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2005-197 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 4E Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20050197 Date Issued: Thursday, July 28, 2005 This is to certify that work requested to be done as shown by Permit Number P20050197 has been completed. Tax Map Number: 523400-308-006-0001-061-000-0000 Location: PETRIE Ln Owner: SAMUEL & VIOLA WAHNON Applicant: RODNEY & SHELLEY DURKEE 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 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: P20050197 Application Number: A20050197 Tax Map No: 523400-308-006-0001-061-000-0000 Permission is hereby granted to: R0DNF,Y& SHF,I J.F.Y DT 1RKF,F, 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. Tie of Construction Value Owner Address: SAM UEL & VIOLA WAHNON 39 SARATOGA ROAD Mobile Home In Park $45,000.00 Total Value $45,000.00 GANSEVOORT, NY 12831 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2005-197 LOT 53 PETRIE LANE RODNEY& SHELLEY DURKEE 28 X 40 SQ FT 2005 MOBILE HOME $42.20 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, May 05, 2006 (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 T n of eens u day,May 05, 2005 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbwy, 742 Bay Road, Queensbury, NY 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 Office Use File Permit No. Name: 900A)6V 151 if Address: S3 Dv4j�5 64,t 64 al%p Fee Paid Reviewed By: t Phone No. Property Owner Information 47r� Parcel Information Aj CfF QUW 090— of Placement: �?,9-P?co iilw'p, Name: k Property Location: LuT —Ire f- LYV Address: Ro4 Shrer Avme Name of Mobile Home Park: rzf applicable) (40 Phone No. Tax Map Number: Mobile Home Information Zoning Infonnation Approximate Value of Home: $ Zoning Classification: New Home: es No es Size of Property: ft.by ft. Replacement Home: es No Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard (4-,,C', f L rear yard zkicft. Singlewide: Doublewide: Side yards 2,C &and 2--c-) ft. Number of Rooms: (exclude baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: I car, 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: , 2 car, car Storage building: Yes No Foundation Support: Other. TYPE SIM&DEPTH Water Supply. well or, aly Piers x Runners << x Is Septic tic Permit Required? Yes or Slab x Further information requested on the reverse side of this sheet W Name of Installer or Mobile Home Dealer. t oez - Address: > Phone No. Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number. %j) o C) 9 -7 (P 2. Name of manufacturer '�''��� 3. Plan Approval Number: 4. Model or Component Designation: (New Home OMY) f C �JC 5. Date of Manufacture: -� 'L 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: �owner,owners agent,architect,contractor ------......__........................... _..._�_ Special Conditions of Permit By Form: 1 r/19/1999sh Code Enforcement Officer NO.558 903 11.01 GLENS FALLS MOBILE & MODULAR 4 7454437 ' � f�� f( — $ -rI� l0 1 �.___,__--- D�R-��,ate�S�5 iG—w... •. ��Ico�1VI�'L 7>f T�4-C�� P,I6.4 �KEIVED OF QUEENS13 RY UJ fA f� • Q o "I ha4seen or observe ,or bi lieve I saw evidence of, all objects such as hoes s,rvel ,trees,fences, etc., t shUwr� on this doctamen I also represent that t have pe soa it measured th dista es set forth on the diagram." S(GtVATIi DAZE L o Al uamdQTenarr SlTiinnmll^ tni ns,s. r► ��n rv- �-.�_ Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1 OWNER INFORMATION: ................... .............. .................. Office Use Location of installation: L dri "!