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2001-046 '� 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: P20010046 Date Issued: Friday, April 27, 2001 This is to certify that work requested to be done as shown by Permit Number P20010046 has been completed. Tax Map Number: 523400-121-000-0006-059-002-0000 Location: PETRIE Ln Owner: SAMUEL &VIOLA WAHNON Applicant: CURTIS & JENNIE GUARDIOLA/DELORENZO This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY rArfi 4 ,. ,y'r Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 toe s Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010046 Application Number: A20010046 • Tax Map No: 523400-121-000-0006-059-002-0000 Permission is hereby granted to: CURTIS & JENNIE GUARDIOLA/DELORENZO 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. Type of Construction Value Owner Address: SAMUEL&VIOLA WAHNON Mobile Home In Park 60,000.00 39 SARATOGA ROAD Total Value 60,000.00 GANSEVOORT,NY 12831 Contractor or Builder's Name/ Address Electrical Inspection Agency NEW YORK BOARD OF FIRE UNDEI Plans &Specifications 2001-046 28 X 68 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $92.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Thursday,February 20,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the To Quee s : »ury T, ,sd y,February 20,2001 SIGNED BY ( 4 for the Town of Queensbury. Director of Building Code nforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, lVY 12804 (518) 761-8256 A building permit must be obtained before placement,of mobile home on parcel. No inspections will be made until a valid building permit has been issued.- . Applicant Information nn Office Use / • Name: j1</T73 l ^L{ )1DL File Permit No — 6 t/ (,oIVI`P Fclve-eti Z �` Address: 2_-b � Fee Paid , ©� Reviewed By: Phone No. '7 ? Z�-�S7_ ® 6 1 V Property Owner Information Parcel Informatio1EB Zoof s 1 Proposed Date of Placement �4 :!'s'F QUEENSBURY Name: l� 4 Y() AP+ll7 CQDE Property Location: 3( 2.i L4 Address: 3C Road,Street,Avenue (-4AJSeVs OAT !V(yi Z��)) Name of Mobile Home Park: \,(r ?SV rev �,/ (if applicable) p� n ' Phone No. ' 2 1f O / Tax Map Number: I / / Sq t,sa.„ Mobile Home nformation , cj 014 stiff . Zoning Information Approximate Value of Home:$ (U OC • 0 C7 S (, Zoning Classification: i4-1-{ma--RA- New Home: dp No 02 Size of Property: ft.by ft. Replacement Home: Yes o ¢ Existing buildings: Size of Mobile Home: D ft. by ft. Setbacks: front yard ft. ; rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: .3 Accessory Building(s): circle Number of Bathrooms: '7-- Detached garage: 1 car; 2 car, car circle: (Gas Fireplace or Woodstove Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other TYPE r, STZF&DEPTH Water Supply. circle Piers f l/H:5 PP Y Runners Slab well municipal Further information requested on the reverse side of this sheet 1110. 11,/ lil..Adta--2a, ' JI1 �Name of Installer or Mobile Home Dealer: }U - Zo Address: ir, Phone No. 7q12zt State of New York Division of Housing& Community Renewal,.• " • Insignia of Approval of the State Building Code • Complete information below found on a"plate"or"sticker"which should be affixed to the mobile home. 1. Insignia serial number: 2. Name of manufacturer: 1-0-11,64H 3. Plan Approval Number : 4. Model or Component Designation: (New Home ONLY 5. Date of Manufacture: I 3 0 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: 5(A1v-&.