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2012-140 ..1111 '` 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: P20120140 Date Issued: Monday, January 28, 2013 This is to certify that work requested to be done as shown by Permit Number P20120140 has been completed. Location: 183 PITCHER Rd Tax Map Number: 523400-308-014-0001-052-000-0000 Owner: ARC COMMUNITIES 14 LLC Applicant: ARC COMMUNITIES 14 LLC This structure may be occupied as a: Mobile Home In Park By Order of Town Board 611 )) r e gLOCDA. TOWN OF QUEENSBURY Issuance of this Certificate of Occupancy DOES NOT relieve the property 4 owner of the responsibility for compliance with Site Plan, Variance, orlot other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement or Zoning Board of Appeals. 1 AO` TOWN OF QUEENSBURY !fr. ET 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20120140 Application Number: A20120140 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: ARC COMMUNITIES 14 LLC For property located at: 183 PITCHER 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: ARC COMMUNITIES 14 LLC Mobile Home In Park $30,000.00 PO BOX 61102 Total Value CHICAGO IL 60606-0000 $30,000.00 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications BP 2012-140 97 Gregwood Circle -Forest Mobile Home Park Mobile Home 1,232 sq. ft. year 1988 $147.84 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,April 11,2013 (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 Town of Queensbury; Wedn•sday, April 11, 2012 SIGNED BY / a for the Town of Queensbury. Director of Building&Co.- Enfo ' mens cil6arturci `� 1 i r ; b`!b ('T -1_5d+ OFFICE USE ONLY TAX MAP O. PERMIT NO. � 14 � DATE ISSUED: C � ll �' ; -7 ' PERMITTEE 14 /•��APPROVALS: ZONING TOWN CLERK ; 1 To WN TEra'SBORY 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:,A9/ 'c �v2�-S7. Pie4'A Name: Address: 97 <-TRt6 wood ele._e�c= Address: q--1 6-2c6 t )cl ori e/kate (Q vt7.usis Uiey AP/ /2Y0'i QuE6tVSS8v2 y At/ /23-01) Phone No.(5/ F ) 7 ys-, 7 7 6,, Phone No. Parcel Information Proposed Date of Placement: /0--/1-20/0 Property Location: 9 7 6--1?E 6 4-000/_.1 e/ crC, Road, Street,Avenue Name of Mobile Home Park: tD PEs .l /-7h'a/- (if applicable) Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: $ 361 DOC) Zoning Classification: New Home: ❑Yes I ]NoI 3 y Size of Property: /,0 ft. by /10 ft. Replacement Home: U/Yes ❑No I 1 �� Existing buildings: Size of Mobile Home: 2 2 ft. by '-/�� ft. Setbacks: front yard_ ft. rear yard ft. / side yards ft. and ft. Singlewide: Doublewide: Number of Rooms: (exclude baths) Accessory Building(s): Number of Bedrooms: Number of Bathrooms: Detached garage:❑1-car n 2-car ❑ car ❑Gas Fireplace❑Woodstove ❑Wood Fireplace Attached garage: 71-car ❑2-car n car Foundation Support: Storage building: nYes ❑No Type Size & Depth Other: Piers Water Supply: ❑Well ❑Municipal Runners Slab Is Septic Permit Required? ❑Yes 1-7(No Continued on page 2 Town of Queensbury • Community Development Office • 742 Bay Road, Queensnury, iv x 1zou'l Name of Installer or Mobile Home Dealer:/?J'Y/J)O//L) �c)13tSS Address: ‘.5 3? 1-5 7-C3A-) S/914 its y Phone: Z%- OS- 8' Complete information below found on a"Plate" or"Sticker"which is affixed to the mobile home: ✓ Insignia serial number: ✓ Name of manufacturer: C A/ ✓ Plan Approval Number: ✓ Model or Component Designation: (New home only) ✓ Date of Manufacture: /9 g g 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, Owner's Agent, Architect, Contractor • • SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer Qv Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804 --r-" -)LUL,b K -1 D -k". Queensbury Building & Code Enforcement -- Manufactured / Modular Final Inspection Office No. (518) 761-8256 Arrive: am/pm Depart: I-3C) am/pm Date Inspection request received: n Inspector's Initials: eft NAME: fT( `'Pa/7k PERMIT* 4v ( D LOCATION: 1'? •LL DATE: /—a q-- /2 Manufactured Home — s Modular Home Footings Foundation_ Backfill_ Framing Comments: Yes No N/A Foundation support, pier spacing, Per manufacturer 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 sq.ft.per 1,500 sq.ft. Hot water relief valve piping outside %Y Deck, porches, steps, railing Fumace/hot water operating I Garage Fire proofing f Fire Door/Door closers Plumbing Fixture/3"Vent through roof[Modular] :/ Foundation insulation[if applicable] 7' Smoke/Carbon Monoxide Detectors/Interconnected ,/ Final Electrical Variance required / Data Plate okay Manufactured HUD seal okay Y p J,/- 1,90A-1 ,,h-1 iCl Warranty Seal after January 1,2006 /� tiV-C V/"'1 1 1 1----7 Installers Warranty Seal _ 18"x 24"access or 22"x 30"attic access v .f Vapor retarder under home 6 mil poly or other fy: 911 Street number Okay to issue C/C or CIO[Temp_/Perm.] LY...") Model# Serial# 51U4. 47 Al'''- Manufacturer r.-l'k"'k _ `eiv Date of Manufacturer r1,3 tb L:1Pam Whiting120101Building Codes Forms\Manufactured_Modular Final Inspection_03 04 10.doc INSTAL!. NO.118934 STATE OF NEW YORK DEPARTMENT OF STATE • t ONE COMMERCE PLAZA + "44'A• 99 WASHINGTON AVENUE , 99 ALBANY,NY 12231 INSTALLER'S WARRANTY SEAL THIS SEAL REMAINS THE PROPERTY OF T R'• DEPARTMENT OF STATE ❑ NEW MANUFACTURED(HUD CODE) In' RELOCATED MANUFACTURED(HUD CODE) • A. Manufacturer's name: AC\C6 i �^ l\ \A. \(� B. HUD label number: �� - \ 5 Q Lfl \c-A Serial number: \Li {, ,4( 11 ' C. Retailer's name: D. Retailer's address: i 1 t CQ T k; '�} E. Retailer's certification#: `` Telephone#: F. Installer's name: V) ` ]r' .