�S A e a V,L . Tax Map N0308 P I 0 File Permit No. Fee Paid Owner's Name: �.4 Im �(1/}kk A) ................. ................................................................................. Address: 6,4,J5;&V6012F 41� 2. INSTALLER'S NAME PHONE NO. 73 t?dl : 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s) and multiply#of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980- 1991 x 130 gal/bdnn = 1991 —present x 110 galfbdrm = 3 3 0 Garbage Grinder Installed yes no Spa or Hot Tub Installed yes— / no�z 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Too izra-ohv SaiLNature Ground Water Bedrock orl=ervious Material P. ater Supply Flat ' sand at what depth at what depth (nunicipal -RWing loam —feet feet we7T -' Steep slope clay if well; water supply %slope other from any septic-system depth: absorption is ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool Tub. Septic Tank: gallon(min. size 1,000 gal.) Fie,,4-T7 6AJ 0 (E�>C/-0 Tile Field: each trench ft. Total System Length: Z>D 1 pj Seepage Pit(s): number ofL_ size of each: ft. by ft. Size of Stone to be used: # depth or thickness feet Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: f Size of each:_gallons TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a material fact or circumstance known by or on behalf of an applicant, shall be void. I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. C-D Signature of responsible person Date ,',twit •tit" �Z�tt;��t:salnii•y Srwt:r;r stt:tl 5c:wsi�;e I)i:tt>tr::tl (:1tst�itrt• - Appmidlx ;.SP,'PAltNl'l0N tZI��.Z�liltt�ltill+:I�3'l`;; y • Z .7. �� �► 1 poNp Y'lELt_ IN tl�%TX'ik- ... .fit lt'1A4 , ry rrrat.v Rohr) ?, SlaNA►'TURE &INFORMATION I = VVN;sloj r-rr-awv►.\y„an.v...».:; , ULENS FALLS MOBILE & MODULAR a 7454437 N0.558 D02 A.ppucatfion for Permft Septlr Disposal Syt rt(t f��- Town ofQueensbury 742 Bay Road OueewAury,NY 12804 (S19)161-8256 j i- OWNEIL xNFORMAT ION: L of �.f ;. UL , µ m_. Office USo Location of iustaU.aCion: � _ r Tao Map No3°S•O� � ! fP 1 Fj,lc Pe�Onit 1�0.� 1��'___.`_✓"� Owners Natnc: &A >sae Pe!d Address: _ 3,-W 2T gi /l/ 4 _,�. .. ..��.... . . ._ ...a 2. INSTALLER'S NA.No (r PH6NE NO, 7 3, RESZE> sZKC.E YNFQRUATION: (circle year of dwclling,Indicae#'bedmam(s)oixd n u ciply Y#of bedrooms with applicable gallons pier bedroom to oqual total dullyflow) Y=Af Hnuse• No.of�ed�rgo x ComnutatiOn 2t �ota3 DSi1V FIoW 1980 or older x 150 gallbdun = An '''"L ION 1980—1991 x 130 g%Mdrm = 1991—present 3 x 110 gal/bdrm '� o ckrb"P Grinder Tastailed Yes— no .M AY Spd or Hot Ttib Installed yes TOWN OF QUEENSBURY 4: PARCEL IlVFORMATION: (circles lieablo iiltormadon do Indic ate mea8iaetnerxts) I @I G ANQ,CODE s9axa-umn Qmuw Wow klmajgj srYnd at what depth at what depth uRicf a laa�rt e we r S'tagp Slope clay — tf welh water Supply _,_9S siopa other from any Septic-sySyam depth: absorption it ft. other r Pacalntioan Tess: 1'1'o be corrtpleted by 1ice�sPd professional engistxcr or as+ehiteCr) , Rate' _ minute per inch 5. PROPOSED SYSTEM: Tbr mrw Action: All inQividual scwaea disposal systems mast 6c desiignad by s liccnscd profeaStonal cbgiA,eer ar azrl►itaot(usiless Axstallnd to a Ptomaine 8aard agptored aeYbdivisian). Add 250 galleas to ebu sizr of*-septic ttak sad leacb field fbr oath Gubage G4,dr4 Spa or Wlrirlpooa Tab. 6ycr0Txi,vco Septic Tstale gallon(mix.Am 1,000gat) Tile Field: each trench__ ___ Total Systeui L=Wft size ofea� Size�f Stone to be used' 'rp /depth or diiAna= Bad SY&UM Size: x .Altcmxuve Systeaa• length and/orstre �. HOLDINO TANK SYSTEM: ('tf Tcquirtd) Number of tauten: f Si c of OWL— -gallons t ToTAL CaPaaty: gallons Note: Alm=Systcia and associated electrical work must be ingested by a Town approocd clectxioaI inspcotion agency. 