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2007-128
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. P20070128 Date Issued: Thursday, September 18, 2008 This is to certify that work requested to be done as shown by Permit Number P20070128 has been completed. Location: 55 WARREN Ln Tax Map Number. 523400-308-006-0001-063-000-0000 Owner. SAMUAL J WAHNON JR Applicant: SAMUAL J WAHNON JR This structure may be occupied as a: Mobile Home Out of Park By Order of Town Board TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the 4 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 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070128 Application Number. A20070128 Tax Map No: 523400-308-006-0001-063-000-0000 Permission is hereby granted to: SAMUAL J WAHNON JR For property located at: 55 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. Type of Construction Value Owner Address: SAMUAL J WAHNON JR Mobile Home Out of Park $63,000.00 DEMETRIA LEMNOTIS Total value $63,000.00 1304 STATE ROUTE 9 GANSEVOORT,NY 12831-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2007-128 1568 SQ FT MOBILE HOME(OUTSIDE OF PARK) $94.08 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,April 19,2008 (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 Town17b7 Thyr/sd y,Apri119, 2007 SIGNED BY for the Town of Queensbury. Director of Building& de Eircernent 0~-(2~ APPLICATION FOR PLACING A MOBILE HOME ~~~'~ q~~ OUTSIDE OF A MOBILE HOME COURT: ' ~ ~' , I ~ ~ }1 ; This application for a Mobile Home Permit shall be accompanied by a plot plan fi~bV4~ ~,, ,~ ._, w~~svRY ; drawn reasonably to scale showing all dimensions, the size of the lot, the location ~UILDIIVG; AND ~b~E~ `~ the lot of the Mobile Home, the water supply and sewage system. If the applicant is not the owner of the premises, then the application must be accompanied by the written acknowledged consent of the owner. Applicant Information Property Owner Information S~ TWA fl Name: ~. Ns ~ ~ ~}(L Name: ~~(,~ ~/ A- ~~ rVl ~~ 7'%S Address: (~dt~ Address: ~ ~ ~' ~rs2~e ~1~T ~~~ T J~.~ Phone No: ~ ~( ~~~~ Phone No: ~a ~<-O CJ f Parcel Information~~Jt~ 1~1~~ Property Location: ` ~ Tax Map Number: ~`~~ ~ ~ `- ~ `' ~ Road, Street, Avenue Mobile Home Information Approximate Value of Home: $ ~~~~ Replacement Home: a No New Home: Ies No Size of Mobile Home: ~ ft. by~~ ft. Singlewide: Doublewide: Year: Model: ~r~ Make: { ~I ~ Serial # 6l ~ ~ ~~~ ~ X~1 State fully the reasons for this request: ~-~~ pplicant's Signature Date ~~- Toznn of Queenshur~/ • Comrnunity Development Office • 742 Bay Road, Queenshun/, NY 12804 TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5902 AFFIDAVIT 518-761-8201 TOWN OF QUEENSBURY STATE OF NEW YORK COUNTY OF WARREN I swear that the following used mobile home that will be transported into the Town of Queensbury for placement will have the following. A building permit approved and issued, meet all zoning requirements, the mobile home's HUD sticker affixed to mobile home and meet HUD requirements for the Middle Zone. As the person responsible for the transport and placement of this mobile home, I accept total responsibility for removal of the mobile home from The Town of Queensbury, if it does not meet the requirements for placement. Signature: Mobile Home v Signature: Town of Queensbury Code Enforcement Officer "HOME OF NATURAL BEAUTY ... A GOOD PLACE TO LIVE" SETTLED 1 ?63 ~ Date: ~~ ~, Owner's Agent, Mobile Home Contractor Date: ~~ _~ •~/I•n/IIA•f lint/Ilf fffll/fn• ~`41In Iinnlflfnnnff llln /nf ll ilnnini ~.-•.IiIIf~ ~ OFFICE USE ONhY ` ~ti „ ~ ,TAX MAP NO.,~„r._PERMIT hlO. ~ DAT6 tSSl1ED: ,.~_ i ~ ~ ` ~ PERMIT FEE~~ •.APPROVAt,S: ZONING TOWN CLERK ~ r % r I fIf/IIn/IInIII/III nnIlnlnr~nn~n/rIIl f~~n nn ll Iii/Il innnnnlf/Ilfnnil nnf nnn ~..ff.f/inf.-n...f.., ~ ; r ~ i/n/f inn Winn nrn~~rn~ MOBILE H01VIE - ,A~PPLIC~A.x'.I'ON, EO~R ;PER;MI ~': A building permit must be obtained before placement of nlobil8 home on parcel. No inspections will be made un~l a - vardbuilding permit has been issued. A~p1>!'crfnt .tx~~ornzafiio~ Name: ~e~~ s ~ (s hlo~ ~c1A-~ Address: j ~JO ~ ~. - -- ~~,, ~ tla b~` J~.9 ,~(, Property Ozan~er ~,~~~~~ N~~me: ~ Aa ~ ti°N2~0 77 Address: 1 38 ~ ~ Q C~~~Y~~Lo(~r 7,~ Phone No. ~ $ ~~ ~ Phone No. ~Parcet Inf~v~ C proposed Date of Placement: 5 Property t_ocation• ~ ~ 191~~+~ - Road, Suet Avenue Name of Mobile Home Park: ~ I ~" _:(if'app~ae) Tax Map iV~naber:.~~'~°'~ ~ n`{O~ Mot ile F,1"om~e Inforrna#~o>z Approximate Value of Home: $ _~~~~ ~ ~ ~ New Home: ~ pNo~ . Replacement Home~(Yes 1 Nio"~ .'~~ ~ . Size of Mobile Home: ~ ~d~~ ,~ ff- by 12tQ R Singtewide: ~ t)oublewide: ~_ Number of Rooms: (exclude baths) Number of Bedrooms: 3 Number of Bathrooms: Grote: Gas Flreplaoe / 1Naodstove !Wood Fireplace honing Ir~~iarnsa>~iox~ ' ' f Zonlag Class~ication: ~ ~~! 1'*o u 3~N~j size of Property: .~.~~, ft. b~+~~ ~ - t ~dstirtg buildings: x S, ~ ~ t d~`P setbacks: front yard ~ is~ ~ rear yard ~ ft. side yards _„~•_ ft. and _,,, ft- Piccessory Building(s): drde Detac~ted garage: 1.~car 2-car car Attad7ed garage: 1-car 2.•car car Storage ~Eauilding• Yes Foundation Supprort: `type Size .2 ~ ~ Depth Pters ~~,~~~ ~, To:~m of Queensbuty • Com~mu~nity Development Of j`icae • 742 Bay, Road, Queens~vut'J• ~v r tcov~ ether: ~ Water Supply: well or munld Is Septic Permit Required? Yes or ~XISTi~~I 04f03f2007 10:17 7982803 GF MOD PAGE 02 .......~....~.....~... ~".~.i.....ii............~.....-.,~..ri.... OFFICE USE ONUY ~ ; ~~.~-/-63 ~ TAX MAP N0. .. PERMIT NO. ERMIT FEE ~ APPROVALS: ZQNING TOWN CLERK r r ~ r AI'PL,~CA~TON FOR SEPT'~C D.~SFOSAZ SYS7'E~[ ~PE.R~IT: A PERMtT MVST BE OBTAINED BEFGRE WORK BEf31NS. APPLICA710N Is SUBJECT To REVIEW Bt:FORE ISSUANCE OF A NAL-o PERMR. ~mQ~j,,r~;~ L~mn~'~'I~s OWNER: _SQrkt~tL ~ -~-~~. ~''LDYI INSTALLER: ~ ~~~ A ~8 ~'e ~~C~r.V~/~%.~- ADDRESS: ~~~~ 4 ~~ Q C ~~ b/ I- ADDRESS: ~ ~~ 4 ~+ ~ C--~~e ~ ~~}" PHONE PHONE NOS. ~ ~ ~ ~ ~ ~ 7 ~-- LOCATION OF INSTALLATION: ......r..,...-.-.,.........,, YEAR BUILT ~ ..,_,... NO.OF ~~~ BEDROOMS .,... ....................,,,....__......,.._._ ....,,_ __.._....~_..........,.-..w._.W....,.,...,...._.... COMPUTATI01~ T = TOTAL DAILY FLOW ..~,,............._...... .. i 98n or older _~--~._,,,,,_.__.,.,,..~....,,,,,,. .................~.. W.. .~...,.~...,........,..,,,.,.........~.....,.,,, X ~ 150 gallon per bedroom ,t i 981 -1991 1992 -present ~ X 130 gello~ per bedroom •. _.._._._....,...._..___..~-..__._... ... ,..~~ X 110 gallon per bedroom .-.....-.....~W~..~....... RESIDENCE INFCRMATION; C'ARI9AQE QRINDER INSTALLED? _. . SPA OR HOT TUB WSTALLED? PILRCEL INFORIIIIATION: / TOPOGRAPHY: LAT OLLING STEEP SLOPE /DSLOP~~,., / SOiL NATURE: SAND~_ LOAM CLAY OTHER / GROUNDWATER:... WHAT DEPTH? .~}~"" BEDROCKIIMPE_ RVIOUS MATERIAL: AT WI~AT DEPTH? __~I / DOMESTIC WATER SUPLY_: MUNICIPAL WELL_ (IF WELL; WATER SUPPLY 1=ROM ANY SEPTIC-SYSTEM ABSORPTION IS / PERCOLATI.ON TEST: RATE !S P)=R MIINUTE PER 1NCH (TEST TO BE COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT) PROPOSEp SYSTEM FOR Nt~W CONSTRl1CTION: All Individual sewage disposal systems must be designed by a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool #ub. / SEPTf TANK: _GALLON (MIN. SIZE IS 1,000 GAL,) TILE F1ELD: EACH TRENCH FT. / TOTAL SYSTEM LENGTH: ~„_.FT. SEEPA E IT(S): HOW MANY? / SIZE OF EACH FT. X F?. SIZE Ole STONE TO BE USED: # /DEPTH OR THICKNESS FT. / BED SYSTEM.SIZE: _Q,~C ~~ / ALTERNATIVE SYSTEM: l%/ ~ Gi ~V LENGTH AND/OR SIZE .lo X / L / HOLDING TANK SYSTEM: (If required) NO.OF TANKS: /SIZE OF EACH / GALI!,ONS. /TOTAL CAPAClTY,• GAL. NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTEp BY A TOWN APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED. For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which Is based upon or' is grant®d In reliance upon any material mtsrepresentatlon or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and Ali requirements of the Town of Queensb Sanitary Sewage Disposal Ordinance. ' B `~ r O -~ Sig tune ~f Person R orlsi 1 Date QUESTIONS ? CALL 781-8258 OR EMAIL jades®au~epsburv.net visit OWR WEBSIT'E FCR MORE INFORMATION Ylf6t5er,ptteensbuty,~n~et Town of QueensburY/ • Crnnmunity ,Development Office • 742 Bay 12oad, Queensbury, IVY 12804 >,L INSPECTION REP©RT Town of t]ueensburY Building 8 Code Enforcement 742.Bay Roan pueensbury, NY 12804 (51 761-8256 A1tRNE: M .y ~ ART: INSA~~ DAZE INSPECTION REQUEST RECEIVED: NAME: LOCATION: .~ J - ~- DATE: PERMIT # IiiOHILE NOME h[O1DtJT.AIlI HO>1tB FOOQ'LI!iGS - TaOUNDAT(ON ,_ BACKFi1L _ ~~ _ NlA.. YES NO 1. fo~mdation support, pier spacing per manuf . ............._.......... - - - 2. anchoring per manuf . ............... _ _ - 3. wafer line shut off ................... ,_ - - 4. sewer tine support (g~! 4 fed ....... - ~-- -- 5. heating crossover (dblewide) off grd. _. -- -- ti. dryer vented outside ..: ................... _. - 7. skirting ventilated .................... _ 8. hot water relief valve piping outside - - - 9. deck, porches, steps. railing .......: - -- -- 10. fiunace/hot water operating ........ - - ___- 11. garage fire proofing .................. _. - - 12. door closers ....:...............::..... - - - 13. plumbing fixture : ..................... - - - 14. foundation insulation (if app1.)...... - - - 15. smoke detectors ....................... - ____ - iti. final electrical ........................ - - - 17. variance required ..................... - - - 18. data plate okay ....................... - - - t9. mobile HUD seaLdcny .............. --- - - Model # Serial # .~ Manufacturer t)ate of Manufacturer OKAY TO ISSUE CIO YES NO (,omments: ~L' ~~ ~d Dccov p~~ b ~ ~ ~~~--10 .~ Foundation Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & Code Enforcement Arn ~ am/pm Dep~~ am/pm 742 Bay Rd., Queensbury, NY 12804 fns or s Initials: ~~f v ~ ~j NAME: PERMTT #: S~_ LOCATION: 7C~~ 11 INSPECT ON: TYPE OF STRUC Comments Y N Footings Piers i~rT4 ab Reinforcement in Place The contractor is responsible for providing protection from freezing for 48 hours following the placement of the concrete. Materials for this en site. Foundation / Wallpour Reinforcement in Place Footing Dowels or Keyway in place Foundation Dampproofing Foundation Waterproofing Footing Drain Daylight or Sump Footing Drain Stone: 12 inch width 6 inches above footing 6 mil for wet areas under slab Backfill Approval Plumbing Under Slab PVC /Cast /Copper Foundation Insulation Interior /Exterior R- Rough Grade 6 inch drop within 10 ft. G L:~Suilding & CAdes Forms~Building ~ Codes~Inspection Forms\Fourxialioit Inspedfon Report.doc Last printed 12/20/2005 9:24:00 AM Septic Inspection Report Offfice No. (518) 761-8256 Date Inspectionyequest nrceived: Queensbury Building & Code Enforcement Arrive: ~- an1/p~, Depart: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ~ U/ (,,~ c~,~ PERMIT NO.: ~ ' NAME: LOCATION: Ct '~.4+~2f~PL~ l INSPECT ON: RECHECK: Comments and/or diagram Soli T :Sand Loam Cla T of Water: Munid 1 Weil Water Waterline se ration distance ft• Weil separation distance Otlier wells: ft• ft' Abso on Field: Total len ft• Le of each trench ft• De th of trenches ft• Size of Stone Pits: Number Size: x Stone Size: pi Size Buildi to tank Tank to Distribution Box Distribution Box to Feid Pit O ni Sealed: Y N Partial End Ca Inl Outlet Pi & Baffles Y N Locatron Se rations Foundation ~ tank ft• Foundation to abso on ft• Se ration of Pits ft• Conforms as r Plot Plan Y N E ineer R rt and As-Built Y N Location of System on Property: ~~C - oY~ Front Rear Left Side Right Side ~~~~- ~2C.~-i f ! f1~ 'S ~ ~ / Q~ Middle Fro Middle Rear m Approved Partial Approved and needs to be re-inspected, Please call the Building & Codes Office Disapproved Last revised 021006 bast revised 1/6/OS to-~z ~,~,y_ s-`~/~~ . SepticInspectlon Report Offlce No. (518) 761-8256 Date Inspec~»_p request received: Queensbury Building & Code Enforoement Arrive: V ~ am/p~t Depart: amJpm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ~~ NAME: LOCATION: RECHECK: ~~ Soil T Cla • afar Munici Weli Water T of Waterline se stance ft• Well separation distance Other wells: ft• ft. Abso Field: Tobl len ft• Le of each trench ft• of trenches 2 Size of Stone - -n.~ See a Pits: Number Size; x Stone Size: Pi i Slz T Builds to tank ~ Tank to DistHbution Box k ` Distribution Box to Field Pit U w 0 ni Sealed: Y N Partial End Ca In Outlet Pi & Baffles Y N ~.v I l/vC-~'t Y 1 ~~ ~~'G~ Location Se rations Foundation to tank ft• Foundation to abso tion ft• Se ration of Pits ft• Conforms as r Plot Plan Y N E sneer Re rt and As-Built Y N Location of System~~on Property: Front ~Re~r Left Side Right Side Middle Front Middle Rear PERMIT NO.: INSPECT ON: n~-~~ Comments and/or diagram ~~~ ~5 _ ~ ~ i ~-~ Svstem Use , to s: proved ~rtial Approved and needs to be re-inspected, please tali the Building 8c Codes Office Disapproved Last revised 021006 Last revised 1/6/05 o~ iz8 fI1 m° m ^C r z m s (n D m 11 REAR PROPERTY i.liVE _-_ --- _-__. __. --- ,.. ......,.