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2010-044 iA TOWN OFQ UEENSBURY cors742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100044 Date Issued: Tuesday, June 10, 2014 This is to certify that work requested to be done as shown by Permit Number P20100044 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 occupied as a: Mobile Home In Park By Order of Town Board / o h� TOWN OF QUEENSBURY i '� Issuance of this Certificate of Occupancy DOES NOT relieve the property (- 4 /9 4 45t 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 FON Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100044 Application Number. A20100044 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: 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 Mobile Home In Park 4294 ROUTE 5 Total Value CALEDONIA,NY 14423 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-044 10 WINDSONG DRIVE - ANGEL AGARD - 784 SQ FT MOBILE HOME IN PARK $47.04 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, February 26, 2011 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town o nsbury� Frid• , F•bruary 26, 2010 SIGNED BY f _ f for the Town of Queensbury. \ Director of Building&Co: Enfoement 3 OFFICE USE ONLY D t E I - V�fJ 'C TAX MA, NO. PERMIT NO. /0 0 44' DATE ISSUED: E , �� FEB 1. 2 2r 10 PERMIT FEE � APPROVALS: ZONING TOWN CLERK t f TOWN OF QUEENSBUF3Y =.BIJIL.DING-&OODES- MOBILE HOME —APPLICATION FOR PERMIT: A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Property Owner Information o e- � Name: +;p ly E (A4AQ,) Name: '1�OtM E-1-5\t_0(j) %--c) Address: 1O UJ c t t1 F Address: -2._x:)0 t- v 7 F R_O E._ avE_ b y_ ,Z4 LA (1)E \ 3R ) ► vaSiNtA Phone No. 793 t?-)1-t(c) Phone No. - s` - z4 1 01,:, I ' Parcel Information Proposed Date of Placement: Ey_Ab"- 00 Property Location: \ ( U3i 00,600 )J Road,Street,Avenue Name of Mobile Home Park: 1-c g.TEp,) la146Efifapplicable) Tax Map Number: 309 .9-7:—k Mobile Home Information Zoning Information —>Approximate Value of Home•$ 3Q 1000 Zoning Classification: New Home: ❑YesNo Size of Property: ft. by ft. Replacement Home: ❑Yes NoExisting buildings: Size of Mobile Home: I y ft. by � 1//9 ft. Setbacks: front yard ft. rear yard ft. side yards ft.and ft. Singlewide: Doublewide: ,Number of Rooms: (exclude baths) Accessory Building(s): -y Number of Bedrooms: - Number of Bathrooms: Detached garage:❑1-car ❑2-car El car ❑Gas Fireplace❑Woodstove D Wood Fireplace Attached garage: ❑1-car ❑2-car ❑ car Foundation Support: Storage building: Yes 0 N Type Size & Depth Other: Piers Water Supply: ❑Well Municipal Runners Slab Is Septic Permit Required? ❑Yes ❑No Continued on page 2 fibTown of Queensbury • Community Development Office • 742 Baty Road, Queensoury, LV 1 IZ.OU-1- • . Name of Installer or Mobile Home Dealer: Address: Phone: Complete information below found on a"Plate"or"Sticker"which is affixed to the1� mobile home: ✓ Insignia serial number: C H 3 O � / 8 3 44 0 -7 D (o ✓ Name of manufacturer: TT\t. IC}-,RM P\d0 ✓ Plan Approval Number: TD 1-4 1 ) 1?9 ✓ Model or Component Designation: New home only ✓ Date of Manufacture: // • • AFFIDAVIT • Town of Queensbury State of New York County of Warren • 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 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 not, and that such work is authorized by the owner. Signature: k}(:, -� /� Cy-Q-b Own r, O ner's Agent, A hitect, Contractor • • • • SPECIAL CONDITIONS OF PERMIT /2/By: / • Code Enf. -ment Officer Town of Qui.PtzsbuYy - Community Developm n Office - 742 Bat 'oud, Queensbury, \TY 12804 Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No. (518)761-8256 Arrive: • 3 aem .