RC-000749-2016 TOWN OF QUEENSBURY
Il742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
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Community Development-Building& Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: RC-000749-2016 Date Issued: Friday, December 9, 2016
This is to certify that work requested to be done as shown by Permit Number RC-000749-2016
has been completed.
Tax Map Number: 308.6-1-65
Location: 48 WARREN LN
Owner: Michael LeBlanc,Jr.
Applicant: Michael LeBlanc, Sr.
This structure may be occupied as a:Mobile Home
1,600 sq. ft. By Order of Town Board
Manufacturer: Champion TOWN OF QUESBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the aVjFr//I/v/A
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.
TOWN OF QUEENSBURY
742 Bay Road Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000749-2016
Tax Map No: 308.6-1-65
Permission is hereby granted to: Michael LeBlanc,Sr.
For property located at: 48 WARREN LN
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
Tvceof Construction
Owner Name: Michael LeBlanc,Jr. Mobile Home $75,000.00
Owner Address: 48 Warren LN Total Value $75,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Valued Homes
1572 Route 9
Fort Edward,NY 12828
Plans&Specifications
Mobile Home
1,600 sq.ft.
Manufacturer: Champion
$192.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,November 3,2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury beforjthee iration date.Dated at the Town o QueensTh s ovember 3,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
OCT 2 7 2016
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Dec. 9. 2016 1 :42P MDIA No. 5820 P. 3/3
MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
5a,J&that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the following conditions.
Owner. Mike Leblanc Date: 11/29/2016
Occupant: Same Locatio94 Warren Lane
Occupancy .ngle Family Dwg. Queensbury,Warren Co. NY
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Applicant:
Don Beagle
1483 Hadley Hill Rd.
Hadley, NY 12835zzb
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Joseph A.Holmes
No. 032265205804EL . .._ .r
Equipment:
1 -200 Amp Disconnect; 1 -200 Amp,Feeder To Home
This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This ceNacate applies only to the use,occupancy and
above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership
Inspection. No warranty Is expressed or Implied as to the mechanical safety,ef& of the property indicated above,this caftificate shall be immediately null and Vold.
ciancy or fitness of the equipment for any p"culer purpose. This certificate anall In the event mat this certificate becomes Invalid based upon the above conditions.
be valid for a period of one year from the above noted date. should the electrical this certificate may Do revalidated upon reinspection by Middle Department
system to which this cerliriCale applies be shared in any way,including but not limit- Inspection Agency.Inc. An application for inspection must be submitted to Middle
ed to,the introduction of additional electrical equipment and/or me replacement of Department Inspection Agency, Inc. to Wtlate the inspection end revalidation
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged fermis service.