- r owner,owner's agent,architect contracto Special Conditions of Permit By: Form: 1 111 8/1 999ah Code force nt Officer BLDG. PERMIT NO. 2 0 01-0 4 6 APPLICATION FOR A TEMPORARY CERTIFICATE OF OCCUPANCY A TEMPORARY CERiTIFICATE,OF OCCUPANCY is hereby requested for the property , located at; Lot 31 Petrie 'Lane ; (Curtis & Jennie Guardiola/Delorenzo) for the'following uses:, Mobile HOme February 28 ,, 2001 vivvruto.A DATE SIGNATURE.OF APPLICANT TEMPORARY CERTIFICATE OF OCCUPANCY The-TEMPORARY CERTIFICATE=OF`OCC-UPANCX-is-hereby -( APPROVED— ----" ( )DISAPPROVED with the following conditions: Certificate - of Occuapncy to be is Sued upon completion ofl, 1 ) Piers and Anchoring 2) Install skirting & Dryer Vent 3 ) Call for Fireplace Final TEMPORARY CERTIFICATE OF.OCCUPANCY FE 10.00 EPOSIT: )$ 00.00 received on February 28 , 2001 - Date of Issuance Director of Bldg. & Code nfor ment TillS TEMPORARY CERTIFICATE OF OCCUPANCY EXPIRES 60 DAYS FROM THE DATE OF ISSUANCE. NOTE: This Certificate is NOT VALID unless signed by the Director of Bldg. & Code Enforcement or his designee. • . . . . , • . , . . . . Fire Marshal's Office qv - Town of Queensbury, 742 Bay Road,Queensburv, NY (51$) 761-8205 , . ,•- . Application for Fuel Burning Appliances & Chinin'eys . applicable to solid fuel,& vented gas appliances . , PA) _ 1 Date _e_, • 20 c"/ . . Permit No.', ., . i .. cp . . . Application is hereby made to the Building Codes Of/ice/or th-e,issuance qf a BitiOng anci Use ,. Permit pursuant to the New York State Fire Prevention and Building Code., The applicant 61.on'ner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that arepart of. these requirements and also will allolt,all inspectors to enter premises to perform required i 17:Speeli011:S". .. ;al . . • ., , , • --.' NOTE to applicant: . Rough-in and Final Inspections Are required. . . . . . Applicant Information , Fuel Burning Appliance Information . - • (circle appropriate words) NameArj . ., SiOVC: ' ' - wboar. coal : pellet Fireplace.insert• • - . , . 2 i 1),,,, Address:-, i c. i( k e LC'tre-- I YFtreplace, factor -built: . wood 1:::gki:s.,----3 . (..)•t,,, ,n.SV31,0 Li 10 t,1. j 7.-K\fiLl Fireplace, masonry:. ,wood : gas Furnace: . : wood gas, oil /- ,. , . , Phone: 61s., IN3-"i IN " . If non-masonary applioance, pleaSe prdvi, de . , . i .i /I. .-r- ,.., A") r . Owner:c-u-r t 4 -,v4f,A616.. /. d-o:Pf 4,ixeLL',e.."-:.-2-6, Manufacturer Name: r al 60• . . - , ,., ,• . . . , • • . 04 r, ki• 4: l'\'''.,'Y-A. r . • . Address:3i. Pei It ic' I Airci4! ' Model Number: 1 - , il) v • ..1.{,.'; R. :' ri / :\j 14. i-24_,) Lif . . . . ., • . . .., -Chimney Information . ' . ; Phone: (GiSP "iP LI').)-`-' 7 (circle appropriate words) Masonry block to t'„bAick sn.e. ' - . Flue • ' .,tilersVel,--)size:f inches . . Exact Address: 3/ p7./ iie iv I.4 rv... - - _. : . •.. . . .of contr n suctio or installation lafctory-Built • Manufacturer name: . . . . . . . Model Numbr:' Note: Listed By: ' Number: . Construction /Installation must conform io—NYS-Fire Prevention &Building Indicate (circle) chimney material: Code. Consult available Town of Queensbury „ Handouts regarding required inspections. Double wall 1 Triple wall / insulated / , Direct venting • Chimney Liner , - OCOLABLERICX*''SEN..,r1Piplzietaxxexat— Tcrsarix .a.frclkiace.oxibur3r 1%TexArr Ifeoz-lir 1 .. , Fire Marshal Code# S Collected S Refunded Received.front (re:landed to): • • 4,76-,-. address; — . 