7, SICI'NATURE &INpORMATION FOIL RBSPONSMLE PERSON(pleasr,rrad) )For your protectj=.pleaSe note tjW pursuant to Secuao 136-29 oflthe Code of the Town j of Queembury,an-y petunt of 0pproval granted which is based tgPo6 ox is granted in z elisaoc upon auY material uAarepiesantAtionid s Crar tkilttre to make a 2$atc7 iAl fact or circumtance lmown by or an behalf of an applicant,sball be.v ` I have road the xc clatioas een�sb t to ibis opliamaicu and 3anitary Sewage Disp° :tip abide by ssl brdizix+nac_these and aL[ requiremc �-- Signature of re*Potlslble person Date Queensbury Building & Code Enforcement - Residential Final Inspection cWentJ112"- Chimney Office No.(518)761-8256 Arrive: am/p art:Date Inspection request received: -7 `? Inspector's Initials: yNAME: J t1 PERMIT#: , ,l.— LOCATION: `j (f ,rDATE:TYPE OF STRUCTURE: oe , ComIVI Y N NiA Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof minimum 6" Roof Co lete/Exterior Finish Complete Guard 30 in.or more @ stairs,decks,patios Guard at stairwell at 34 in.or more Guard at deck,porches 36 in.or more Exterior Finish Complete Interior/Exterior Railings 34 in.to 38 in. Platform at all exterior doors Interior Handrails stairs 2 or more risers Enclosed Stairs Sheetrock Underside minimum ''/2" Gypsum Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 ft. or within line of site Oil Furnace shut-off at entrance to furnace area FurnaceiHot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Tern 110 Interior privac. /trim/doors/main entrance 36 in. Bathroom I Kitchen waterti ht Safe Pzui_/Window in stairwells safety lzin Interior Smoke Detectors: Every level: / Every Bedroom: v _ ` Outside every bedroom area: Inter Connected: / Battery backu Carbon Monoxide Detector Bathroom Fans,if no window________,__ Plumbing fixtures Foundation insulation Floor truss,draft sto in finished basement 1,000 sf Emer enc a Tess below rade Basement stairs closed rise>4 inches Garage Floor Pitched_____________ Gara a fire roofin /'/.hour fire door/door closer Duct work Sealed ro erl Gas Logs in Seated or Glass Enclosure AtticeCC—a ss 30 in.x 22 in.x 30 in.(ht.)In accessible area Crawl S Daces 18"x 24" access, 1 s . ft.-150 s .ft.vents Buildin No./Address visible from road Final Electrical Site Plan /Variance required Final Stove Plot Plan As Built Se Dtic S stem/Sewer De t.Ins ection Sticker Flood Plain Certification,if re uired Oka to issue C/C or C/Of Tem orar /Permanent L:\PamW\Buildinq,&CodeS`\Inspection Fortns\Res.Final Insp.form 2.docLast printed 2/12/04 L INSPECTION REPORT OBILE / MOOULAR NA R Town of Queensbury f�, �� r►— Building & Code Enforcement 1 742 Bay Road Queensbury, NY 12804 ] 1'5 ,r (518) 761-8256 (-1 ST ' ARRIVE: DEPART:I A�cv_INSP: Oak- DATE INSPECTIONREQUEST RECEIVED: ` q p NAME: t.Ar Pe LOCATION. l W J J�`�b�elo�6 1e DATE: f4i. 7/ (l aS PERMIT#0 MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFU.L_ FRAMING_ N/A YES NO 1. foundation support, pier spacing per manuf. ........................ — — anchoring per manuf. water line shut,off ................... . — _- 4. sewer line support ®4 feet ....... — 5. heating crossover (dblewide) off grd. _ 6. dryer vented outside ...................... 7. skirting ventilated .................... — 8. hot water relief valve piping outside f deck, porches, steps, railing ........ — — fiunace/hot water operating ........ _ 11. garage fire proofing .................. 12. door closers ........................... — 13. plumbing fixture ...................... _ V%/, _ 14, foundation insulation (if appl.)...... — — smoke detectors — — — final electrical .. �`L� r... 17. variance required ..................... — 18. data plate okay ....................... — ; — 19. mobile HUD seal okay .............. Model #—:ZA kO I Pr Serial Manufacturer N.:�- _ - Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments:e-r'�Lpers 4V"%-- T2fZ�7 C�NA WAX FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256/jam ARRIVE: DEPART: INSP: C DATE INSPECTION REQUEST RECEIVED: NAME: V2�/L U LOCATION: \ DATE: �D I.� PERMIT 465147 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 (dblewide) off grd. — — 6. dryer vented outside ...................... 7.. skirting ventilated .................... - 8. hot water relief valve piping outside 9. deck, porches, steps, railing ....... ,10. fiunace/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#V)c Manufacturer h-SA-R-j Date of Manufacturer 0�- OKAYY TO ISSUE C/O YES NO Comments: �� Lf c ��t i v Septic Inspection Report Office No.(518)761-8256 Date Inspection request received: ' Queensbury Building&Code Enforcement Arrive: am/p epart: 3 am/pm 742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: )M NAME: )11(,� PERMIT NO.: � 51 LOCATION: �� =� "� RECHECK: INSPECT ON: _ ` Comments and/or diagram Soil �erMpnicipV/ ay r. T Well Water A-TG4A-j 1 DA-) Waterlines ararion istance $. Well separation distance ft. �I�. Other wells: ft. ''�.Dpw n-, Co P 7— Absorption Field: Total length ft. Length of each trench ft. � -Depth of trenches ft. Size of Stone Seepage Pits: Number Size: .A Stone Size- Piping Size Type Building to tank Tank to Distribution Box Distribution Box to Field/Pit L Opening Sealed: Y/N/Partial End Caps Location/Separations Foundation to tank ft. Foundation to absorption ft. Separation of Pits ft. Conforms as per Plot Plan Y N -Engineer Report and As-Built Y N Location of Syste on Property: Front �ar Left Side Right Side Middle ront Middle Rear System Us4Stas: pproved Partial Approved and needs to be re-inspected, please call the Building&Codes Office Disapproved Last revised 1/6/05 oo r f � s TYPE0D 'srockADE, TAINED By �RK 9C AWN-- Jz Do l *53 Durkee / �a,( ! 1 / 9s.8 . / Q• h )y jb�C' o J Tv ���� �o CfL�.9 L`9N�S rys• 75• �.R.F �o°w S J to N & GF I ! O �RrI��gNC `, � of BUIL rOo�r AND Q�EENSBURY GSOr CODE EN �UROEMENT 742 BAY ROAD )• /ggoo QUEENSBURY NY 12804 1 ANCHORING OF MOBILE HOME / FRAME IS REQUIRED PER MANUFACTURERS SPECIFICATIONS I TOWN OF QUEENSBURY BUILDING DEPARTMENT c'u?6 LDING & P Based on our limited examination BY comppliance with our comments shah 7- i11EVN�C? Fill Pnot be construed as indicating the , t ► � plans and specifications are in full compliance with the Building Codes cf N�iw York State. r Di"cc- 3 A l0 A OPTIONAL GLAMOUR w BATH 14b,-o- U (OMITS LINT 6'-.$' 61-0 -$' S•_q. 9•_4.111 fill T T TL 3 rro-E 3 T . {0�1 A F o A J Fill N BA2 B/R NOOK z ci OOK a 6 S{„a f i A o CATHEDRAL CEIILING C CV U OPTIONAL TrtRU-OUT MASTER STAIRWELL I MASTER ; � LIVING BEDROOM fSTAIAWELL N/A BEDROOM ` ROOM, B/R 2 w/40: ROOF LOADI i .i OPTI ` i d ; A IL b u u 3Ai01- A 2840 Approx, 1067 Sq. Ft. E n ^ TITLE 2840 REVISI[Ni5 SGALE PATE pWG. N0, A S T R L! GATE NUMBER V DNH, BY RE EAEENCE 3A101-A LITEPATUPE Qnrr ORIG LIT, c/� New x ►T �° OJZ\�(�'P�- S�5 iC-- 5 \ N 6-c0 b , r� LL 4 Y 4 r"AG "I h o • T 1� O t "✓C-�Prl C 1 c ,'!�j 620 lt— `1 4` I O 7 r L V-j C�) N C Lj G x Q 4Ec-P46C- lei 7', V