2008-559 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUP-A-NCY
Permit Number. P20080559 Date Issued: Tuesday, December 23, 2008
This is to certify that work requested to be done as shown by Permit Number P20080559
has been completed.
Location: III AVIATION Rd
Tax Map Number. 523400-295-018-0002-004-000-0000
Owner. IVAN & JANE BARSUKOFF
Applicant: IVAN & JANE BARSUKOFF
This structure maybe 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 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&Co nfo ent
PlanningBoard or Zoning Board of Appeals.g PP
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080559 Application Number. A20080559
Tax Map No: 523400-295-018-0002-004-000-0000
Permission is hereby granted to: IVAN&JANE BARSUKOFF
For property located at: 111 AVIATION Rd
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: IVAN&JANE BARSUKOFF
82 ROCK CITY Rd Mobile Home In Park $6,000.00
HUDSON FALLS,NY 12839 Total Value $6,000.00
Contractor or Builder's Name/ Address Electrical Inspection Agency
Plans &Specifications
2008-559
LOT 5 - 840 sq ft mobile home- Sharon Warren
$25.40 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,November 04, 2009
(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 Town of Que nsbury; F Tuesday,November 04,2008
SIGNED BY ' r for the Town of Queensbury.
Director of Building&Code Enforcement
/27 OFFICE USE ONLY `
TAX MAP NO. PERMIT NO �LI YS DATE ISSUED:
-�A PERMIT E ' P OV S: ZONING TOWN CLERK
/ -i -a--.--r r r r r r.r r r r r rr r.r r-r r
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: ' Aa 'L' bj eq i rev) Name: `.�-1dG�•� a—"
f
Addre s: 17 Address:
Phone N � ��� � Phone No.
Parcel Information
Proposed Date of Placement: i.,'r Property Location: "
e'' ,Skc dam} '`f `` Road,Street,Avenue
O�ir1
Name of Mobile Home Park: if applicable) Tax Map Number:
: .......................................................................................................................................................................... .........................................................................................................................................................................
Mobile Home Information Zoning In ormation
r
c
I Approximate Value of Home: $ / / Zoning Classification:
New Home: ❑Yes 1.1r� Size of Property: ft. by ft.
Replacement Home: es ]No Existing buildings:
I Size of Mobile Home: {T ft. by ft. Setbacks: front yard ft. rear yard ft.
side yards ft. and ft.
Singlewide: Doublewide:
I Number of Rooms:(exclude baths) 3 Accessory Building(s):
Number of Bedrooms:
Number of Bathrooms: Detached garage:❑1-car ❑2-car ❑ car
❑Gas Fireplace]Wood Fireplace Attached garage: ❑1-car ❑2-car ❑ car
Foundation Support: Storage building: es ❑No Y
Type Size & Depth
Other:
Piers
Runner Water Supply: ❑Well 4llunicipal
Slab Is Septic Permit Required? Wes ❑No
i...................................................................................................................................................................................................... ..
Continued on page 2
Town of Queensbury • Contnninity Development Office • 742 B(c y Road, tteenstntry, iv r izou4
Name of Installer or Mobile Home Dealer. tD L^�ee�/ J1,461
Address: Phone: � "l
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ . Insignia serial number: �)— a I �� C
✓ Name of manufacturer:1 KYI..Tt 0
✓ Plan Approval Number:
✓ Model or Component Designation:
f "I
✓ Date of Manufacture: -/ (New home only)
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, w s cified or not, and that such
work is authorized by a ow ;?
Signat re:
Owne wner's nt,Architect, Contractor
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforceme fficer
j
',u� Town of Queensbury • Community Developme ' office • 742 Banij Rona, ueensbury, NY 12804
L�FINAL INBPECTI rREPORT
MOBILE / MC304JLAR
Town of Quawnbury
130king & Code Enforcem"
742 Bay Road
Queensbtxy, NY 12804
(518) 761-8256
ARRIVE: DEPART-—DJNSP�_
DATE INSPECTION REQUEST RECEIVED:
NAM: kA
LOCATION: A-A\JX1
DATE: Z (0 PERMIT#
MODCMAIL HOME
MOBILE HOME
FOOTINGS— FOUNDATION — BACKFUL FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf. ........................
