2013-393 - TOWN QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
401.
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130393 Date Issued: Tuesday, October 08, 2013
This is to certify that work requested to be done as shown by Permit Number P20130393
has been completed.
Location: PETRIE Ln
Tax Map Number: 523400-308-006-0001-061-000-0000
Owner: SAMUEL & VIOLA WAHNON
Applicant: TIMOTHY BOSLEY
This structure may be occupied as a:
Mobile Home In Park By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property - ay.0 ;gACt*--
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
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: P20130393 Application Number: A20130393
Tax Map No: 523400-308-006-0001-061-000-0000
Permission is hereby granted to: TIMOTHY BOSLEY
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
39 SARATOGA ROAD Mobile Home In Park $46,000.00
GANSEVOORT,NY 12831 Total value $46,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2013-393 Lot 15 Petrie Lane
MOBILE HOME 14' x 60' + 6' porch= 840 sq ft living space
Model 3LEW111349A Serial E6414-7007
$100.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,August 30,2014
(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 n of ens ;f1 , ugust 30, 2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
#•
OFFICE USE ONLY • ;
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TAX MAP NO3o • 4-,Eley�T NO. 13 3 `',3 DATE ISSUED• : 2 0 2013
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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: Tiv1/t 605be\--1 Name: cj1/14 Aqi-WeVU
Address: ea iSoy 15-sci Address: (3 C1 0 1
0, 110e; 14/(_s i ),',(, , 4
Phone No. 4-gC7,rr774c, Phone No. 7 2-W
Parcel Information
Proposed Date of Placement: 4s4)0 Property Location: ZIT/5-
( /5- 0 '1' / ' ak-ee
Road,Street,Avenue
Name of Mobile Home Park: at.e.u.41,LA-,'
},.‘//#'7,. .+pficable) Tax Map Number: 12.A— (e) —59
__.._.___......_..._---
Mobile Home Information�lZoning Information
Approximate Value of Home: $ 40600,D 0 Zoning Classification:
New Home: 49 No Size of Property: ft. by O ft.
Replacement Home: Yes m %O 1 • Existing buildings: try r_
Size of Mobile Home: It-I- ft. by (P ft.44c, Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: >( Doublewide:
Number of Rooms: (exclude baths) tp Accessory Building(s): circle
Number of Bedrooms:
Number of Bathrooms: ( Detached garage: 1-car 2-car car
Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Size & Depth Other:
Runners Water Supply: well or municipal
Slab Is Septic Permit Required? Yes or I_-)1---No
Continued on back
•
Town of Queensbury • Community Development Office • 742 Bay Road, Queensvury, iv I lag)*
99 13 --3q3
Name of Installer or Mobile Home Dealer: IYIe I��
Address: I i 14- 1t i 1 I " ' \ Phone: T7g T77c 2-D
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile hgme:
✓ Insignia serial number:
✓ Name of manufacturer:
✓ Plan Approval Number:
✓ Model or Component Designation:
(New home only)
• Date of Manufacture:
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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
c 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
5 shall be complied with, whether specified or not, and that such
work is authorized by the owner. y
r1
g- Signature:• /
$r Owner, Owner's Agent,Architect,cs?ntractor 5
...
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
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Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
We_A / -_ (1{`,, 1
Queensbury Building & Code Enforcement -- Manufactured / Modular Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart ` SD am/pm
Date Inspection request received: Inspector's Initials: ef,./(AD
NAME: i ,,n t� c1-`-3 1 l,� PERMIT#: /3- 3 93
LOCATION: / 5 PH-rt e Leone DATE: / U - ,),--1:
Manufactured Home
Modular Home
Footings_ Foundation Backfill_ Framing
Comments:
Yes No WA
Foundation support,pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off V/
Sewer line support @ 4 feet
Heating Crossover[doublewide}off grd.
Dryer vented outside
Skirting ventilated 1 sq.ft.per 1,500 sq.ft. 4
Hot water relief valve piping outside
Deck,porches,steps, railing
Fumace/hot water operating
Garage Fire proofing
Fire Door/Door losers V
Plumbing Fixture/3"Vent through roof[Modular] , ` ,
Foundation insulation gf applicable] - V
Smoke/Carbon Monoxide Detectors/Interconnected /„.
Final Electrical
Variance required
Data Plate okay
Manufactured HUD seal okay
Warranty Seal after January 1,2006
Installers Warranty Seal
i •,
18"x 24"access or 22"x 30"attic access
Vapor retarder under home 6 mil poly or other � )
911 Street number / 0 1`' "2 -Ct& -A (4 t(eIS4Z47
Okay to issue C/C or CIO[Temp_/Perm.] 9, /
Model# WA/L I I V011" Serial# ,.o It k- A_�c 1le
Manufacturer ......)Ai V 1t'!v`j
rnik
Date of Manufacturer el (2J2- I
L:\Pam Whiting\20101Building Codes Forms\Manufactured_Modular Final lnspection_03 04 10.doc