-..-.... ---- ~.,,. , ,,-_...1_"- ._ .___ -.... __._ ..__ _...- ,,..,_.. ___ .,.,.- .--- ~.,,,., . ___ ._ --- -----~---- I 1-_.... - -u...., , ~ I__...,,. - ,,...w- ..._._. _ --. - __. _. _ -. _. ,h- .. _ ...-._ ._ .. ......_ .._. _ i,r..- ...,,, . _ ,~,..._.. , - .._ . ___ . .. ..__. ..... -- ~,.... ---. . --- .. . .r,,. - - ---- . .. .1.~- __ ,. - -- __,. _ - ,, _._ . --- _ ..__ . -_..,, _.. ,._._ 1_.--- ___ - ~..,, ,_- _-- -- _._ t-_ , ... ~ ,. - _. _ . _ ._1 _ ____ _ __ ,,, . _ 1,,,-. .. - - I ~ I _. __ __ ~ __,_.. ...,, ._.._ _. ._-- .-- ...._ .__ __._. . f__ _.__ ._ _.__. .-_.._. . _ _.___ -- -- i -.- ~ .,.,,,_ ~, .. .-.-... ,..,.. ,.._. __-.... ..__ .__. _.__..,~ ..... ..,r- --_ _..._. __.._ 1u L__. _ .. __.._. J .. 4 ., -_ __ _~...... __ -__ ,_- 1 1 I ~ ~ i _ .,..... ,,.,,,., ,,.,,~,_ _ _~ ~ . . - . -- .l ,~ . ,. ,,~„ . ..._ -- __ - - a ., ,,, ... ,a~ -- _ __ -- _ -- __ ~ I I ~_ 1 - - ~ I , i , _ _. ._ - L _ __- __ _ _~_ - --i_ __1 _ - ___ i _~__._ . I _.- . „,. ---. R_. _~. ___a_._._. ~y„,. l I ___.. ,. ,., ._ -- .,.., ,,. ,., i _._ ---- . -- -_ .._1 - ___... -...- .-- _ -- _. - .--.- -..._... ~ ___.___. ; _- _ _-.-- _-. -t_.-_.. __.....-.__ _.~ -- -_....L .__ __. , __ - --- . __ . .-- _- _ -._ __ ___ __.~ __- -__-~ __ . __._L.__ _ -_- _-- . -- .... __ _ ... I ,.. . V • ,~--. ~_ D rn 0 m r m m a co a a ti 0 m a y G o. m to n 0 tl7 y O, a m N 0 m 3 (D '~ O ~o ~ ~ ~~ ~- ~~e ro ~ ~ ~ ~ co „~ ~ O ~~~ ~~~ N ~ ~ N y, ~~ ~~o a, ^. I"' r~°- 3N1~ A.[.b3dO~id J..NO~Id // ~~~ FINAL INSPECTION REPORT MO0t1.E' / MOOULAFt Town of Clueensbury Building & Code Enforcement 742 Bay Road Queensbury, fVY 128{)4 (518) 761-8256 ARRIVE: DFPART:~NSt': ~' / DATE tNSPEGTION REQUEST RECEIVED: LOCATION: DATE: l PERMIT N (~ ~~ ~.~ MOBILE HO11tE h[ODLlLAR HO1I[B FOOrfINGS _ FOUNDATION _ BAf:KFQL _ FRAMING. N/A .YES NO 1. foundation suppod, pier spacuug / per manuf . ........................ _ V 2. anchoring per manuf . ............... _ - 3. water line shut off ................... _ - - 4. sewer line support (~ 4 feet ....... ~ ~ - 5. heating crossover (dblewide) off grd. _ 6. dryer ve_ nted outs' . ................... ~ - 7. skirting ventilated.::. • -. 8. hot water relief valve piping outside - ~ ._ 9. deck, porches, steps. railuig ........ -- i0. fiunace/hot water operating ........ _~ - 11. garage fire proofing .................. - - 12. door closers ..........:................ ~ _ - 13. plumbing fixtwe ...................... ~ _ 14. foundation insulation (if appl.)...... ~ - - 15. smoke detectors. ... ............... .,~,/ - 16, fwaleiectrical ...~~(.`-`~--~-• - 3G 17. variance required ..................... ~ - - 18. data plate okay ....................... - 19. mobile HUD seal okay .............. - ~ - Model ,~ t-~t2( (~~D`[ serial a c5c ~3(~~~- J Manufacturer ( ~ s~ !)ate of Manufacturer G~ ~ ~. ° OKAY TO ISSUE CIO ,,,~~~ NO