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2001-520 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010520 Date Issued: Friday, August 24, 2001 This is to certify that work requested to be done as shown by Permit Number P20010520 has been completed. Tax Map Number: 523400-308-006-0001-061-000-0000 Location: PETRIE Ln (Lot 24 ) Owner: SAMUEL &VIOLA WAHNON Applicant: DARLENE GANNON This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY r3J4' Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010520 Application Number: A20010520 Tax Map No: 523400-308-006-0001-061-000-0000 Permission is hereby granted to: DARLENE GANNON 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 60,000.00 39 SARATOGA ROAD Total Value 60,000.00 GANSEVOORT,NY 12831 Contractor or Builder's Name/ Address Electrical Inspection Agency GLENS FALLS MOBILE HOMES NEW YORK BOARD OF FIRE UNDEI 39 SARATOGA ROAD GANSEVOORT,NY Plans &Specifications 2001-520 DARLENE GANNON LOT 24 QUEENSBURY VILLAGE 2128 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $127.68 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,July 19,2002 (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 ueens ry; Th s s :'y,July 19,2001 SIGNED BY c T for the Town of Queensbury. Director of Building&Code Enforcement Fire Marshal's Office Town of Queensbury,742 Bay Road,Queensbury,NY (518)761-8205 Application for Fuel Burning Appliances & Chimneys applicable to solid fuel & vented gas appliances Date ?)— 22- , 20 t71 Permit No. oc • Application is hereby trade to the Building& Codes Office for the issuance of a Building and Use Permit pursuant to the New York State Fire Prevention and Building Code. The applicant or owner agrees to comply with all applicable laws, ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter premises to perform required inspections. NOTE to applicant: Rough-in and Final Inspections are required. Applicant Information Fuel Burning Appliance Information (circle appropriate words) Name: D Q RLE JE_ C- P‘13v t Stove: wood coal pellet gas Fireplace insert Address: '2_1 Fireplace, factory-built: ( .wood :as 13 125ed-t Fireplace, masonry: wood gas Furnace: wood gas oil Phone: —c 34 Z -- If non-masonary applicance, please provide • Owner: AvF Manufacturer Name: frk cABTI Address: .Model Number: t..F Chimney Information Phone: (circle appropriate words) Masonry block brick stone lue tile eft size. inches Exact Address: � ��.{� pi3 40)0 of construction or installation Factory-Built Manufacturer name: Model Number: Note: Listed By: Number: Construction/Installation must conform to NYS Fire Prevention &Building Indicate(circle) chimney material: Code. Consult available Town of Queensbury Handouts regarding required inspections. Double wall / Triple wall / Insulated / Direct venting Chimney Liner Depaaz'tziatent—XIC)11;117-1:11of Qzzeez3. bu.ry-, New Fire Marshal Code# $Collected $Refunded Received from (refunded to):` Qii11101 address: A 173 3389 (190) Public Safety Zj A 233 2655 (230)Minor Sales DATE: `g) ZZ O Calif.02 r�/ i • wt�- osv+, White(Applicant) / Green(Fire Marshal) / Yellow(Bldg. Dept.) / Pink&Goldenrod(Cashier's Dept.) Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, IVY 12804 (518) 761-8256 ;; A building permit must bp obtained before placement of mobile home on parcel. No inspections will be made j until a valid building permit has been issued. - • I . Applicant Information ' Office Use Name: �n Q� .c tiA►�ec. c File Permit NRik" Address: I N&f i - `atij 5f Fee Paid . (PE ro I � it Q 113 ctrd Ai -�/ rr ( ,,, Reviewed By: Phone No. '7- qo ! `/ Property Owner Information , . Parcel Information Proposed Date of Placement: i434 I' t" , Name: yid • 1 �� ,l,p ri Property Location: LOT ( . Address: j Cr Road,Street,Avenue Name of Mobile Home Park: 6V 1- '`"1-r . !:(if applicable) Phone No_ Tax Map Number: 1 2-` / (O / s— I Mobile Home Information Zoning Information Approximate Value of Home:$ Lapi c t EV/ Zoning Classification: New Home: 4:0 No �,,s., 4 Size of Property: ft.by ft. Replacement Home: Yes No � / Existing buildings: Size of Mobile Home: 2-8-2-8- r ft. by (to ft. Setbacks: front yard ft.; rear yard ft. Singlewide: Doublewide: K. _ Side yards ft.and ft. Number of Rooms: (exclude baths) Number of Bedrooms: 3 Accessory Building(s): circle Number of Bathrooms: 2-: Detached garage: 1 car; 2 car, car circle: Gas Fireplace or odstove Attached garage: 1 car, 2 car, car Storage building: Yes No Foundation Support: Other: TYPE STZF&DEPTH Water Supply: circle Piers Runners wel ; municipal Slab Further information requested on the reverse side of this sheet 1 C2G-- r Name of Installer or Mobile Home Dealer: � 6= Address: 39 a iej\y",. Phone No. e7 2 c ) State•of New 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. 1. Insignia serial number: S.5 l I-16 2. Name of manufacturer: C6Zcit., 3. Plan Approval Number : PP � --I':�D 4. Model or Component Designation: P.' , 8 (New Home ONLY) 5. Date of Manufacture: 1 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: 5htk - owner,owner's agent,archit _ contractor Special Conditions of Permit By: Form: 11n8/1999sh Code F.nforcement Officer FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement pit),) 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:'Z;!;f7 DEPART: :GINS . c DATE INSPECTION REQUEST RE EIVE : � 1 NAME:( r NOY) 1_ LOCATION: 1-1 c Q/�A SZ i OLSC/l►�� DATE: ,--c)., _��� PERMIT# 1 75 1 MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/• , ES NO 1. foundation support, pier spacing 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 . si I- _ 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 detectors 16. final electrical 17. variance required 18. data plate okay / _ _ — 19. mobile HUD seal okay Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: 71:6 DEPART: !SCO IN:P: DATE INSPECTION REQUEST RECEIVED (�/�� V � 666 1 NAME: G MIU►� LOCATION: p DATE: 0 ()( PERMIT// r2 t rS OtO MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING N/A , YES NO 1. foundation support, pier s lacing per manuf. _ / 2. anchoring per manuf. 3. water line shut off 4. sewer line support @ 4 feet _ 5. heating crossover (dblewide off d. _ 6. dryer vented outside a _ 7. skirting ventila "• _ 8. hot water relief va - g o tside — _ 9. dec, • rches, steps, railing I. furnac-!I• water operating 11. garage fire proofing J/ _ 12. door closers ✓ _ 13. plumbing fixture — 14. foundation insulation (if appl.) _ it 15. smoke detectors _ — 16. final electrical 17. variance required 18. data plate okay _ ✓/ _ 19. mobile HUD seal okay — 1/ Model # Serial # Manufacturer rate of Manufacturer OKAY TO ISSUE C/O S NO Comments: 3 cpcoR is2)00? c;s_ yY\ k1P1 FIRE MARSHAL TOWN OF QUEENSBURY ej QUEENSBURY, NY 12804 (518) 761-8205 FIRE MARSHAL INSPECTION REPORT REQUEST R IVED P RMIT#0/ 5O NAME VM\CA 1 � LOCATION SCHEDULE INSPECTION ON ` AMP ANYTIME APPROVED N/A YES NO EXITS AISLE WIDTHS EXIT SIGNS EMERGENCY LIGHTI FIRE EXTI UISHERS FIRE ALARM SYSTEM FIRE SPRINKLER SYST FIRE SUPPRESSION SYSI EM HOOD INSTALLATION INTERIOR FINISHES STORAGE: CLEARANCE TO S'RINKLERS CLEARANCE TO H TING UNITS REQUIRED SIGNAGE V CHIMNEY WOOD STOVE FIREPLACE-MASONRY FIREPLACE-FACTORY BUILT 't-Vtt- t,RocC REMARKS: OK TO THIS DATE 6 1 B L �2D 25 FEC_ INSPSLIP.PUB IN E TOR FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury � Building & Code Enforcement 742 Bay Road IA I Queensbury, NY 12804 'VeJ. (518) 761-8256 ARRIVE:Z ,DEPART: 2.:,. .)IN:': _ DATE INSPECTION REQUEST RECEI k NAME: s APSWRJIIIIIIIIM,11101,11111 ,1 LOCATIO :' 'it ' o'1 l Q C DATE: to �--� O 1 PERMIT#0 1 —Dd(.) 