2013-005 .11"Akii 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: P20130005 Date Issued: Wednesday, January 23, 2013
This is to certify that work requested to be done as shown by Permit Number P20130005
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
Veyireree4 TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property /l
owner of the responsibility for compliance with Site Plan, Variance, or �,LP•� t7
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
`� a 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130005 Application Number: A20130005
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 applicanon 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
RAYMOND JONES
424-0508 P.O. BOX 702
BALLSTON SPA,NY 12020-0000
Plans&Specifications
2013-005 39 Gregwood Circle
Mobile Home Marlette Serial ft
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 To of Q ensb2; ! i 2013
�� r 1 �a 04,
SIGNED BY � for the Town of Queensbury.
Director of Building&Code Enforcement
•
JAN
d v20'3• r
• OFFICE USE ONLY • •
• 36g /11,1 •
•
TAX MAP NO. PERMIT NO. /3'Ubv OATS ISSUED: .
PERMIT FEE )3 e PROVALS: 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: AciIildingName: 4 .6 (' Prorys
Address: P6 . C(x m \ Address: _ / 17 9 eih-erc/
km
kinI.�4 r' apaIM 1. Ix)ao ie JTL b ii n _.i 6()4
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Phone No. -1 0 - q-O 0 b Phone No. ,�} f g- t7 - / ! 7(
Parcel Information
Proposed Date of Placement: /---.- - ri Property Location: C v «C1 L1V o
- ^ , � n OCIi(- —
Road,Street,Avenue
.1 Name of Mobile Home Park: (if applicable) Tax Map Number:
Mobile Home Information I Zoning Information
Approximate Value of Home: $ Zoning Classification:
New Home: BYes ❑No I Size of Property: Le o ft. by/g9)ft.
I lid
Replacement Home: Yes 0 No 1 Existing buildings:
Size of Mobile Home: \5 ft. by,'1 ID ft. Setbacks: front yard S ft. rear yard-59-
ard ft.
side yards—1740 ft.and,_,'j/'_ft.
Singlewide: X Doublewide:
Number of Rooms: (exclude baths) 5 '= Accessory Building(s):
Number of Bedrooms: 3
Number of Bathrooms: a j Detachedgarage:D1-car 02-car ❑ car
Attached garage: 1-ccar02-car car
0 Gas Fireplace�Woodstove [.�Wood Fireplace i 9a S = ❑ ❑
Foundation Support: Storage building: ❑Yes ❑No
Type Size & Depth Other:
Piersi
1L r1,`,, c 1) r Water Supply: Dwell �Manicipal
Runners 7
Slab t is Septic Permit Required? :Nes ►�4 No
l..—._...._�.__..�___._r._.._....._._.... ____..__._..�—.,.. _. ... _.____...__........M._ _..._.— ......_.. _,.,_..__ —..._._J
Conbfnued on page 2
0. Town of Queensbury-Community Development Office- 742 Bay Road, Queensoury, iv r izaw
Name of Installer or Mobile Home Deafer: C--VAT I r t ti tT _.
Address: Pk) -BO y,..4V 1&.t 4 ?c ? Phone: .5 L -Lc J 'D& (o
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number. �,
✓ Name of manufacturer: "/1 r1c\(t ILA Q
✓ Plan Approval Number.
✓ Model or Component Designation:
` 1 1( home only)
✓ Date of Manufacture: }}
11.r
'Y1 ��Lc c :ix . It 1,. :
/�.S.L-:lL-i!:!'J1_1!i!:!:'!1!il:Y�:l:_lr._:li.irn'1!1.-'L�iflli CiSi }LF1litLT1!-�• i'ar,fllxlrlSslvuLitx!v:/:r•.i
AFFIDAVIT +
5 i
j
Town of Queensbury State of New York
County of Warren
I swear that to the best of my knowledge and belief the s
3 statements contained in this application, together with the plans g
and specifications submitted, are a true and complete statement 4
of all proposed work to be done on the described premises and
that all provisions of the BUILDING CODE, the ZONING 1
45 ORDINANCE, and all other laws pertaining to the proposed work ;
shall be complied with, whether specified or not, and that such
i work is authorized by the owner.
Signature: -----
Owner, if er's Agent,A 7itect,Contractor
.12..a.a.1.u:a:..:...,. .i,..w.,. ,.,..,....asr.ux-w•-1-.—_J.-.*(....wx-. -wxx�:.c..ANJL,+:.4
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
alli Town of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: am/,�m Depart: C , /1� am/pm
Date Inspection request received: Inspector's Initials:/`J
NAME: 'S R PERMIT#: / 3 - 06 5
LOCATION: 361 () 'C DATE:
Manufactured Home 7�
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
tv7,
Sewer line support @ 4 feet
Heating Crossover[doublewide}off grd.
Dryer vented outside +M
Skirting ventilated 1 so.ft.per 1,500 sa.ft. 11.7/
Hot water relief valve piping outside
Deck,porches, steps,railing V/
Fumace/hot water operating V
Garage Fire proofing . /
Fire Door/Door closers
Plumbing Fixture/X'Vent through roof[Modular]
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected
Final Electrical
Variance required f
Data Plate okay /
Manufactured HUD seal okay Vr
Warranty Seal after January 1,2006 V
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 -7
Okay to issue CIC or CIO[Temp./Perm.] � ��r:. - 1v ( l Z-(
Model# 0 I,t /ti)M,. Serial# ! v✓ i (1 FA-
Manufacturer AManufacturer
Date of Manufacturer
L:\Pam Whiting120101Building Codes Forms\Manufactured_Modular Modular Final Inspection 03 04 10.doc