-part -L tir Date Inspection request received: Inspector's Initials: _ I NAME: `fit , l' "`� Atil( 1 ���PERMIT //5 " a 1 LOCATION: i r 1 ci,S %: DATE: {9 —In— 1 Manufactured Home Modular Home Footings Foundation Backfill_ Framing_ (, — 85( A+3GaL Comments: Yes No N/A Foundation support,pier spacing, Per manufacturer / Anchoring per manufacturer 2'from ends ��. `T Water line shut off ��e\c� Sewer line support @ 4 feet Cc N1 B t) O CV et V1V—V Heating Crossover[doublewide}off grd. t -\-\c L Dryer vented outside Skirting ventilated 1 sq.ft.per 1.500 sq.ft. \ \\\ b Hot water relief valve piping outside Deck,porches,steps,railing 1 •� Fumace/hot water operating W t�� ���C� �� � Garage Fire proofing AA 0 p V3 'C1 f\tk Fire Door/Door closers r Plumbing Fixture/3'Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay .V 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 CIC or CIO[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:\Pam Whiting\20100uilding Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No. (518)761-8256 h f / Arrive: Z-7u • -part Date Inspection request received: Inspector's Initia . NAME: )of RGoRD PERMIT- . � _ � 4ManuLOCATION: 10 W 1 tv c).1)01001 E h DATE: 63—l0 —)11- Manufactured factured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support St 4 feet Heating Crossover Edoublewide}off gni. Dryer vented outside Skirting ventilated 1 so.ft.oer 1.500 so.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers 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 CIC s C/O i emp. Perm.] \ L,.c C) Model# Serial# Manufacturer Date of Manufacturer L:\Pam Whiting120101Building Codes Forms\Manufadured Modular Final Inspection 0304 10.doc Ink s-r-Pr-Cu s Queensbury Building & Code Enforcement- Manufactured / Modular Final Inspection Office No.(518)761-8256 Artive: \ pa -V7)-45-: Date Inspection request received: Inspector's India . NAME: Pr nA3�'� C � :� , PERMIT*: /D -C%(i'Y LOCATION: 1 t.) toAtiAt (. DATE: Manufactured Home Modular Home �� .—CJ § Footings_ Foundation_ Backfill_ Framing_ Comments: Yes Mo NSA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends o Water Nne shut off C� c b Sewer line support©4 feet Heating Crossover[doublewide}off grd. Dryer vented outside Skirting ventilated 1 so.ft.aer 1.500 so.ft. Hot water relief valve piping outside tWv�►--�►'�� Deck,porches,steps,railing Furnace/hot water operating Garage Fire proofing Fire Door/Door closers 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 2T x 30'attic access Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue CIC or C/O[Temp./Perm.] Model// Serial it Manufacturer Date of Manufacturer L:1Pam Whiting%2010‘Building Codes Foms\Manufactured Modular Final Inspection 03 04 10.doc PIP' MIR 1 SLI, % Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No. (518)761-8256 Arrive: - Iri Depart Date Inspection request received: Inspector's Initis 5 D 1� NAME: /°Sl 6: 'ct= `4„1i CSI .4.50:-'d PERMIT* /C -C (t' LOCATION: /Z) L ( ✓1A-3 t%,1s. DATE: -7 — (G-I - Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Yes WA Foundation support,pier spacing, r D-a ftp-Q Q Per manufacturer Anchoring per manufacturer 2'from ends Water ane shut off Sewer line support @ 4 feet ✓ Q-� C3\ -G-- y� L Heating Crossover[doublewide)off gni. Dryer vented outside �©� Skirting ventilated 1 so.ft,per 1,500 so.ft. // <--7 Hot water relief valve piping outside ~-- c LL � ` ✓ t,V__ Deck,porches,steps,railing Fumacelhot water operating Garage Fire proofing Fire Door/Door losers - ./j --.. .. C"-- ---- TA)V-ANCE-Va" Plumbing Fixture/3"Vent through roof[Modular] \`"'C' \-NN" c-c-+�...., (--Y---- -/_-- Foundation insulation[if applicable] II Smoke/Carbon Monoxide Detectors 1 Interconnected — \A OZ� ‘ 1n Final Electrical � -� Variance required 421 -_v 5 Data Plate okay f Manufactured HUD seal okay ✓ \ l E \- `-- E - ) 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 /I Okay to issue CIC or C/O[temp.i Penn.