( U G. Installer's address: -94 J Qi •�,Ll cS/X1 C 1( 1.1i/9.0 H. Installer's certification#: r t`J Oni--1 I C) /)!�I LY) / Telephone#: �{ �/ OJT(149((.1 I. Date installed: g — I Municipality issuing building permit: (P1(JL (-J/(1�t ;i(. / '/ (City,Town Vi is e) J. Customer name and physical address (911)where home is installed: 'Y ( t(`i1 titJ�.11.1 i-1\n , �� 11 t , C-A'PCl u 1C.I L l;k--1(‘ L 1 Nu( Q ( ?'1 D(l(1 A ( ,New York. 1 By attaching this SEAL to this manufactured home,the undersigned Installer of this manufactured home warrants as follows: 1. That the installation of this manufactured home meets the standards of the New York State Uniform Fire Prevention and Building Code. 2. That the Installer is certified as an installer by the New York State Department of State. The foregoing warranties are in addition to and not in derogation of all other rights and privileges which the consumer may have under any other law or instrument.The foregoing warranties are in addition to,and not in limitation of or substitution for,any and all other warran- ties,express or implied,given or made by the Installer whether contractually or_by operation of law. Printed Name of Person Signing Seal `�� `` 1 �' f �r 1 )L1 }� Signature of Installer or Limited Installer: t If you have a problem with your home,you should first contact your installer or retailer.If the problem is nbt resolved by the Installer or Retailer you can contact the Department of State at(518)474-4073. DOS-1680(Rev.03/09) Yellow Copy—Department of State White Copy—Retain for Your Records Goldenrod Copy—Permitting Agency Seal—Affix to Home — /044A_ Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection 11��r Office No. (518)761-8256 Arrive: am/pm Departtam/pm Date Inspection request received: I/7//3 Inspector's Initials: J NAME: n I <,�� rn may- , i ��;Iv `a 'PERMIT#. 1 - l 1I () LOCATION: 97 6l e ( I?,,' DC-,7 c , ; C ie DATE: 1/I Lib Manufactured Home Modular Home Footings— Foundation_ Backfill_ Framing Comments: Yes No ' WA Foundation support,pier spacing, Per manufacturer 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 sq.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 closers 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 C/O[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Building Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection Office No. (518)761-8256 Arrive: am/pm e ar l am/pm Date Inspection request received: Inspector's Initials:�/ NAME: Li ,Nt.P eQtv--- PERMIT#: ' ivn LOCATION: / Q LLrt9C? l DATE: A\ikV-7> Manufactured Home Modular Home Footings_ Foundation_ Backfill Framing Comments: ymt No N/A Foundation support,pier spacing, -„,;(/ Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off Sewer line support @ 4 feet Heating Crossover[doublewide}off grd. Dryer vented outside ✓ �✓ /� ��"f/ �� Skirting ventilated 1 so.ft.per 1,500 so.ft. Hot water relief valve piping outside Deck,porches,steps, railing /if Furnace/hot water operating Garage Fire proofing477 Fire Door I Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] ✓ Smoke I Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okayAc- Manufactured HUD seal okay ;•. \Warranty Seal after January 1,2006 Installers Warranty Seal V� '18"x 24"access or 22"x 30"attic access Vapor retarder under home 6 mil poly or other 911 Street number 1 Okay to issye-E!C'or C/O[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Building Codes Forms\Manufactured_Modular Final Inspection 03 04 10.doc Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection Office No. (518) 761-8256 Arrive: / 2"Peam/pm Depart am/pm Date Inspection request received: I - „3" / p Inspector's Initials: NAME: ) Lt✓N Anr. / +&LJ PERMIT#: / `I LOCATION: 7 �;rtit-'/'%l DATE: I —41 `/—� Manufactured Home Modular Home Footings Foundation_ Backfill Framing— Comments: Yes No N/A 0 L&"4 "�. Foundation support,pier spacing, Per manufacturer 9ag 55-6 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 sa.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 closers 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 /E;e f, �� Te,,wor n'` 911 Street number y ! .I / E�1G OJ2a� Okay to issue CIC or CIO[Temp./Perm.] �/�j c�' tfrY,y Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Building Codes Forms\ManufacturedModular Final Inspection 03 04 10.doc -1-Ps-A-- U3 Queensbury Building & Code Enforcement— Manufactured I Modular Final Inspection Office No. (518) 761-8256 Arrive: / '' am/pm Depart am/pm Date Inspection request received: Inspector's Initials: 2)A NAME: fcLQ7 CPcJ PERMIT#. a ` Nv LOCATION: ,a rt DATE: Cd Manufactured Home Modular Home Footings_ Foundation_ Backfill Framing_ Comments: Yes No N/A Foundation support, pier spacing, S E a V\ Per manufacturer Anchoring per manufacturer 2'from ends ., 31g8v� olo 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 so.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Fire Door/Door closers 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 - r4-1 /" 911 Street number Okay to issue C/C or CIO[Temp./Perm.] Model# Serial# Manufacturer Date of Manufacturer L:1Pam Whiting120101Building Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc