3CR Model# Serial# Manufacturer .. Date of Manufacturer L:Pam Whiting120100Buildding Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No.(518)761-8256 Arrive: t Dt 2O Si art Date Inspection request received: Inspector's Initials* NAME: L,+U � PER . LOCATION: \ \ w 1AT\O e Rc An DA E: \ — 1 \ Lor 2_0 MOt)w Atv» Manufactured Home 7-.9-R, VOW Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Yes No WA Foundation support,pier spacing, Per manufacturer ✓ �- (�/j C� C A LL II Wt Anchoring per manufacturer 2'from ends ✓ �� C \ OF t`'\O 51 LE kap Water line shut off Sewer line support @ 4 feet - ` EC_ Heating Crossover[doublewide}off grd. Dryer vented outside ✓ r t�bT'Nk 1-Lo�Q oC7 Skirting ventilated 1 so.ft.per 1.500 so.ft. ��1C- Hot water relief valve piping outside Deck,porches,steps,railing } C3 o-r\-; t-R 0 D t P 6 b A o Q�" -n Rig Fumace/hot water operating Garage Fire proofing / 30" P PCO\ G�A O 'b fou Fire Door/Door closers ✓ G v i4QO 5 ‘31D-\---N-s, 5\ �.J1=�-�_ Plumbing Fixture/3'Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical / N o tAE �J�.t 1 1 1J ZE,r►1pi Variance required Fo CZ VuJ( R�T4-fl 1 t_ 1 rJ ECT1 Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 EED PCO F OF F ‘13 Installers Warranty Seal £C�c\� �}1J pe ,--\--`© 18'x 24'access or 2T x 30'attic access ✓ ` Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue C/C or C/O[Temp./Penn.] Model# Serial# Manufacturer 7 Lc-‘ — 2-5. Date of Manufacturer C L:1Pam Whiting120101Building Codes Fo ms\Manufactured Modular Final inspection 03 04 10.doc i ''''' •) „ ,..).,. E , L. A-L- 1(1 ,4,,,,,,_i,,-4zi, , -) TOWN OF QC ENS,URY / I/ 1 / -' 7L/ //./.-. BUILDING a CODES /,..---"? -. 'I/ '' /1•1111,11A '2'1 1677- s 3/ • 7 .. .Z'•(, -),--6r._ ! '7-7.z 5 ', 7 ,_----7--___L "-I ., .____ /- , / . , ( tsc\ LC) - _ rl,,, i I io(ul/k I i --------------j--I----._._.,___, • . --.. I. N L LEoaEn - �< - �� ____ 11111 DEC 2 � , .. 11� �•- � �,a, � .• � ,.<< TOWN • • . arazI ..0-intrAll / BUILDING& CODES . -----7-----A/7C/' d7v-C---- , i - it___NEDI Fe I iWINS\--- beAraZrn( . 1 ct c7 If f ! . V . . .. r. • 4.".A.... Alb r ...,,.......-•-" N� R ten'--1 1l IM . r 1111113,... -- . NOTICE tf, 0.ANCHORING OF MOBILE HOME i FRAME !SIZE?, . • a • • — MANUFACTURERS SPECIFICATIONS lig MO - { TOwk. Cr OUEENSBURY BUILDING DEPARTMENT Based on our limited examination,compliance wiP1 our comments shall not be construed as - inrJ a°int 11.e plan,: anrj c ecif,caPinns are in tun corn ':,,,'n -ti,th he Building Codes of Ycn FiJF ( OPY ! , TOWN OF QU. a �- • BUILDING & ' 0a "' ' ''•'.'''r r Reviewed B : d �� • Date: ,A151111 a 43 w wqj a (V L p Z O x O P� 42 VA � O x .0 0 1 `S� l r 1 n C 1