2001-269 TOWN OF QUEENSBURY
742 BayRoad,Queensbury, 12804-5 2 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20010269 Date Issued: Thursday, June 14, 2001
This is to certify that work requested to be done as shown by Permit Number P20010269
has been completed.
Tax Map Number: 523400-125-00.0-0001-029-013-0000
Location: VANDUSEN Rd
Owner: FRANK &DELORES PARILLO
Applicant: KEITH WASHBURN
This structure may be occupied as a:
By Order of Town Board
Mobile Home In Park TOWN OF QUEENSBURY
( j4 y.
Director of Building&Code Enforcement
1
TOWN OF QUEENSBURY
4111$11-
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010269 Application Number: A20010269
Tax Map No: 523400-125-000-0001-029-013-0000
Permission is hereby granted to: KEITH WASHBURN
For property located at: VANDUSEN 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: FRANK&DELORES PARILLO Mobile Home In Park 40,000.00
215 BALLARD Rd Total Value 40,000.00
GANSEVOORT,NY 12831
Contractor or Builder's Name/ Address Electrical Inspection Agency
TODAY'S MODERN HOMES
54 ROUTE 9
GANSEVOORT,NY 12831
Plans .:Sc Specifications
2001-269 KEITH M. WASHBURN
1440 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS
$65.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,May 11,2003
(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 Queen my; Fri ay,May 11,2001
SIGNED BY for the Town of Queensbury.
Director of Building Co c nforcement
Application for Permit— Mobile Home
Town of Oueensbuiy, 742 Bay Roaz Oueensbury, IVY 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
Name: WE 1 (V1 . LO.F5 t-4goek.) File Permit No. n/Z(p
52 `�l r(�-+ (c)P
Address: Al) Fee Paid C u
CCUS 8t32v k Y 19-KO . Reviewed By:
® 82001
Phone No. '1 —03 I?j BUILDING AND COD
Property Owner Information . Parcel information
Name: -n P 4 l�l/ -a,i L( Proposed Date of Placement:
• Property Location: q (�IR F Woof) Cat 1'a,(...(E
Address: l,?j I-cJ' (?. 0-A - - • - Road,Street,Avenue
O Ups Rc.:Ly a 1,3`, iafSOq:. Name of Mobile Home Park: �(j2i=,S j PAeK
(( applicable)
Phone No. 7 q — (.(.0(o 'Tax Map Number: )G/. / I / J9)
Mobile Home Information Zoning Information
Approximate Value of Home: $__ [�.
Zoning Classification:
New Home: 60No
Size of Property: ft.by ft.
Replacement Home: Yes ED
Existing buildings:
Size of Mobile Home: 97 ft. by 60ft.
Setbacks: front yard ft. ; rear yard ft.
Singlewide: Doublewide: , V Side yards ft.and ft.
Number of Rooms: (exclude baths)
Number of Bedrooms: —/ Accessory Building(s): circle
Number of Bathrooms:
Detached garage: 1 car; 2 car, car
circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car
Storage building: Yes No
Foundation Support: Other:
TYPE SIZE&DEPTH Water Supply: well or municipal
Piers x
Runners x
Slab x Is Septic Permit Required? Yes oNo
Further information requested on the reverse side of this sheet
Name of Installer or Mobile Home Dealer: TO�a 5 fl7 r� me 5 '` vJ+t '
~� �°• ] 516,- iU cell
Address: 6 / !*, q G-4,Ae t,oar 1 ✓,J \ 1 c:2
Phone No. C6/ ) 597' - /6 43 D.
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number: f)O-03 06 — i'l,B
2. Name of manufacturer: S'h n P_, i w&54btccl7
•
lott-
3. Plan Approval Number: '��� "L�9�� D�
4. Model or Component Designation: (JO S 1. (0 SO Cr
(New Home ONLY) /
5. Date of Manufacture: .57' 99
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: 7 /re/ ,/�
owner owner's agen architect,contractor
Special Conditions of Permit
By:
Form: 11/19/1999sh Code Enforcement Officer .
1 1 \LY&J�
FINAL INSPECTION REPORT
MOBILE / MODULAR v 7.
Town of Queensbury 'UU
Building & Code Enforcement , /0
742 Bay Road �Q
Queensbury, NY 12804
(518) 761-8256
ARRIVE: \ ODEPART: \i (bINS
DATE INSPECTION REQUEST RECEIVE
M
NAME:
LOCATION: R G—�P� Vc 7O(XJ C.,A fd P
DATE: (l.)y '"l E0 I PERMIT_
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING
N/A , YES NO
1. foundation s 6.+rt, pie spacing —
per manu .
2. anchoring pe manuf. _ _ •
3. water line shu off ..
4. sewer line sup.irt Co 4 feet _
5. heating crossov= dblewide) off grd.
6. dryer vented o
7. skirting ventilated
8. hot water relief va a piping outside —
9. deck, porches, steps railing — /
10. furnace/hot water o ating _/
11. garage fire proofing j _ _
12. door closers ✓ / _
13. plumbing fixture _ J
14. foundation insulation (if a 1.) —
15. smoke detectors
16. final electrical
17. variance required
18. data plate okay _ _
19. mobile HUD seal okay
Model # lv 'r (QS(1;2-- £i I erial # ,8 V ty-D E1e
Manufacturer bie..Rt \3'
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
Nc.656 '01 PM W:5L3 ID:FRANK J. PILLO FAX:518 5N.4121 PE
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Frank J. Padlio
•COmmERCAL& :NDu-S-stAl PRenrpT;PS
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MAY 14 2001
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TOWN OF QUEENSBURY
BUILDING AND CODE
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215 Bai:ard Road • Gansevmwt • New vork 12531 • (518) 5A4-1444 • Fax(518)584-4121
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FILE (( '•Y ANCHORING OF MOBILE HOME "h ' �' &
FRAME IS REQUIRED PER MAY 0 8 2001 .<
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MANUFACTURERS SPECIFICATIONS TpiNN OF R sc j y co
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BUILDING AND CODEm
TOWN OF & f E ' ° r Y MODS°DAYr e
TOWNui
OF QUEENSBURY BUILDING DEPARTMENT
, V a HOMES cn
Dared on our limited examination, BUILDING • ,/.- cn
compliance with our comments shall
REVIEWED s �� j 3
not be construed as indicating the REVIEWED B .,/,1, ,//,r/ 1,. �i DNS Fans f i
plans and specifications are in full -I
compliance with the code. DATE .� {���use-�aa2 0
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BEDROOM UVING ROOM ° J ro
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14' - No. 3 , , Na. 2 m
to'-B" 12'
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6802CT/6024 3BEDROOM - 2BATHS - CATHEDRAL THRU-OUT (1,370 SQ.FT.)
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FILE No.669 05/11 '01 AM 11:49 ID:FRANK J. PAR ILLO FAX:518 584 4121 PAGE 1
Frank J. Parillo
COMMERCIAL&INDUSTRIAL PROPERTIES
Pu-';-
RECER/E!,
NIAY 11 2001
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�� ND CODE
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215 Ballard Road • Gansevoort• New York 12831 • (518)584-1444• Fax(518)584-4121
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