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2010-471 TOWN OFQ UEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201 �. 1Qu may, Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number. P20100471 Date Issued: Friday, November 12, 2010 This is to certify that work requested to be done as shown by Permit Number P20100471 has been completed. Location: OHIO Ave Tax Map Number. 523400-309-013-0001-059-001-0000 Owner. TODAY'S MODERN MOBILE HOME SALES, IN Applicant: HEATHER VANNESS This structure may be occupied as a: Mobile Home Out of Park By Order of Town Board TOWN OF QUEENSBU1 Y Issuance of this Certificate of Occupancy DOES NOT relieve the , ��: 1 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&Code Enforcement Planning Board or Zoning Board of Appeals. 1 TOWN OF QUEENSBURY `T 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20100471 Application Number. A20100471 Tax Map No: 523400-309-013-0001-059-000-0000 Permission is hereby granted to: HEATHER VANNESS For property located at: 8 OHIO Ave 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: TODAY'S MODERN MOBILE HOM PO BOX 4272 Mobile Home Out of Park $12,000.00 SARATOGA SPRINGS,NY 1286 Total Value $12,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-471 Area Variance No. 29-2010 Approved 7/28/2010 Heather VanNess - 924 sq ft mobile home $30.44 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, September 28,2011 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the of Que b , T�esda , September 28,2010 SIGNED BY c /) " for the Town of Queensbury. Director of Building&Code Enforcement • / OFFICE USE ONLY TAX MAP NO. PERMIT NO. / f DATE ISSUEDhg; 11 PERMIT w 3Q 'APPROVALS ZONING TOWN CLERK �,-t'e�E'. SSP � �:j 2010 r L` T �`� TOWN OF QU ENSBURY BUILDING & CODES MOBILE HOME -APPLICATION FOR PERMI : A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Information Property Owner Information Name: Heather A.VanNess Name: Today's Modem Homes Address: 244 Corinth Road Address: PO Box 4727 Queensbury, New York 12804 Saratoga Springs, New York 12866 Phone No. 518-925-8729 Phone No. 518-222-3694 Parcel InformationM ev-C e Proposed Date of Placement: ASAP Property Location: 8 Ohio Avenue, Queensbury, New Yo d Road,Street,Avenue Name of Mobile Home Park: (if applicable) Tax Map Number: 309.13-1-15 Mobile Home Information Zoning Information Approximate Value of Home:$ 12,000.00 Zoning Classification: MDR New Home: ❑Yes ©No Size of Property: 60 ft.by 99.6 ft. Replacement Home: ❑Yes No 0i)4 T-t Existing buildings: None Size of Mobile Home: 14 ft. by 66 ft, Setbacks: front yard 21.6 ft. rear yard 11.2 ft. side yards 21.7 ft.and 20.3 ft. Singlewide: ✓ Doublewide: Number of Rooms: (exclude baths) 6 Accessory Building(s): Number of Bedrooms: 3 Number of Bathrooms: 2 Detached garage:❑1-car 02-car ❑ car ®Gas Fireplace Woodstove ❑Wood Fireplace Attached garage: 01-car 02-car ❑ car Foundation Support: Storage building: ❑Yes 0 No Type Size & Depth Other: Piers Runners Water Supply: ['Well ©Municipal Slab 10.5' 65' Haunch' Is Septic Permit Required? ['Yes ©No Continued on page 2 Qv Tow,' of Queensbury • Community Development Office ce - 742 Bay Road, Queentit'urii, :V 1 1LOU Name of Installer or Mobile Home Dealer: Maurice Combs Address: 96 VanDusen Road, Queensbury, New York Phone: 518-793-3171 Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home: ✓ Insignia serial number: 2341 CHB-07-1-1466C-2341 ✓ Name of manufacturer: Champion ✓ Plan Approval Number:Varience#29-2010 ✓ Model or Component Designation: (New home only) ✓ Date of Manufacture: 09/19/90 �rr:r:r:r:.-:r:r:r:r:r:rt:r:_.r:r:r:_.rr-.r:r.t.rru:r:r-.r.r:r:rf:r.rrr:r:r:rr:r:r:r'.r:rar.r-✓ar:r:r f:_ + 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 5 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 5 shall be complied with, whether specified or not, and that such work is authorized by the own�eyr..�� Signature �t.(,1 ( ChniOwner, Owners A ent,Archit ,Contractor s .r:..:..:r:..r..:r:..:.:.:r:r:...:.u:s.�.�.�......,.r.s.�.,r,.:.....:r....,..�.1.rr....:r.s:r.1......a,.u..:.:s:,..�:�u:�v:r:.:..:..:.,.". SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer CtTown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804 INSTALL NO. 1312o _ stATe of NEW YORK DEPARTMENT OF STATE ,:,,,-. ONE-CO1RCE PLAZA 99*SHINOON AVENUE A-LBAtit NY 12231 INSTALLER'S WARRANTY SEAL - 0 THIS SEAL REMAINS THE PROPERTY OF THE DEPARTMENT OF STATE- _i_ W MANUFACTURED(HUD CODE) X RELOCATED MANUFACTURED-(HUD CODE) A. .Mafactltrer' nus name:C iM t or% '=1' #t t I eiglove , B. HUD label number: [ Serial number I-I C4;lit 3 '1_ - t C. Retailer' s-name y D. Retailer's address: a. Ai 23 E. Retailer's certification( E T (a3 7 Z Telephone#:(: 'i S) -718• Z 5 d t F. Installer's name .