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2001-361 TOWN OF QUEENSBURY Fos 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010361 Application Number: A20010361 Tax Map No: 523400-121-000-0006-059-002-0000 Permission is hereby granted to: OUEENSBURY VILLAGE MOBILE HOME PARK 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 Mobile Home In Park 20,000.00 39 SARATOGA ROAD Total Value 20,000.00 GANSEVOORT,NY 12831 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2001-361 LOT 20 PETRIE LANE 1680 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $102.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,June 08,2003 (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 Tow eensb ; rid y,J ne 08,2001 SIGNED BY c / for the Town of Queensbury. Director of Building& ode En` orcement ti _ JUN 042001 D Application for Permit— Mobile Home .'Town of Queensbury, 742 Bay Road Queensbury. NY 12804 (518) 761-82 U 10� QFgUAENEDN��URYILDIP� CODE 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 Iirformaiinn .. ..___ ................__._.._...._ _...._.__..._........,.,.,,,.......,......- ......... , ,,..,..,,, rp t` (Ice 1.lie Name: - e& 5 FA-\ !S atti\l---e I '° �'"►. . File Permit No� '"'�`` ' `•o Address: 6-o W. .� J• ��t2 �� Fee Paid �.� ( �v g-p4(t� ( oe--r N �t� )Z�' I Vgl(i�./ Reviewed ay: ----.... ........ �! PhoneNo. .....................................__....,....,,.....,.....,.,.,.. 1'roperty Owner Information Parcel Information 104 10 rr'1 Proposed Date of Placement: OA S JT Name: r\- n { ,��r Property I44tion: �_G 7 l�V" 0�('f -014 IQ 'l Address: � 5 f Road,Street,Avenue efreti\I o aer g .\( Name of Mobile Home Park:&t.A'e, 14.44-9. V ) fil-43 ' (if applicahle} Phone No. 3 1 g--7y g6 C --� Tax.Map Number: 177.� / /0' o Mobile Home Information Zoning Information Approve Value of Home:$ 3-Ctr) '"/ /f� n� n 1C - Zoning Classificon:1"l ( ��f"Y►'-1`, (�/IV'ii�t ' New Home: Yes Now `761 . Size of Property: _ ft.by fi. Replacement Home; Yes e„) ,.. . , ¢ Existing buildings: ,�-1 Size of Mobile Home: i-U ft, by too ft. Setbacks: front yard it.'; rear yard. . ft. Singlewide: Doublewide: -Side yards it.and - . ft. Number of Rooms:(exclude baths) C, Number of Bedrooms: 3 Accessory Building(s): circle Number of Bathrooms: 2- Detached garage: I car; 2 car, car circle: Gas.Fireplace or Woodstove Attached garage: I. car; 2 car, car Storage building: Yes No Foundation Support: _ _ Other: r . Rt1:F k 7aE'Til Water Supply circle. Piers Runners 1 Slab well ; ,m 'opal Further information requested on the reverse side of this sheet z0 'd b£:b I (1Hd. 66-8I-AON • • Name of Installer or Mobile Home Dealer: • Address: 3CI. .s\ 1/4A4afrept_ .(;),(..:4„...)- (ted-- / Phone No. 5-IT-?1 r2-5-6 • State ofNew York Division of Housing&Community Renewal Insignia of Approval of the State Building Code • Complete inforMation below found on a"plate"or"sticker"which should be affixed to the, , mobile home. erIA. 4c: 6C4/4 100yril 1. Insignia serial number: Opp- . . •2. Name of manufacturer: 3. Plan Approval Number: 4. Model or Component Designation: • (New Home ONLY) • •_ . 5. - 'Date of Mantitacture: . . • i•- ' :` AFFIDAVIT ' • --ToWn of Qtieenspnry'..:, • State of New:ifork ; - • • ;,;.„ • County of Warren - _ - •H I Swearlhat 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. Stguatare: owner,owner's agent,architect,contractor • - • „_ • ) ;.- • Special Conditions of Permit By: Furrn: I 1/181999sh Code Enforcement Officer • £0 'd q£17I nHt RR-RI-AnN • • ' Application for Permit—Septic Disposal System Town of Queensbury 742.11ayRoad Queensbury,NY 12804 (518) 761-8256 , • 1. OWNER INFORMATION: • Office Use Location of installation: r' /�'J ✓�/� / - Tax Map No. / / File Permit No. 56( Owner's Name: 6 - 1M-0 .66- klo-t.. . Foe Paid . • . Address: Leif- Z' !,(J e-via Cam— •. • 2. INSTALLER'S.NAME : PHONE NO.