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2010-097 TOWN OFQ UEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Q ur3', Community Development - Building& Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100097 Date Issued: Tuesday, August 02, 2011 This is to certify that work requested to be done as shown by Permit Number P20100097 has been completed. Location: PETRIE Ln Tax Map Number: 523400-308-006-0001-061-000-0000 Owner: SAMUEL & VIOLA WAHNON Applicant: SAMUEL &VIOLA WAHNON 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 r"-N\I'`- - J / // �t property owner of the responsibility for compliance with Site Plan, -),:w , `V Variance, or other issues and conditions as a result of approvals by the `r 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: P20100097 Application Number. A20100097 Tax Map No: 523400-308-006-0001-061-000-0000 Permission is hereby granted to: SAMUEL& VIOLA WAHNON 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 39 SARATOGA ROAD Mobile Home In Park $72,000.00 GANSEVOORT, NY 12831 Total Value $72,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2010-097 9 Petrie Lane- 1456 sq ft mobile home - Gene&Brenda Habinowski $90.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,April 06,2011 (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 wn o ee f/�rye u/.da April 06, 2010 � SIGNED BY . \ for the Town of Queensbury. Director of Building&Code Enforcement e • %L Ci /._/_/ (j OFFICE USE ONLY , O f7 b _ TAX MAP NO. PERMIT NO./0-0 • DATE ISSUED: , _ , • k; 2 o Lu1v iAP PERMIT FEE PROVALS: ZONING TOWN CLERK !'• i % BUILDING & CODES 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:°flue ' m--- ' 1o1 l�C t J 19Q i Name: �5 144 T g A*)k.) Address: IT ' ) Address: ) 3 c\ q 170- 9 ( wwv,.D.6.,,L,1 0 af,,dtto K,) .y Q-A yaCe L1R)L7 N ,\r, Phone No. 302-( 3 ti 4.3 2.---7 Phone No. M S'r2 Parcel Information rAte ' Proposed Date of Placement: $ S71 ,2 Property Location: 9- iTaA, f,;(,,,_ ,,1 c0- ,, Road,Street,Avenue Name of Mobile Home Park:( \k(1.0(k_.4,,,g_\[ ci1 (if applicable) Tax Map Number: 12.) -to -S9 Mobile Home Information Zoning Information Approximate Value of Home:$ 7 2-00 0 Zoning Classification: - New Home: Yeses No Size of Property: GI—ft. by )L)1)ft. /ii cto � � Replacement Home: Yes) No Existing buildings: Size of Mobile Home: .2 ft. by b 1-ft. • Setbacks: front yard I\''4, ft. rear yard fU//ft. side yards 2 S ' ft.and 2S ' ft. Singlewide: Doublewide: Number of Rooms:(exclude baths) S Accessory Building(s): circle Number of Bedrooms: 3 Number of Bathrooms: 2-- Detached garage: 1-car 2-car car Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: Storage building: Yes No • Size & Depth Other: Piers ' Runners Water_S.uppty: well o •" Slab -.- Is Septicliegnitl'UgU ired? Yes or No '-, _ n bads • 0 Town of Queensbury • Community Development Office • 742 Bay Road, Queensvury, iv r 1Lo114 A/Ge?itxrzlA- Name of Installer or Mobile Home Dealer ,%a= -°/' . ' -- PC11 Address: 06 ( J 11, q Phone: 7q`7 S5--<O Complete information below found on a'Plate'or"Sticker°which is affixed to the mobile home: ✓ Insignia serial number. ( ?-.2-C/O0)f fr()b! V.2_214-6 ( Name of manufacturer: t-XA Q '. ✓ Plan Approval Number. ✓ Model or Component Designation: ,.A ) 3-- (New home only) ✓ Date of Manufacture: /4 - `-1-ID AFFIDAVIT V J 5 J Town of Queensbury State of New York a 1 County of Warren z - s s 5 I swear that to the best of my knowledge and belief the statements contained in this application, together with the plans 1 and specifications submitted, are a true and complete statement C 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 g work is authorized by the owner. s c Signature: - S Owner,Owner's Agent,Architect, Contractor J XJiXX�-�SXT LiJ:�iXXr:lir.'!.-l.-l.-Xf:X1JXXt:.iXI:JS.I.-I.-�JXIiKX�IX - ----�ilL:�:JiJ?�1:1. SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer CaTown of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804 � � ' ,7� / 1 t �� 't/(L:i ueensbury Building & Code Enforcement— Manufactured / Modular al Inspection Office No. (518)761-8256Anive: .: 414140, Date Inspection rt am/pm pecti request received:S� f Inspector's Initials: NAME: 6--11-t,--, 7 1' ��r'/Y% �-� l/6.Oi Oil( J -) 1 . _ !t PERMIT _ (�� LOCATION: 1 /1-2 r• C' ZiA__-, DATE: 1 — 77- % ` Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Yes No WA Foundation support,pier spacing, Per manufacturer r Anchoring per manufacturer 2'from ends / Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide}off grd. Dryer vented outside Skirting ventilated 1 so.ft.per 1.500 sq.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing _ Fire Door/Door dosers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal // 18"x 24"access or 22"x 30"attic access Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue CIC or CIO[Temp. " Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Building Codes Fonns\Manufactured Modular Final Inspection 03 04 10.doc 2 -4 i--r.7.cia .___ Queensbury Building & Code Enforcement_ Manufactu / M• • ar Final Inspection /IP Office No.(518)761-8256 Arrive: .L .;.- •- 77--aran62 Date Inspection req t received: inspector's Initis311W4iff �'``� NAME: a 10 t 11 C%i:. J r I PERMI It / —07/ LOCATION: 7 / 71ri Lf.--,_ _ DATE: -27,4' 2 /O Manufactured Home Modular Home Footings_ Foundation Backfill_ Framing— Comments: Yes No I N/A Foundation support,pier spacing, It Per manufacturer I Anchoring per manufacturer 2'from ends J / Water line shut off Sewer line support @ 4 feet Y Heating Crossover[doublewide)off grd. ���lll[ 1 Dryer vented outside Skirting ventilated 1 sq.ft.per 1,500 so.ft. J Hot water relief valve piping outside J I Deck,porches,steps,railing Furnace/hot water operating J Garage Fire proofing I J Fire Door/Door closers + J Plumbing Fixture/3'Vent through roof[Modular] J I Foundation insulation[if applicable] J Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical L/ ‘......,,,, Variance required Data Plate okay _ Manufactured HUD seal okay ,K‘,„,..`� Warranty Seal after January 1,2006 �.j? (i \‘‘10 installers Warranty Seal bp 18'x 24'access or 22'x 30'attic access /j` Vapor retarder under home 6 mil poly or other /" r 911 Street number Okay to issue C/C or CIO[Temp./Perm.] If° Model# Z5zA X21 Serial# VZZ-Ot js V\--: N Co 0©®Z'77 t Manufacturer V-E ,a° Date of Manufacturer 4t7 Lk- b — L-1Pam Whiting120101Building Codes Forms Manufactured Modular Final Inspection 03 04 10.doc