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting1201018uitding Codes Fonns\Manufactured Modular Final lnspeclion 03 04 10.doc Queensbury Buildin•; Code Enforcement— Manufactured / Modular Final Inspection Office No.(518)761-8256 Arrive: 12 f,9,ra part .41.-__ a pm Date Inspection request received: Inspector's Initials: NAME: 11.b M - #i e,1 krolf d PERMIT* /0-0w , A "T J �) LOCATION: to W I n OS®r1 DATE: -7 ,S- 15 Manufactured Home Modular Home Footings_ Foundation_ Backfill Framing_ Comments: Yes No NA Foundation support,pier spacing, c_�p p a .--0)67-111 Per manufacturer r Anchoring per manufacturer 2'from ends Water line shut off / /i/ Sewer line support 4 feet �YV/ ��N` A��Z `N4 Heating Crossover[doublewide}off grd. Y •�� -1 Dryer vented outside i 17 U Skirting ventilated 1 sa.ft.peer 1.500 sa.ft. Hot water relief valve piping outside Deck,porches,steps,railing 11- \\ Furnace/hot water operating / �T Ni°,` ` Garage Fire proofing Ij / j `Fire Door/Door losers C� e�'4--'� �� / Plumbing Fixture/3"Vent through roof[Modular] I� _A i �� 47 �C S Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected ,L" \ t_ --\-- \‘) 1;-W Final Electrical `� c � Variance required U � N�,- b, Data Plate okay 1 Manufactured HUD seal okay f `G V,- � Warranty Seal after January 1,2006 Installers Warranty Seal 1 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 CIC or CIO[Temp.l Perm.] Model# Serial# tki-7- - (-1-) l 'O'NC.7. Manufacturer D_ V �� \ j Date of Manufacturer j� GG G L:1Pam Whiting120101Building Codes Forms\ManufacuredModutar Final Inspection 03 04 10.doc 'c -,:› � - t � - . ; t1 S1-4-1-113 Queensbury Building & Code Enforcement— Manufactured / Mod - Final Inspection Office No. (518)761-8256 Arrive: t% 4D - 1D a pm Date Inspection request received: Inspector's Initials: NAME: te.).1.t. �'�.±�'OA V( Qi PER Earr /6--Q`/ LOCATION: J /) LJ 0,441 I/^ ti DATE: —1 3 Manufactured Home Modular Home Footings_ Foundation— Backfill Framing Comments: Yes No WA Foundation support,pier spacing, Per manufacturer 0 0 Anchoring per manufacturer 2'from ends Water line shut off Sewer line support©4 feet Heating Crossover[doublewide}off grd. 1.1.6 Po U,E2_ 5 C V.E 'I Dryer vented outside �YP` 'et �E t) Skirting ventilated 1 so.ft,per 1,500 so.ft. _ Hot water relief valve pipingYck outside /G /E \ e_bh't 6�, ro/ iNP Deck,porches,steps,railing AC�,Pt4-V stt SL \ � SEE Fumak e/hot water operating Tc SJ E C_o fAV LE\ E )�' 1 Garage Fire proofing j�lt&C7 fJ` \\1 i-j 1 tZ?VE Fire Door/Door dosers Plumbing Fixture/3°Vent through roof[Modular] Foundation insulation[if applicable] Smoke I Carbon Monoxide Detectors I 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 CIO[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting\20101Building Codes Fonns\Manufactured Moamar Final Inspection 03 04 10.doc /`L ' ,`.) / 1 ` '' � t`` /Modular / t \. . f Queensbury Building & Code Enforcement— Manufacti 'red %-Modular Fi�naC Inspection Office No. (518)761-8256 Arrive: D". e . , a a Date inspection request received: I 4 :._rt :. nspector's lnitia' NAME: A iv f` ! /9•C ki !f7 , PERMIT#: /7 —Cry ?' 