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 d. 6. dryer vented outside..ti ... _ _/ _ 7. skirting ventilated — �// 8. hot water relief valve .';•s g outside _ J 9. deck, porches, ste.:, railing _ — 10. c•i-. water o •ratan! 4' _ _ garage fire proofing / _ _ 12. door closers ✓ _ 13. plumbing fixture _ I 14. foundation insulation (if app I.) _ _ 15. smoke detectors _ J 16. final electrical ✓ _ 17. variance required _ 18. data plate okay / 19. mobile HUD seal okay _ ✓ Model # 1( �T1C:1©r)- ` erial # .--' t3Pt,. Manufacturer C FV51 L_r__\-D 01")\! Late of Manufacturer <Le,---.— OKAY TO ISSUE CIO YES NO Comments: — RD V \ e. �7gf :)—N w ) • bo --r'Hfi� -1 L.44 — P5 6 \ - 07e e6c4 FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ,40, ARRIVE:\`OCiDEPART: ` ict IN" DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: 1 CST Z� f E klE LF E DATE: 13 - PERMIT# n\`57t. MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFILL FRAMING N/A YES NO /1. foundation support, pier spacin.'\�� / per manuf. �f /( 2. anchoring per manuf. ... 3. water line shut off _ /4. sewer line support 0 4 feet v 5. heating crossover (dblewide) o grd. _ _ 6. dryer vented outside 7. skirting ventilated - _ __ _ 18. hot water relief valve piping ou i s• _ 9. deck, porches, steps, railing . . ... 10. furnace/hot water opera 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 # Se .1# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES /NO Comments: sPk - 7-70q-%k� Cc r __-- 0 k iN \-)roi ---:, 71 U C7 & 7 ---- W-41 -4 .n . (Th , L- ------------ --5---) 14 - .. Cr\\I---\--- 0) , I t °PO vrk NZ, CD. ,--- 1#6"<%% lekil e0, 0 , • v • '" • • .. Stock # 24.7 1- S -20 MAJESTIC 105 uprox 2026 sq. fft . . 28X8Q Glens Falls Mobile & Modular Homes, Inc. 39 Saratoga Road • Gansevoort, 12831 (518) 798-2801 gfmhomes.com (fax) (518) 798-2803 • —C • '•a,�� n,r rll�-• JIA•STL'RRL'J7eUUNN,'1 IU'-J,r e'_7lAJIlr.YnOUJI :•312121;1: 11, •,e i j s, ! '-a : e'-7 I=1r.wroDJr T r;«I I nrnn,n„r .1 ..:1....::: ........ • I"" .7:IAilii•Til: 11 .:.ill :...:.:-. b., L ODNIIS nRDJr [' - 1 re'-t a r7'_7 on 'I • 11 ` ,1 1,I. DINING'Wool( (` • ,I i r-,I141Ie- /'/1•!A'sRDUJ/7 • !:' '{ arI: :,I. � e a It'-7 A nll f eforCIIL'N' ttfitty 7- _ UC7 QQ• trr rl��1 JL'S'TI C 10 Tr;' w.�! /U) . .�fl.:�(, Nit Pr 28x80(7G) . • r . ,,, .m, I, __ ___:l__ _ ePT. DEDIfenJ/ flAS'L'UL'NT LOCATION -` •"""'"" ? •-•- •� `fll T, RL'!'L S'Fl.'U f'flllC/l.::. /FA:l:Afl.'A J' I.nr.17 I(�N I,/ ®�1 I'9a• :JN l'fJCL' Dl'!!f.'DRUUJI Y' I.9,RI ':III't'. RLI 1?l. /'nill'll •i P. • Lam:ft.ri'MUM':,� It'•1 : 7• aarn a•r rq �!Z_:fl_.a_�..,..i__.-.-.: .,, .0, '!N rt.,(rt or nuotoox, 7. r•w•n.«•.an.« o . *Coos*av wi.,c�u:'r _--_ -. 111111111" �'7f1/IAfI: Il IIIIJ/ n \ Tflg IIIM --• TCt':?W Gr OUEEWSBURY C,t.i.,E-?A<G DEPARTMENT Based on our limited examination, compliancewith our comments shall not be construed as indicating the plans and specifications are in full NOTICE cornpliance with the code. ANCHORING OF T �ysag�i; OF C4 �w <<' c a-�, MOBILE HOME , :,.. FRAME IS REQUIRED PER ���`( �� �t�I � MANUFACTURERS Uft SPECIFICATIONS e (PO REVIEWED — V\A\ V �,.. — . ter-:-'a '� DATE •