(_,,,,,,,#; L..c_)c �i c.., , U Installer's address: s . a ' . _ 11. _ . _ 2-e),=="1 H. Installer's certification#:11 01.6.0377.3 Telephone#: Si e) s 7-0 S.7 --=1 I. Date installed: # Mum , s li issuingbuildingpermit: f �� 't.7�t t7 tY -�'1.�.�rr (City, sown, i 3 J. Customer name and physical address.(911)where home is iti alled: .1 V , „ , 9 i i Ave t;,to e,,,, / ) 112 ,New York. By attaching this SEAL to this manufactured home,the undersigned Installer of this manufactured home warrants as follows: 1. That the installation of this manufactured home meets tudards of the New York State Uniform Fire Prevention and Building Code. . . 2. That the Installer is certified as aninstallei`bythe New Yotk State Department of State. The foregoing warranties are in addition to and not in derogationf all other rights andpiivileges which the consumer may have under any . other law or instrument.The foregoing warranties are in addititito,and not in limitation of or substitution for,any and all other warran- ties,express or implied,given or made by the Installer,whether4ontractually or by operation of law. Printed Name of-Person Signing Seal: Som d ZT a t Signature of Installer or Limited Installer: G"" .—::: ----,-.---.4..V If you have a problem with your home,you should first contactyour installer or retailer.If theproblem isnot resolved by the Installer or Retailer you can contact the Department of State at(518)474.4073. DOS-1680(Rev.03/09) Yellow Copy,-Departmsntof State White Copy--Retain for Your i# ords Goldenrod Copy— Alter*A - S'eaK—Affx to Hone Aa.` , °� M y m ' .. i ', 1 i ,,,4 1':,y n {..{4` f,w1‘1 'tl " r'#^7', ,-RF N^ ''''F''''''''''''''' 4e,r v,, "1, • d' • ' Y• .. �1 V • lfi"p1f .f,. }, • .,v�' } Jpj a rV ^ - ger " - 1l2 -12 7A okso( Queensbury Building & Code Enforcement— Manufactured / odular Final Inspection ce No.(518)761-8256 Arrive: am/ Depart�lj am/pm Date Inspection requ:st receiv •: Inspector's Initials: `G NAME: , A L,CJ_ PERMIT* •LOCATION: _ j • ( - DATE: Manufactured Home Modular Home Footings_. Foundation_ Backfill_ Framing_ Comments: Y7No WA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends (77Water line shut offSewer line support 4 feet /Heating Crossover(doublewide}off grd. ,/ Dryer vented outside v Skirting ventilated 1 so.ft.per 1.500 so.ft. yVV Hot water relief valve piping outside Deck,porches,steps,railing Furnace/hot water operating V 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 ( k4" ! tb / . 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 :61i �/ 911 Street number Okay to issue CIC or CIO[Temp./Perm.] Model It Serial# L.t4 fL' 2 341 Manufacturer C t.4ii "l0-kJ Date of Manufacturer 9.. n / 0 L:1Pam Whiting120101Building Codes FormsWlanufactured Modular Final Inspection 03 04 10.doc /D ' . eensbury Building & Code Enforcement-- Manufactures odular Final Inspection Office No. (518)761-8256 Arrive: "114am/pm De art � �am/pm Date Inspection reques received: Inspector's Initials: // NAME: J' /'\. J(ff5 ' PERMIT#: /O -4/7 / LOCATION: S" O h i p A ✓ DATE: /0-77.-/ Manufactured Home Modular Home Footings_ Foundation_ Backfill Framing_ Comments: Yes No WA Foundation support,pier spacing, V Per manufacturer Anchoring per manufacturer 2'from ends / <�. A Water line shut off — • Sewer line support§4 feet Heating Crossover[doublewide}off grd. Dryer vented outside ' f Skirting ventilated 1 so.ft.per 1.500 so.ft. \/ P—_ J- Hot water relief valve piping outside +� - r v� Deck,porches,steps,railing V 1.a•--%--L3- -?-1-C— k0-14... � Fumace/hot water operating _______- Garage Fire proofing f Fire Door/Door dosers Plumbing Fixture 13"Vent through roof[Modular] f Ca Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical &:\u1 \`0 Variance required /� Data Plate okay .,4,7,. Manufactured HUD seal okay Warranty Seal after January 1,2006 Vit Installers Warranty Seal 18"x 24"access or 22"x 30"attic access f Vapor retarder under home 6 mil poly or other V 911 Street number ill Okay to issue C/C or CIO[Temp./Perm.] 1 Model# Serial# f..1f..1_,-02) ` 1,,"� - 01 („,2 Manufacturer C-- Date Date of Manufacturer i, k.ck\CAP L:1Pam Whiting120101Building Codes Forms\Manufadured Modular Final Inspection 03 04 10.doc COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC. Main Office 176 Doe Run Road-Manheim,PA 17545 MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL Permit No.....IL -4-.1 .T I Cert. No 7 2 4.7 Cut-in Card No. / Owner .F 7 01311 Location h i o !- e•-• Installation Consisting of q—r Installed By .//3 ,S Lic.No. 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 of 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 making inspections at any time, and if its rules are violated,the Company shall have the right to rev his certificate. Date /O—1�`�S? INSPECTOR.—,L--7,2111-''"(6"-P4 Member N.F.P.A.,I.A.E.I.