2013-001 .•4111ft, TOWN OF QUEENSBURY
I ET
742 Bay Road Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130001 Date Issued: Friday, January 18, 2013
This is to certify that work requested to be done as shown by Permit Number P20130001
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
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property ygefie—
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
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: P20130001 Application Number: A20130001
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
PO BOX 61102 Mobile Home In Park $30,000.00
CHICAGO IL 60606-0000 Total Value $30,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
RAYMOND JONES
424-0508 P.O. BOX 702
BALLSTON SPA.NY 12020-0000
Plans&Specifications
2013-001 28 Briwood Circle
Mobile Home Eagle River Serial # ER 02778
5136.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,January 04,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town Asbury Fri ', nuary 04,2013
,
SIGNED BY // for the Town of Queensbury.
Director of Building&Code Enforcement
r
3 + OFFICE USE ONLY
TAX MAP NO. � '� Jr��PERMIT NO. 0</)( 3 001 DATE ISSUED:
!_ JAN 0 3 2013
PERMIT FEE/3 l0($OAPPROVALS: ZONING - TOWN CLERK
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: 0,0, ry-fri, Jk Name: 4 .a ( ParenLIS
n rr�� Pichr
Address: �. ) . P(;)C. rlCld\ Address: J 0 .�
CDR 1. s ( opa , AtkIanan tu f 91.0(1_,R,1 n c.,, l 3)q
Phone No. ,j 1 g- qcN'C O? Phone No. ,5R-_ 7 Parcel Information �I�l r
Proposed Date of Placement: I - A ' I Property Location: o(g r I �j✓ .1A -(^
Pax
Street,Avenue
�
Name of Mobile Home Park: )YPS-r� Pax h (if applicable) Tax Map Number:
Mobile Home Information Zoning Information
Approximate Value of Home: $ (1 �LC Zoning Classification:
New Home: [RYes ❑No Size of Property: (JO ft. by la 0 it
Replacement Home: [ Yes ❑No Existing buildings: O
Size of Mobile Home: \ 5_ ft. by f LD ft. Setbacks: front yard L. rear yard 1. O ft.
side yards?- __ft. and__LA _ft.
Singlewide: X Doublewide:
Number of Rooms: (exclude baths) 5 Accessory Building(s):
Number of Bedrooms: 3
Number of Bathrooms: ,`1 Detached garage:❑1-car ❑2-car ❑ car
El Gas Fireplace❑Woodstove ❑Wood Fireplace Attached garage: n1-car E12-car ❑ car
Foundation Support: Storage building: EYes El No
Type Size & Depth Other:
Piers Water Supply: Well Municipal
Runners :50")< 4/ I ( � " PP y ❑
Slab Is Septic Permit Required? ❑Yes [Z,No
Continued on page 2
QTown of Queensbury • Community Development Office • 742 Bay Road, Queensvuny, iv r i Lau+
Name of Installer or Mobile Home Dealer: t_-V Ir IY 1 l
Address: P X) 20 t t 1 cl 4i-k c Phone: 5-i4 'tocx -O& (o
�cxt(9
Complete information below found on a"Plate"or C 1"Stintichhke�r°which is affixed to the mobile home:
✓ Insignia serial number. t✓ R. l
✓ Name of manufacturer: a 9 4, g, r j
✓ Plan Approval Number. NI }F /5K 3`7(c f /41(0
I Model or Component Designation: ' (-S
I (New home only)
✓ Date of Manufacture: I I i Il
4an:r::v:::rv:::r�•:eiv::usr.,uc::rr::s-tr nvs nisi.rv:ac.:::ra.v:iv:rrr:.�.rsri.rnaui:v.ays::r:r: ur:r�
'.; 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 3
and specifications submitted, are a true and complete statement I
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
c shall be complied with, whether specified or not, and that such
work is authorized by the owner. }
0ti'.4l
Signature:
• — 3
Owner, O er's Agent,A hitect, Contractor
.:w.:..rxx�:+r.+u:.:.u:.::x+w:+r:i:.+..-r�r+ur.+rw• :.w:1:..:.:.a rx s a.r�w:�:..rxx.+-...srrfSs CPa-1
SPECIAL CONDITIONS OF PERMIT
S.