2. anchoring per manuf.. ............... Yo
3. water line shut off ................... e
4. sewer line support 0 4 feet .......
S. heating crossover(dbleuide) off grd.
6. dryer vented outside ..,z...................
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. dock, porches, steps. railing ........ z
10. ftirnace/hot water operating ........
11. garage fire proofing ..................
12- door closers ...........................
13. plumbing fixture ...................... V
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#2Xt(,P6-715T
Manufacturer
Date Of Manufacturer
OKAY TO ISSUE CIO NO
Comments:
FIIV` L INSPECTION RE .J
AIA-1-
MOBILE / MOOLILAR
Town of Ouemsbuty
Budding & Code Enforcement
742 Bay Road
Quemsbury, NY 12804
(518) 76141256
ARRIVE: DEPART:t.�I MSP:
DATE INSPECTION REQUEST RECEIVED: d10
NAME:
LOCATION: _ , 1 J
DATE: 2MIcK PERMIT# - SS
MOBILE HOMIR MODULAR HOME
FOOTINGS - FOUNDATION - tRACKFUL ____ FRAMING
NIA . YES NO
1. foundation support, Pier spacing
per manuf. ........................ V/
2. anchoring per manuf. :..............
3. water line shut off ... ...
4. sewer line support 0 4 feet ....... _
S. heating crossover(dblewide) off grd.
dryer vented outside ...;...................
7. skirting ventilated ....................
8. hot water relief valve piping outside =
deck, porches, steps, railing ........
10. f umceAx t water operating ........
11. garage fire proofing .................. —
12. door closers ........................... —
13. plumbing fixture ......................
14. foundation insulation if
15. smoke detectors .......................
16. final electrical ........................ -
17. variance required ..................... y _.-
18, data plate okay ....................... _
19. mobile HUD seal okay .............. —
Model # Serial#
Manufacturer
late of Manufacturer
YJ
OKAY TO ISSUE CIO (YN0_1
Comments:
N6'� -
�, v�t c�Leh
on&
FINAL INSPECTION Repop:IT
MOBILE / MCOULAR
Town Of Queensbury
Bufting & Code Enforcement
742 Bay Road
Quomsbury, NY 12804
(518) 761-8256
ARRIVE", DEPART INS
DATE INSPECTION REQUEST REECE11
NAME:
LOCATION_ ,11k
DATE: PERmrr#_D?,
Moslizi HOUR EKILAR HOME
Foo'nNGS— FOUNDATM_ RACKFW.L_ FRAMING_
NIA . YES NO
1. foundation mq4xwt, pier VW1"9
per mand. ........................
2. anchoring per manuf. ...............
3. water line shut off ...................
14. sewer line support @ 4 fed .......
"'5* he�tg= r' off grd.
vented outside
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. deck, porches, steps, railing .....
10. fiuuace/hot water operating ........
t 1. garage fire proofing ..................
12. door closers ...........................
13. plumbing fixture ......................
14. foundation insulation (if appl.)......
15. smoke detectors .......................
I& final electrical ........................
17. variance required .....................
18. data plate okay .......................
19. mobile HUD seat okay ..............
Model# Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE CIO YES -_A/NO
,A c.,to
(/0
C7�
NOTICE
ANCHORING OF %A-91Lt H,
FRAME IS REQUIREU pt.R
S
MANUFACTURERS SPECIFICATION'S f'OVVN Of- QLJE
BUILDING &
Reviewed B
Date:
(SOPY
60
TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full 4.
compliance with the Building Codes of
New York State.
5 111144