2009-590 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
E R.TIFI ATE CIF OCCUPAN
Permit Number. P20090590 Date Issued: Wednesday, February 17, 2010
This is to certify that work requested to be done as shown by Permit Number P20090590
has been completed. .
Location: PETRIE Ln
Tax Map Number. 523400-308-006-0001-061-000-0000
Owner. SAMUEL & VIOLA WAHNON
Applicant: KEITH LECLAIRE
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 (�Dj 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: P20090590 Application Number. A20090590
Tax Map No: 523400-308-006-0001-061-000-0000
Permission is hereby granted to: KEITH LECLAIRE
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 $70,000.00
GANSEVOORT,NY 12831 Total value $70,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2009-590
33 Petrie Ln- Keith LeClaire - 1680 sq ft mobile home in park
$75.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,December 11,2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at Town o e nsb,J� 6�Friday, December 11, 2009
SIG BY /< z. r� °, for the Town of Queensbury.
Director of Building&Code Enforcement
............................�:. -...........rw....../
/`�tC� / OFFICE USE ONLY = pi* .
TAX MAP NO PERMIT NO. DATE ISSUED:
PERMIT FEEY7S ROAPPROVALS: ZONING TOWN CLERK ' x / e, �! ' r
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MOBILE HOME -APPLICATION FOR PERMIT:
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a
valid building permit has been issued.
Applicant Information Property Owner Information
Name: Name: C Y
Address:
Address:
Phone No. � � I Phone No.
Parcel Information ) &ql
Proposed Date of Placement: Property Location: L6f 33 J44X4
Road,Street,Avenue
Name of Mobile Home Park: Ja�e,.(ifapplirble) Tax Map Number: "�
Mobile Home Information Zoning Information
Approximate Value of Home:$ j D� � Zoning Classfication:
New Home: Yes No = Size of Property. ft.by J v ft.
Replacement Home: Yes No = Existing buildings:,) n �
Size of Mobile Home: = ft. by ft . Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: Doublewide:
Number of Rooms:(exclude baths) ' 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: es No
Size & Depth Other:
ers
Runners ` Water Supply: well o municip
Slab = Is Septic Permit Required? Yes or No
_.._.. _....._._..__....___
Continued on back
Touln of Queensbury• Community Development Office• 742 Bay Road, Queensoury, iv x izaw
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Name of Installer or Mobile Home Dealer:
Address: 1 2 Phone: LZ- O l
Complete information below found on a'Plate"or'Sticker"which is affixedd to the mobile home:
✓ Insignia serial number.
✓ Name of manufacturer:
✓ Plan Approval Number:
✓ Model or Component Designation: �-
(New home only)
✓ Date of Manufacture:
AFFIDAVIT
V
J
J
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J
Town of Queensbury State of New York
Cc County of Warren
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I swear that to the best of my knowledge and belief the
statements contained in this application, together with the plans
5 and specifications submitted, are a true and complete statement x
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 y
shall be complied with, whether specified or not, and that such
work is authorized by the owner.
M
Signature:
J
Owner, wneFs en Architect, Contractor v
7 2
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SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
Town of Queensbury• Community Development O./j`ice• 742 Bay Road, Queensbury, NY 12804
FINAL INSPECTION REPORT
MOBILE- / MOOULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queens", NY 12804
(518) 761-8256
-
�
ARRIVE: DEPART:I TNSP: 14
DATE INSPECTION REQUEST RECEIVED:
NAME: CG r
LOCATION:
DATE: - PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS_ FOUNDATION _ -RAQKFII3. FFAMING
N/A _ YES NO
1. foundation support, pier spacing z
per manuf. ........................ — —
2. anchoring per manuf. ............... _ —
3. water line shut off ...................
4. sewer line support 0 4 feet ....... _ —
5. heating crossover(dblewide) off grd. — _ —
6. dryer vented outside ..:...................
7. skirting ventilated .................... _ —
8. hot water relief valve piping outside — —
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 Mors .. .
16. final electrical ... Q -
17. variance required ..................... — —
18. data plate okay ....................... _
19. mobile HUD seal okay ..............
Model# t) Serial# )
Manufacturer41fiv?
�� �
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments: A.
P t l°l
TOWN EENSBURY
BUILDING_ & 0 ENFORCEMENT
742 a Road
Queensb _NY 12804
(518)761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name �a G
Location v 1
33
Date fie
SOIL TYP : Sand 'Loam 1ay-
77�
Results of Percolation st-
(if applicable) Rate-Min a/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Le th
Length of each trench T
Depth of trenches
Size of stone
SEEPAGE PITS: Number-�
Size - ft. x �,
Stone size L
PIPING: Sizel I Type
B1 dg. to Tank -"" tA- 'i
Tank to Dist. Box7Partfa
Dist. Box to Field/Pi7VIo
Openings Sealed? te
LOCATION/SEPARATION Foundation to Tank \44,o� feet
Foundation to Absorption feet
Separation of Pits eet
Conforms as per Plot Plan ,"Yes/
LOCATION OF SYSTEM ON PROPERYW.
(circle one)
Front - Rear - Left-Side - Right Side
Middle Front -. Middle ar.-'-
COMMENTS:
SYSTEM.USE APPROVED: YES .,_.,.,...NO
Arrived: y"
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oiance with our
pt construed as ndi ling the
__.. an and specifi ti e in full
iance wi Buil ing Codes
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Lot #33
STOCK # 435
Glens Falls Mobile & Modular Homes, Inc.
(518) 798-2801 (fax) 798-2803
1304 Route 9 Exit 17N Gansevoort, NY 12831
601
13'-2" '•d•
tt
ISLAND 42
MASTER
DINING
SUITE RETREAT BEBEDROOM 'i4' PORCH
It
I M.BATH * e
till
1 ►µ7Rr 1
OR1f LYMiL1lI
y INCREASE WIDTH OF HAlL T*Pfurrow
® LIVING !
12' PORCI-i I ROOM SUN ROOM 1 f
BEDROOM#3
/
1
9'
Redman Homes of Ephrata, Pa. Model # A580SR 28X60
Aprox. 1680 sq. ft. Sweet retreat master bathroom
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