2008-463 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE (.3" U" OCCUPANCY
Permit Number. P20080463 Date Issued: Monday, September 15, 2008
This is to certify that work requested to be done as shown by Permit Number P20080463
has been completed.
Location: PETRIE Ln
Tax Map Number. 523400-308-006-0001-061-000-0000
Owner. SAMUEL & VIOLA WAHNON
Applicant: SAMUEL & VIOLA WAHNON
This structure maybe occupied as a:
Mobile Home In Park By Order of Town Boatel
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&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOVXN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080463 Application Number. A20080463
Tax Map No: 523400-308-006-0001-061-000-0000
Permission is hereby granted to: SAMUEL& VIOLA WAHNON
For property located at: PETRIE 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. Tie of Construction Value
Owner Address: SAMUEL&VIOLA WAHNON Mobile Home In Park $74,000.00
39 SARATOGA ROAD
GANSEVOORT, NY 12831 Total value $74,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2008-463
35 petrie In
$69.08 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, September 05, 2009
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the T
f Quee bu /°F 'day, September 05,2008
SIGNED BY for the Town of eensb Qu ury.
Director of Building&Co e Enforcement
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TAX MAP N� PERMIT NO. DATE ISSUED: ;
PERMIT FEE- APPROVALS: ZONING TOWN CLERK ;
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MOBILE HOME -APPLICATION FOR PERMIT:
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a
valid building permit has been issued.
Applicant Information Property Owner Information
Name: 1 Name: 4AJ 6
Address: F Address:
Y
Phone No. qq 7 I a Phone No.
Parcel Information a3a
Proposed Date of Placement: Property Location: �-S � I 1 "� L -1`
Road,Street,Avenue, i
Name of Mobile Home Park: I t (�fapplicable) Tax Map Number.
Mobile Home Information ' Zoning Information
Approximate Value of Home:$ C C` 00 1 Zoning Classification:
1 New Home: Yes No = Size of Property: J J ft.by ft.
I Replacement Home: Yes No = Existing buildings:
1 Size of Mobile Home: Z ft. by ft �/ : Setbacks: front yard — ft. rear yard T_ft.
side yards ft.and -:26_ft.
Singlewide: Doublewide,
Number of Rooms:(exclude baths) geplace
Accessory Building(s): circle
Number of Bedrooms:Number of Bathrooms: Detached garage: 1-car 2-car car
Circle: Gas Fireplace/Woodstove/W Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Size & Depth Other.
ers : Water Supply well or Cmunlp�al
Runners I
Slab = Is Septic Permit Required? Yes or
Continued on back T
Taum of Queensbury• Community Development Office • 742 Bay Road, Queensaury, 1V x izaw
Name of Installer or Mobile Home Pealer
Address: 30 C `i
Complete information below found on a"Plate'or'Sticker'which is affixed to the mobile home:
J-
✓ Insignia serial number I L 3 r/ 1 J Z) X u
✓ Name of manufacturer. `~ _
✓ Plan Approval Number `� � L?-73
✓ Model or Component Designation: (�DD
I , (New home only)
✓ Date of Manufacture:
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AFFIDAVIT
y V
J
M
Town of Queensbury State of New York e
County of Warren x
x
7 �
v y
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
s of all proposed work to be done on the described premises and x
that all provisions of the BUILDING CODE, the ZONING
ORDINANCE, and all other laws pertaining to the proposed work y
shall be complied with, whether specified or not, and that such
work is authorized by the owner. y
y
Signature:
Owner Owner's Agent, chitect, Contractor
J
V
i
SPECIAL CONDMONS OF PERMIT
By:
Code Enforcement Officer
Toum of Queensbunj• Community Development Office• 742 Bay Road, Queensbury, NY 12804
FINAL INSPECTION REPOAT
MOBILE / MOOULAFI
Town of Queensxtry
Buildng &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: DEPART: 2 INSP:
DATE INSPECTION REQUEST RECEIVED:
: _. �te-
N
LOCATION: '
DATE: �' ;"j _' - `�. PERMIT# ; --
0�
MOBILE HOME MODULAR MOM
FO(7T[NGS_ FOUNDATION ` BACKIIlL— FRAMING
NIA YES NO
1. foundation support, Pier spacing
per manuf. ........................
2. anchoring per manuf. _
3. water line shut off ................... — —
4. sewer line support a 4 feet ....... _
S. heating crossover(dblewide) off grd. � _
b. dryer vented outside ..<...................
7. skirting ventilated ....................
8. hot water relief valve piping outside — —
9. deck, porches, steps, railing ....... — —
10. funuceAwt 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 ....................... --
19. mobile HUD seal okay ..............
Model # Serial#
n ,
Manufacturer
Date of Manufacturer
OKAY TO ISSUE eW YES NO
Comments:
FINAL INSPECTION REPORT
MOBILE / MOOLILAR
Town of Que&Wxjry
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 76141256
ARRIVE: DEPARTtU�Nspdk=AZ)
DATE INSPECTION REQUEST RECEIVED:
NAME:
LOCA77ON:
DATE: �?
PERMIT#
MOBILE 110�mz �MoDtU�MLAAR NOW
F007INGS FOUNDATION — BACKRU FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf. ........................
2. anchoring per manuf I ...............
3. water line shut off ...................
4. sewer line support 0 4 feet ....... A/-
5. heating crossover(dblewide) off grd-
6. dryer vented outside x...................
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. deck, porches, steps, railing ........
10. ftunacelhot water operating ........
It. garage fire proofing ..................
12. door closers ...........................
13. plumbing fixture ......................
14. foundation insulation (if appl.)......
IS. smoke detectors ........
16. final electrical .......I
17. variance required .....................
18. data plate okay .......................
19. mobile HUD seal okay ..............
Model #011�910)( L) Seriat# OPV12-
f
Manufacturer
z
Date of Manufacturer
NO S
OKAY TO ISSUE CIO YE&
'eQx�N, A� V-�� _fZ_
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RE�1EW COMMENTS
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Revisions
No.
TOWN OF QUEENSB N Y
COUNTY OF WARRE JVAP #
N.Y. STATE LIC. NO• 35617
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12494
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