1-,,-1._ ,,-„_,-_ .J LOCATION: �� . , ,�� `�'C bi^ DATE: '� •—'Z� 1 Manufactured Home Modular Home Footings_ Foundation_ Backfill, Framing_ _ Comments: _ _Yes lo_WA_ Foundation support,pier spacing, ,!, j- Per manufacturer Y , Anchoring per manufacturer 2'from ends ? ^1 7,' - /f Water line shut off iZ_ 2—`r-- / r V Sewer line support @ 4 feet / Heating Crossover[doublewide}off grd. Dryer vented outside — 1 t3eC VI LL r"CWCD V—i I L7 Skirting ventilated 1 sv.ft.oer 1,500 sa.ft. VD9. tA6 est\_ _ OSE Hot water relief valve piping outside — CO MVt,E�c \\'R tS \Lh 61`-'Deck,porches,steps,railingc* 1 Fumace/hot water operating ��� AG`E— ks\--- __Vb Garage Fire proofing ., Fire Door/Door losers / t � AC�E�� O Plumbing Fixture/3'Vent through roof[Modular] X •cp �. I. E._ `, Foundation insulation[if applicable] — 4.3 EED -c-k) .3 EQ\F A T -Vpr\-' p% Smoke/Carbon Monoxide Detectors 1 Interconnected F\1 L 'E_Lkc--ci�AL \tS Sck_�T\C Final Electrical �'Pr/j e,EE• 4:Xse Variance required EEV TO \TES-i -`{ * u___ \Te-k Data Plate okay P‘9V--e-V Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18'x 24'access or 22'x30'attic access 1 -\--rj C--z*--- Vapor retarder under home 6 mil poly or other � ��� \et 911 Street number Okay to issue C/C or CIO[Temp./Penn.] R C5 0\t--- NV V? o w' Model# Serial# GSD r7 � ` - Manufacturer ��''--'IYY Date of Manufacturer L_:\Pam Whiting120101Building Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building &Code Enforcement 97-313----Ity co 742 Bay Road Queensbury, NY 12804 - (518) 761-8256 of ARRIVEICDEPART:1 ,1•45 INS=. L-1\ 105 Ak--7 4LE (31\ go DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: ADL\IVCV)_6ata6__De_:_. DATE: - PERMIT I , A MOBILE HOME MODULAR HOME FOOTINGS 'FOUNDATION BACKFRL 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 S. 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 appl) IS. 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 CIO YES NO Comments: • , , ,-L.)4,,..- .•7 , --,---, (,, / , 7,- ) 6 141 :0-Cor'i 6) DvC , . t)) 0 Qteei,,,,,)C 13 Lh2--d_ fv-j... 21 ‘,.... 1/43 " / THIS PLAN T. ri,Ei 1 N 2 1 2,?..)o a4 .J; CT ',I H I, T IM E i . I. f F b iFlteCOPY NOTICE • 30 ANCHORING OF MOM HOME co Co % 6 U ToN FRAME IS REQUIRED PER co MANUFACTURERS SPECIFICATIONS Fic.x- L.F4 poefz, __ _ _I 0 -D1°'1h1611 r. 1(Y\ 0 1 / C...) .K" t---, '"4. / .1i0 •k. .0. 13 ---, — L - ,13 -;--9-1-- Q. — ,c, ko x vz..,_Eu c-i'x.,„3' t_fy. 0041i.l.k1 Li NOTICE '•ei_ I.5C IEV 5 .' ) LOCR IA -ru 115e. no. e:-.)E ; Vttai KRAFT PAPER INSOTION MUST 6i) gePLFIC. ., t.)41.6-rviG, botprx_oosz, t>. 1..1 ‘z 00v--4 1, b1 - tr"I NON-qp :USTIBLE BAB Ptici-kop‘ w-N oeht_e_ Ac.ta‘E_ -1-b NC Z Ft t. Rt.._. ELE_CT124C_AL. 1 116PECMOIJ , _ ,'' ' 0) \ tb-1-Ftt.. _ . .--x if--g Reek6agTtEATED NOTICE 1-PoDI o 6 Pc.t. C) 10-I -R5 . TOWN OF QUE 14 INSULATION MUST BE COI/E:RFPIDitiC)tt_ E---)- \ 1, 1-.5yL..P1-7\ e,''. ,.- \ •F-l._ Q,_.C\-\ BUILDING & C 4" op, air Reviewed By: Alit- ABIA 5 MINUTE THERMAL 1344RRviii7 /TN i-- Community Development Office Town of Queensbury • 742 Bay Road • Queensbury, New York •12804 PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME OR MODULAR HOME: 1. Application is submitted and reviewed. a. Two (2) copies of plot plan and two(2) copies of layout must accompany application, along with septic application (if needed). 2. Permit is issued. a. Permit card is placed on property. 3. Footing forms are inspected before pouring concrete (Outside mobile home park). a. Home is placed on foundation or piers. 4. Arrange for electricalinspection 5. Septic Inspection if needed. -1471-14g-M7 7. •;. '. and platform - ..' .' . width a .' door swing with handraits on both sides of Tr4ci "':AtErrettot lot cors -- 8; Final Inspection by Building & Codes Department. =-,Aft:rr*bit,OVOtigjactq_ocf_liik*4t*trat be anchored - ancnorea to the ground upon whichthey are sited per ro.nr ré tequirèments., 10.If anchoring is not possible due to weather conditions or any other item, a Temporary Certificate of Occupancy will be issued. a. Fee: $10.00 b. Deposit: $100 (refunded when all items are complete) QUESTIONS? CALL 761-8256 OR EMAIL codesQueensburv.net VISIT OUR WEBSITE FOR MORE INFORMATION www.cluensburv.net B 9-LTR 11-05 rt t U4'\,0 J ` -` t t.10 \<? ,k \,-d‘c� \,-d‘l J 0 Nti V