4 17$ 3389 (190) Public Safety ''''•fr C • - -•,-:-:;:, / .4 233 2655 (230) Minor Sales ./ , le f ' ''. • . .'-,'--- i ( • I. /.4", -Ity.ri-cae44.e. - 7r-It 4 1".. a.--24.02 White(Applicant) ; Green(Fire Marshal) I . Yellow(Bldg. Dept.) / Pink S.:Goldenrod(Cashier's Dept.) Ai CiTh9. —)M FINAL INSPECT N REPORT',. MOBILE :/ MODULAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 b Nak---- ARRIVE: DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME:'. i� 0 Al LOCATION:: $ a , ,- AA.I DATE: _ - �- A . PERMIT# ® 1 n 1 (p MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ .BACKFILL_ 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 5. heating crossover(dbl: 'de) off grd. vf_ dryer vented_outside — 7. skirting ventilated _ 8. hot water relief valve •ipin_ outside _ _ (' 7 eck, por es, steps, aili _ _ . 10. furnace/ho\\water ope at' g . — _ 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 oka — _ 1 Model # Serial # Manufacturer Date of.Manufacturer. 1 OKAY TO ISSUE C/O. ' YES . :NO " Comments: OK • z r v o p 1&IAA U �!b.r- i. k > ® . FIRE MARSHAL TOWN OF QUEENSBURY .a� QUEENSBURY, NY 12804 .:. :;,,yie" (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME 6//?._&Ai 27.0 LOCATION 31 ' 1e_ 7RMIT# �r .1/6 SCHEDULE INSPECTION ON .� -7A / AM PM APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYSTEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRINKLER" CLEARANCE TO HEATING UN'TS REQUIRED SIGNAGE CHIMNEY. - W WSTOVE (REPLACE •MASONRY FACTORY BLT. ❑ '.UGH-IN • FINAL REMARKS: ❑ OK TO THIS DATE 674i,_, akin �- INSPSLIP.PUB INSPECTOR FINAL INSPECTION REPORT MOBILE '/ MODULAR Town of Queensbury .. . 9 Buildin & Code Enforcement \ \ 742 Bay Road Queensbury, NY 12804 (518) 761-8256. . (( \� : ap ARRIVE: - . DEPART�,.1; ` INSP. DATE INSPECTION REQUEST RECEIVED: . NAME: . :ate - A _ O. LOCATION:• !. A �. DATE: --• 5 PERMIT Z.-0 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _,BACKFILL_ FRAMING N/A. ,. YES NO 1'. foundation support, pier spacing per manuf. — ® anchoring per mina 3. water line shut off ' 4. sewer line support @ 4 feet 5. heating crossover(dblewide) .o grd. dryer vented outside .... skirting.ventilated7 — 8. hot water relief valve pip -. ou .ide 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.)... .. 15. 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: /g/,5 ALL ,E - G K 16N'l to 57- %fy- {JR• d- c ) Aorg 4ii 5 01 FIRE MARSHAL TOWN OF QUEENSBURY c .. QUEENSBURY, NY 12804 •s , „ ` (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST RECEIVED NAME C-Al NRD e Lk LOCATION -g1 Phi --".?s. PERMIT# 0 l— ("`f4 SCHEDULE INSPECTION ON 12-5—1 6 tt AM PM APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTING FIRE EXTINGUISHERS FIRE ALARM SYSTEM FIRE SPRINKLER STEM FIRE SUPPRESSION SYSTEM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO SPRIN LERS CLEARANCE TO HEAT G UNITS REQUIRED SIGNAGE CHI NEY OD STOVE (REPLACE ❑MASONRY FACTORY BLT. (UGH IN FINAL REMARKS: ❑ OK TO THIS DATE PP.)U )kAii-/4 = /As - (:)A-) 6."6 4/R. INSPSLIP.PUB INSPECTOR I FINAL INSPECTION REPORT. MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742.Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: ... DEPART(.' INSP:J 1" DATE INSPECTION REQUEST RECEIVED: NAME /k U �2.ti0 tack-- LN/ LOCATION: l&N"-�VT 62 DATE: v Z� D Al PERMIT.# r?t `°q MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION _ BACKFILL_ FRAMING_ N/A YES" NO 10 foundation support, p`- .acing per manuf. /`: _ _ yanchoring per manuf. — 3. water line shut off :. _ . sewer line support @ - / — , 5. heating crossover (db •- off grd. gdryer vented outside`: _ skirting ventilated ... � 8- hot water reli• v: - p ping outside 9. deck, porches, steps, ra ling 10. furnace/hot water operat g 11. garage fire proofing 12. door closers — — — 13. plumbing fixture` — 14. foundation insulation (if •ppl.) _ — — 15. smoke detectors 16. final electrical _ — 17. variance required _ — 18. data plate okay — =- 19. mobile HUD seal okay _ — — Model # • Serial # Manufacturer Cc�r 0too5 . G[t Date of Manufacturer • OKAY TO ISSUE'iii--$60. v YES NO Comments:0 Ca i,•.(•3L�T"d-- 0L-42-i €A x°(LU Ate. Aisr/vu- 4skir,r/ 17a,f' 32 VC-Ai-7- A- R f,?c/C /i.co.4-c- FINAL INSPECTION REPORT 3 MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742.Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART-P. a )INSP: r' DATE INSPECTION REQUEST RECEIVED: 1 NAME: L9 O,,A A 1 4'iL 4- LOCATION: 1 V 7 R V 6° , lb DATE: 21' 1 G PERMIT.# C)I- d MOBILE HOME MODULAR HOME "-�j FOOTINGS FOUNDATION _ BACKFILL_ FRAMING_ N/A YES NO 1. foundation support, pier spacing per manuf. anchoring per manuf. \- 3. water line shut off //if 4. sewer line support ®4 feet ( 5. heating crossover (dblewide) off grd. I ✓ 6. dryer vented outside ..s / _ skirting ventilated _ 8. hot water relief valve piping o tside _ 9. deck, porches, steps,&ailing .... ... — ./ _ 10. furnace/hot water operating 11. garage fire proofing 12. door closers / 13. plumbing fixture 14. foundation insulation (if appl.).... . � / 15. smoke detectors / j 16. final electrical ' �1,(e.10......C..C'. — • 17. variance required - 18. data plate okay _ — 19. mobile HUD seal okay Model #Q(� S(QO .1n Serial# 11 670bxv Manufacturer 1.-V66'9,1 `k �J Date of Manufacturer L 1 V5-1 61 OKAY TO ISSUE C/O YE S 40 Comments: /.dig4 .. e. C1 A/to 49 5 4 z linrc, 124/iii4e 06.111T- /�J J�--4LL : ,- • . -., ,, _ ól- O4D : :TOWN OF QUEENS URY BUILDING & C T. 2001 REVIEWED BY F*,.,F.„. r‘,..)a,..„.., pA1 wLt , EE SBIJRY 'DATE ;2e) 11 iii�`' N®CODE ?I I IC Gi"i' r 21l-M a. . , d Z Z TOWN O 'C QUEENS BUD l?t tWL„G OEP, - 4 - Based on our limited examination . IA f a compliance•with our commAts s I " not be construed as indican.the a (���\, N /—�` < plans and specifications ar n full a m ) T To compliance with the code.P j . g G1 0 v 4 8 • 0 e if ;-1 cn - -:NOTICE ii9 KA C•nla3) E. X. 73 ::ANCHORING OF,MOBULE HO \ .: . ` cn FRAME I$ REQUIRED PER 14 .. 'F—i.. IFiCATI a ( IL . In ! T MANUFACTURERS SPEC o ,, 8 II L_ -� �' � 4 ' ' • 11% I,_-,--Ar;ff-- ea r. -,. :. ''' !It— IS " r-E2E i-I V ' ill ,,,..!.' . 21 : IS ! I P. ; $ P 6 )) r`- Ir mar' -Q �,. --0-- ^�1 V E p Si • o°.71 p ki x n_xr _ � o �' 7_ • q.z u. p § � nr r b% • _____ ,,, �,... N �73:. wl . ift ' ' ' � 11 co PIV ::.:7::4 gik--'. OA ti . ,7•_&;`' VI 4% i ?‘ tr "V 'S .q 0 f ,t1 * 1/4'7\,,,N.....,../:::......1) coo 0 snzva Na79 *,-q- TVri !C:TT n10 nn/nc.•en L`b -.-.---1' - 3 ( Lr----F. 3 --. e . N,., • ,......_.... . . . . . • , . .. 2S '*f s . 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