By:
Code Enforcement Officer
etTown of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
1'h - ID
Queensbury Building & Code Enforcement -- Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart: IV, IG am/pm
Date Inspection request received: Inspector's Initials: I
NAME: - d PERMIT#: I 3-Dot
LOCATION: q 6 r' I 0 Of)c DATE: 1'' / /3
Manufactured Home 7`..._
Modular Home
Footings Foundation Backfill Framing
Comments:
Yes ,..,No__ N/A_
Foundation support,pier spacing,
V/4/
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off ‘.///:
Sewer line support @ 4 feet V
Heating Crossover[doublewide}off grd. 'il
Dryer vented outside //,
Skirting ventilated 1 sq.ft.per 1,500 sq.ft.
Hot water relief valve piping outside
Deck, porches, steps, railing
l.7/1
Fumace/hot water operating
Garage Fire proofing 4
Fire Door/Door closers
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable] .
Smoke/Carbon Monoxide Detectors/Interconnected /,/
Final Electrical 1i
Variance required
. / .
Data Plate okay
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 ii`911 Street number , ,
Okay to issue C/C or C/O[Temp_./Perm.]--_.__________
Model# Serial# --*''r-- 2
Manufacturer ) 4 < (2J \/c.."—t--)5
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Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518) 761-8256JArrive: 9)`'( am/ _m Depart: am/pm
Date Inspection request received: ( /(5/I 2 l Inspector's Initials: . 1i-
NAME: _ /jt} ? S //9, c C vrn\'1 c,n c`SPER IT#. i 2,- ut)1
LOCATION: S- r) I Lt,,610 ( t c I DATE:
//03
Manufactured Home
Modular Home
Footings_ Foundation_ Backfill_ Framing
Comments:
Yes No N/A
Foundation support,pier spacing,
Per manufacturer v
Anchoring per manufacturer 2'from ends
Water line shut off V
Sewer line support @ 4 feet / ,4 j Z-/-
/ ` J L,,G
Heating Crossover[doublewide}off gni. c/ 1Nt L
Dryer vented outside I e'Al q 7 t?
Skirting ventilated 1 sq.ft.Der 1,500 sa.ft. ,/
Hot water relief valve piping outside I/
Deck,porches,steps, railing !/
Fumace/hot water operating / 4/`,,J1,- A 1,
/ v�'e
Garage Fire proofing ✓/
Fire Door/Door losers
Plumbing Fixture/3"Vent through roof[Modular] 1/1
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected ` A ; }
Final Electrical i/ ,7�
Variance required I/
Data Plate okay
Manufactured HUD seal okay i// 6f04- " ' �0<'Vif" ti h‘'//Ore)f d{
Warranty Seal after January 1,2006 f ddC t.;r»e.'% (-10'4--
Installers
-1p�
Installers Warranty Seal LZ
18"x 24"access or 22"x 30'attic access ;/
Vapor retarder under home 6 mil poly or other
911 Street number ✓ j3414.44
Okay to issue C/C or C/O[Temp.I Perm.]
Model# Sic 0.5 I )4 Serial# t( Q'-7)f
Manufacturer Er-51k. PIT I-J4yy1v
Date of Manufacturer r i ,I I i t-
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s ii TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
ivira Community Development-Building&Codes (518) 761-8256
Inspections per Permit
Permit# P20130001
Inspection Date Inspection Type
Approved/Denied Comments Permit Type Person Responsible
01/03/2013 Miscellaneous Mobile Home In Park STAFF
Misc 2013-001
permit app rec'd&entered
01/04/2013 Miscellaneous Mobile Home In Park STAFF
Misc 2013-001
permit issued
01/04/2013 Final Inspection Mobile Home In Park DAVID HATIN Staff
Denied 2013-001
Home needs to be moved 18"to meet 20'between homes
/ -
Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: , 15 am/prnm,,Depart: am/pm
Date Inspection request received: Inspector's Initials: J.]k
NAME: � �C' � PERMIT#:
LOCATION: DATE:
Manufactured Home -;-\('
Modular Home
Footings Foundation Backfill Framing
Comments:
Yes`No NIA
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
/1,111:1
A/al2
Vapor retarder under home 6 mil poly or other
911 Street number ` /Me
Okay to issue CIC or CIO[Temp.I Perm.]
Model# Serial#
Manufacturer
Date of Manufacturer
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