2000-735 TOWN OF OUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 161 -8201
Community Development - Building & Codes (518) 7614256
CE. x IFICATE OF COMPLIANCE
Permit Number: P24400735 Date Issued; Tuesday, October 17, 2000
This is to certify that work requested to be done as shown by Permit Number P20000735
has been completed,
Tax Map Number. 523400-121-000-0006-059-002-0000
Location. Petrie Ln
Owner. SAMUEL & VIOLA WAHNON
DAVID LAPELL
This structure may be used as a:
Mobile Home In Park
By Order of Town Board
TOWN OF QUEENSBURY r
Director of Building & Code Enforcement
TOWN OF QUEENSBURY
Et 742 Bay Road, Queensbury, NY 12804-5902 (518) 761 -8201
Community Development - Building & Codes (518) 761 -8256
BUILDING PERMIT
Permit Number: P20000735 Application Number: A20000735
Tax Map No. 523400- 121 -000-0006-059-002-0000
Permission is hereby granted to. DAVID J LAPELL
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. TVUe of Construction Value
Owner Address: S.AMUEL & VIOLA WAHNON Mobile Horne In Park 8,500.00
39 SAR.A.TOGA ROAD Total Value 8,504,pD
GANSEVOORT„ NY 12831
Contractor or Builder's Name 1 Address Electrical Inspection Agency
GLENS PALLS MOBILE HOMES, INC. NEW YORK BOARD OF FIRE UNDER
39 SARATOGA ROAD
GANSEVOORT, NY
Plans & Specifications
2000-735-LOT 6 PETRIE LANE
14' X 70' MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
$35.00 PERMIT FEE PAID - THIS PERMIT EXPHtES: Friday, October 11, 2002
(If a longer period is required, an application for an extension must be made to the code Enforcement Offleer
of the Town of Queensbury before the expiration date.)
Dated at the Town of sbury; Wednesday, October 11, 2000
SIGNED BY for the Town of Queensbury.
Director of Building & Co of enient
Application for Permit — Mobile Home
Town of Queenshury, 742 Bay Roac4 Oueenslrury, NY 12804 (fq -42w b
A building permit must be obtained before placement of mobile home on parcel, Nc vfpajti&rybelYbe made
until a valid building permit has been issued.
Applicant Information
Oj
�},,`'{ ^�
Name: T V1 File Permit1
Address' ! fcs •--rr IFJ�+� -ssr-'
Fee Paid Coco - 0 p
Reviewed By3�
Phone No- . 5):L -T4S— (�`' I
Property Owner Information Parcel Information
Proposed Date of Place ent:
Name; � ,,.�..�P ,r
Property
Address L ocati c9
Road, Street, Avenue
Name of Mobile Home Park
=
(if applicable)
Phone No. Tax Map Number: _ C
Mobile Home Information Zoning Information
Approximate Value of Home: S c
�� -y Zoning Classification:
New Home: Yes
Size of Property: ft- by ft.
Replacement Home: es No
Size of Mobile Home: /Yft. by Z� ft. Existing buildings:
Setbacks - front yard ft. ; rear yard ft-
Singlewide: �__ Doublewide: Side yards ft. and ft.
Number of Rooms : (exclude `Z
ud baths) _
Number of Bedrooms: Accessory Building(s): circle
Number of Bathrooms : u/
Detached garage: 1 car; 2 car, car
circle: Gas Fireplace / Woodsto / Wood Fireplace Attached garage: 1 car; 2 car, car
Storage building: Yes No
Foundation Support. other:
TYPE SIZE & DEFT[ 'Water Supply: well or municipal
Rnxu er� Gj x
Slab is Septic Permit Required? Yes or No
x
Further information requested on the reverse side of this sheet W
Name of Installer or Mobile Home Dealer: + +� t r ; ' lw'
Address:
Phone No. STE 7q t72C3 V
Complete information below found on a "plate" or "sticker"'which is affixed.to the mobile home.
1 _ Insignia serial number: Z T f
2_ Name of manufacturer:
3 . Plan Approval Number :
4. Model or Component Designation:
(New Home 0ATL)q
5_ Date of Manufacture:
_.__---_.............._ AFFIDAVIT
...�_
Town of Queenshu y State of New York
Counter 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 BUQ.DING 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_
Suture: a;.;
er, er's agent, architect,. contractor
Special Conditions of Permit
By:Form 1 111911999sh Code Enforcement Officer
1 'irt 1l :tt'slial 'ti C) Ifie'c To%■ 11 01 Cluce ri5lrr c i . '42 '" I�uutl. Qtt>•cliSlrm-y4 N
{ 51fi1701 -82 O -
Application for Fuel Burning Appliance & {Chimneys
f C applicable to solid fuel & vented gas appliances
Date 20
f
Application is herehl- rrrrfrle to llre 13trildifrg � ['r+cic .v C?!{iri lr,! tlrc•"cruir V rr r+ rrr.5 Cr,rN. ie:%4r7ttuc uc' rla 1tai1lirg rtrl Lsc
1tst Slate c,ppllicrrzt rsr n urrc +'
agrees to ccrrrrnly tr'itlr all applicrthle /a,vs, 0rvlw rill ccs, :3 '. 'zrlcrlitJrr.s, ct,r,l <rll t nrrrlitir�+z.c Owl are pw t q/
tJrc,;e^ re>grrirc-rtrerrls ctrrsl also will eiHow (,111lrS�TCCtrJr',5' 10 "Ile)-
NOTE to applicalit : Rough-in and Final Inspections are 1-egUIred .
A13pllicant Inrormation Fuel Burning Appliance lttforrix,itiota
j ( circle appropriate words)
r'.xnxe: � 5'� L 'l _.,.� t � Stott e: W0041 coal Pellel grrs
I Fireplace insert
Address : INFit'e}xl<ICe, 11,900 gas
Fireplace. masonrv: ycrs
Furnace: lt>aoel gasoil
Phone:
lt' IIQII-Illasonary applicance, please Provide
Owner: _.___„__.___•, � !r� lM� __ - 1'lai3itfacttrrer ?wat7xe: �F ���r �.lk`y�� � . i #.��Ili Address: Model \'iimtxer:
�,.�::-r�:. ' C.-� t'-�r,'C:-. ,,.:� 3-C t M e�-�,'w:. 's�� �,.E k1a:�t.•II�
Chimney Information
Phone: (.' irc�Ie appropriate n cards)
Masonry block brick srone
Exact Address : Rue file steel sire,- inches
�
of Corr strtr criq,u or in srallatiurr Factory- BUilt
Manufacturer name:
Model Number-:
Vote: Listed F3v: �,., IVtiixxber:
Corrstr•rrctiota / Irrstttllcltiarr must
CflFT ores to tAVYSSFire pret.•errriolt & B eililirrg Indicate (circle) clxirxxtxey material :
Cocle. Cotrsult cructiltrlaie To11vrt ofQueeitsburtr
f HfMclotlts regarding recli red ttrsj,,Tectlons. Double u•ull 1�r'ij+?t° ��-rtll / Irra rtl<t!c^rl / Dr+'c•c'I a•t^rlfurs a
C lrinrnei Lirrc°+' {i
j .P cr-f <�OXX'0*�=ZXrRNN!b'uYiW�r .1g7;�zisr• ;�''vz-mac i
F�irc :ltar'sirrrl C`c,rle � ti C-'r�llE�cr�•rl 4 h'e�lirrrrlerl Hcr's^i i fi-r,r+r Ir•c�Jrrnrl�•rl rrr �� -. fJ
w
UCHirrlrl, E•s t : 1
j A 173 3.389 (190) f'zrblic Saf rr --
-1 133 6-5-5 {730) Alias)• Sale,s
While (Applicaw) Greelt ( !`ire Marshal ) 1'rlicr��� ( l3icfg. Ile}�E . 1 !'ink (Cashier's l7clx.)
i
I�IIVAL IIV'BPEGTION REPQFIT
MQ�ILE / MOQIJLAR .t W�
Town of Queensbury
Building & Cade Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE: I}EPART:� INS --
DATE INSPECTION REQUEST RECEN
PIDATE:
a
�_ PERMPAr"'��
M01MLE HOME MO>DULAE HOME
FOOTINGS . FOUNDATION � I3ACKPU.L � FRAMING
NIA YES O
I
. oundation support, pier spacing
per rnanuf, . ... .. .... . ...nchoring per manuf.ater line shut off .... .. .ewer line support 0 4 f eating crossover (dble ) ,o + god ryer vented outsi ..kirting ventilatedot water relief valve p ing outsideeck, porches, steps, iling .. . .. .,arage fire water ope tmg +arage fire proofing .. .00r closers . , . . .. .. .umbing fixture . . . . . .. . . ..nnndation insulation (if 1 .) .
15. smoke detectors ... . —
15, final electrical
17. variance required .. .. .... . . . . . .. .. .. ..
18. data plate okay
19. mobile HUD seal okay . . . .. .. .. .. .. .
Model # Serial N
Manufacturer
r Date of Manufacturer
L OKAY TO ISSUE CIO YES N£7
Comments:
r�rnr.ara. rnrsa,�crronr a�pairgr
Town of Queensbury Cam`
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 76141256
AKRIVE ! DPPART:; IRIS
DATE INSPECITON REQUEST RECEIV
NAME: `
LOCATION:
i
DATE: P rr #00 " 73,C
MOSILE MOME Mil LAA DroMg
FOOrrI M FO[INDA7IQN BA
FRAMING
i
I . foundation NIA YES NO
st>ppo'l-t, peer Spacing
per nunuf . . . .. ... .. .. .. .. . . .. .. . /
2. anchoring per f. �C 3. water line shut off'
4. sewer line support 4 feet
S. heating crossover ( ewide) off z
6. dryer vented outside
7. skirting ventilated
8. hot water relief valve .ping ou do ---
94 deck, porches, steps. 'ling
10. furnace,/hot water opera
l J . garage fire proofing . .. .. . .. . .. . .. 5..1-PiPL. --
12. door closers _�
13. plumbing fixture
14. foundation insulation (if a ).. . . . .
15. smoke detectors ... .. .. .. . . . .
16. final electrical I.. ... . ..
1 , variance required . .. .. .. . . .. . ..
18. data plate okay . .
19. mobile 13[JD seal okay , .. . . . ., ..
Model # Serial
Manufacturer
Date of Manufac � �
OKAY TO I C/ O
cz
COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC
Main Office 176 Doe Run Road - Manheim, PA 17545
MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
Panel Board
No...
. No....h,/. .. ! . :.......................'................... Cut-in Card No��........... .... ..... . ND 0
Owner.............
Locationf07 & .....................,,r......... ......................... ...
- .. . iiW #a — [ 44f:......... ... .. ....... . ............................................................
.....
Inszallation {'onsisting of....l ? . . '{ l/ CC'[r� Ii°k'GZ/v. ...0.............. .. . .. ....._....._....................._......_................
.............................................................. .....................................................................................................
................................................. ............................_„,............................,,...,,...........................,..................._............
Installed By. l......,,t.!..L tc�� ...L!r+ .!T'I"+......... 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 MSPection.
Inspectors of this Company shall have the privilege o£' makloix inspections at any time, and if its
rules art! violated, the Company shall have the right re
ke t c tific z e- (�
❑aze.f.. ...:~. ... . .,'�.............. INSPECTOR ..r!�.
Memher N.FPA., LA EA.
IPIIVAL IIVSPECTIOIV FkZ1M l3M1r
MC3WILE / MC3C3ULAA
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804
(51 $ARRIVE. DEPAR IL u INSP:4
DATE INSPECPON REQUEST RECEIVED: -- {
NAME: / C Gam- L'( V be/}N47 .�¢
ell
LOCATION: F
DATE: �`d PERMIT # r
MOBILE Homy- M0D1tjLA1R OUR
FOOTINGS FOUNDATION � SAC:KFi FRAMING
N/A YES NO
I . foundation support, Pier spacing
per manuf. .. .. .. ... . . .. .. .. .. .. ... _
2. anchoring per manuf. .. .. .. .I.. . . ..
—
3* waterline shut off
4, sewer line support a 4 feet .. . . —
5. heating crossover (dblewide) grd. —
6. dryer vented outside .x. .. .. . . . .. .. .. .. . _ — —
7. skirting ventilated . .. . ... . .. .. .... —
8. hot water relief valve pipin outside
9. deck, porches, steps, rail . . . . . ..
10. furnace/hot water opera _
11 . garage fire proofing 0 . . . . , .. . . .. . — — —
12. door closcrs ... . . .. . .. .. .. .. .. .. .. .. . _
13. plumbing fixture . . . . . . — — —
14. foundation insulation f appl.). .. .. . — _ —
15. smoke detectors . .. .. .. . . . .. . . .. .. .. . _
16. final electrical . .. . . . . . . .. .. .. .. .. _
17. variance required ..... . . . . .. .. .. .. .. —
18. data plate okay — — —
19. mobile HUDokay . .. .. . . . . . . . .. — — —
Model # `- Serial # 2 }
Manufacturer t -- —
Date of Manufacturer �-
OKAY TO ISSUE CIO 'YES NO
Comments:
�} 0 �
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i
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L L SC�MATER R L SEMMO r'eO4"a�" ' L L L III- L. L L.L 1.
_ LLLI � _ LL NO i_ l_ 0" _. Lrrr
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I I
THIS PLAN ON TOWN OF GNU EI-VISBURY
PROJECT SITE AT BUILDING & T.
ALL TIMES FOR REVIEWED BY a
THE DURATION OF DATE
CONST"PtoCTION
TOWN �� TIER�t vBUR? ?: '. ii o � CEFARTh�t:
teased on our iimI examination,
cornplianc:evwith our comments shall
not be construed as indicating the
Plans and specifications are in fuY
wct compliance with the code.
i an* IS REQUWIM FM
"' _ 2000
/ 3c�
a
S 2000