• 1 RESIDENCE INFORMATION: (circle year of dwelling, indicate If bedroom(s) and multiply iI of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: • No, of RedrQoms x Computation = Total Daily Flow 1980 or older `J x 150 gal/bdrm = (J 1980— 1991 • x 130 gal/bdrm 1991 —present • x 110 gal/bdrm = • Garbage Grinder Installed yes` 1 no Spa or Whirlpool Installed yes" / no -/ 4, PARCEL INFORMATION: (circle applicable information &indicate measurements) • QP ' talig Ql tSlxo Q.cQ d WnloriDQOrock..9r.j!!rpofYJsm_M tvt1;tl 17omQslic-.. t.Qr. tiphly . lord at what Ws at whrrl J./►t/i mrurlca Rolling t feel �eet well Steep slope clay if well; water supply %slope other • from any septic-system depth: • absorption is fl. 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 n licensed professional engineer or architect (unless installed in a Planning 13oard approved sulxlivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: l� gallon (min. size 1,000 gal.) �evl�U S t$' �y���/�LLG�Q ��� • Tile Field: each trench f?. Total System Length: - fl.; Seepage Pit(s): number of ?! size of each: ffl. by 63 • ft. • Size of Stone to be used: II _� . _ / depth or thickness Bed System Size: x • Alternative System: length and/or size 6, HOLDING TANK SYSTEM: (if required) Number of tanks: / 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 oldie 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 road the regulations with respect,to this application and agree to abide by those and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. • Signature of.responslble person Date FINAL IIN3SPECTI®N PIIEPooprr MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART): l SP:• DATE INSPECTION REQUEST RECEIVED: NAME: - Vc & iK��� LOCATION: P -rg/G- (�"1 3 '( DATE: Z3 PERMIT# 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 _ t/ 4. sewer line support ®4 feet .. — — 5. heating crossover (dblewide) o . — —6. dryer vented outside ... — 7.• skirting ventilated .. — 8. hot water relief valve piping o side 9. deck, porches, steps, 10. furnace/hot wate 'i g .... ... — 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 # v ✓ iy :erial# P Manufactures b�v A'� Date of Manufacturer 0 i OKAY TO ISSUE C/O, YES p NO Comments: ftzc— -- r2ra,0 5 - /A' , COMMONWEALTH ELECTRICAL INSPECTION SERVICE.INC. Main Office 176 Doe Run Road-Manheim,PA 17545. (VJ'_30 t, MUNICIPAL CERTIFICATE - ELECTRICAL APPR AL -Panel Board No Cert. N2 _ 7 0 8 8 9 Cut-in Card-No.: `" Owner 5 UI2L/ VtC t-ifa6— 1n 12' Location Al U r Z© £ Q--"- Y Installation Consisting of.AO et Le L -Q S-6724.1 /�-r aNL,f Installed By `d .-4 C4 Lic.No. The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:- This certificate only covers the electrical equipment and installation conditions as of date. Upon thf introduction of additional equipment or alterations;,application shall be promptly made for inspection. Inspectors of this Company shall have the jinvilege of making inspections at any time, and if it rules are /v�iolated,--the Company shall have the right,t re ke t '0 ificate. Date 7'�l r° IINSPECTOR 41 5y�a "s ti . I I/�LLLLLL.Lj_.LLLL JJJJ — '.x __ - JJJJJ�Y— FAMILY DINING KITCHEN-LIB jL'�,_LLL JJJJJJ_[ ,-,.;,, _ ROOM u'-a'x 12-7 i n-a x 12'-6-— '� ii yr J J J J J_' 18%17 X 1Z-T ` LLLLL " u"' JJJJJ_ LLLLL "'\i_i_ii_ijJJJJJ_ ra \LLLL S JJJJJ_ `� ";:i a ::i;:,N i �. r I.a.. _7 UVIN' MASTER SECOND J J J THIRD • ROOM BEDROOM t3 3 BEDROOM J J JT BEDROOM 10-s x�z-ta ta'-r x iz'-T W- X 12'-7 J J W-2 X 12'-T / CATHEDRAL CEILING STANDARD THg10Ur... p .,£�'. \ ..oA ...oaf r i rrl 1 E'_•'�Z_)f x D. y s l 1484 SQ. FT. 3BR, 2BA, FAMILY ROOM NF286039E TOWN OF QUb`i'i.:8LIRY i".�1l..!ifNu DEPARTMENT B�,�ect on ou►�iirnited�xarniriafion, cc,n��liance with our cc'mments shalI cO/r3(p/ nc!k a crnsfruetl_as indicating tha PYPuns and specifications are in full FR, F i . ' compliance with the code. RECEIVED JUN 0 4 2001 . TOWN.OF QUEENSBupv SANG AND CODE NOTICE • ANCHORING OF MOBILE HOME TOWN �° tar�x �b FRAME IS REQUIRED PER �� MANUFACTURERS SPECIFICATIONS BUILDING : ...., b REVIEWED i Y 0 cPT, DATE ,. %keek) s \Du icf / 28' / Ii 19' 5 P cf LoT Ler- tT eng. •LeAk- e'f