2007-552 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4E Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Pen-nit Number. P20070552 Date Issued: Wednesday, August 13, 2008
This is to certify that work requested to be done as shown by Permit Number P20070552
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 maybe 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 owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF UEENSBURY
Q _
742 Bay Road,Queensbury,NY 128045902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070552 Application Number. A20070552
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 $2,500.00
900 Total Value $2,500.00
PO BOX 790830
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2007-552
93 GREGWOOD -MOBILE HOME IN PARK- RONALD McPHEE Jr.
$33.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, September 05, 2008
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the own e / ay, September 05, 2007
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement -
�... .<...................................................«.......... r...................
w, OFFICE USE ONLY
�
" TAX MAP NO. PERMIT NO. '��-'CIA TE ISSUED:
PERMIT FEE APPROVALS: ZONING TOWN CLERK ;
,
MOBILE HOME —APPLICATION FOR PERMIT:
A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a
valid building permit has been issued.
Applicant Information Property Owner Information
Name: r1 Aj 14 J Name: �0�0, 1�l ! ' L�il J j ,
Address: -!-3 6req iAcO cc,f e Address:
2 S �y� ./�/ �D ve fl tom✓ )10
Phone No. . 30 -y yo Phone No. L51S)
Parcel Information
Proposed Date of Placement: Property Location: (7r VV0 Je-
`'~� Road,St reef,Avenue
Name of Mobile Home Park: J
(if appfrcabfe) Tax Map Number: (
Mobile Home Information Zoning Information
Approximate Value of Home:$ € Zoning Classification: S l2'(/4-
New Home: Yes No Size of Property: y ft.by ft.
Replacement Home: Yes No Existing buildings:
�j g550
Size of Mobile Home: f l ft. by 70 fL Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: /N< Doublewide:
Number of Rooms:(exclude baths) S : Accessory Building(s): circle
Number of Bedrooms: 3
Number of Bathrooms: I Detached garage: 1-car 2-car car
Circle: Gas fi /Woodstove/Wood Fireplace Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Type Size & Depth Other
Piers
Runners Water Supply: well or unicipa
Slab Is Septic Permit Required? Yes or
Continued on back
Torun of Queenshry• Community Development Office• 742 Bay Road, Queensnury, iv x Lzau*
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Name of Installer or Mobile Home Dealer. tAl O r r I�
Address: �c�n t r Phone:(5-6 )
Complete information below found on
aii'Plate'or'Sticker which is affixed to the mobile home:
✓ Insignia serial number. 14a 13`6 —:20 F 3 �._-5L• F�— -5 0-
✓ Name of manufacturer. 60 rr 4�1,o rn CL Ce i ),.} core,
✓ Plan Approval Number.
✓ Model or Component Designation:
(New home only)
✓ Date of Manufacture: 7 d
z AFFIDAVIT
J
J
Town of Queensbury State of New York
County of Warren z
V
7
♦ I
r J
I swear that to the best of my knowledge and belief the c
statements contained in this application, together with the plans
and specifications submitted, are a true and complete statement x
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 y
5 shall be complied with, whether specified or not, and that such S
work is authorized by the owner.
x
r Signature:
Owner,Owner's Agent,Architect,Contractor
x
SPECIAL CONDITIONS OF PERMIT
L
By:
ode Enfo Officer
Town of Queensbury• Community Development fJ`ice• 742 Bay Ro , Queensbury, NY 12804
TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804 5902 S 18 761 8201
-(Z) �
AFFIDAVIT
TOWN OF QUEENSBURY STATE OF NEW YORK
COUNTY OF WARREN
I swear that the following used mobile home that will be transported
into the Town of Queensbury for placement will have the following. A
building permit approved and issued, meet all zoning requirements,
the mobile home's HUD sticker affixed to mobile home and meet
HUD requirements for the Middle Zone. As the person responsible
for the transport and placement of this mobile home, I accept total
responsibility for removal of the mobile home from The Town of
Queensbury, if it does not meet the requirements for placement.
Si nature: %� ��� o�'C' Date: Idd�e)
9
Mobile Home Owner er's Agent, Mobile Home Contractor
Signature: Date:
Tow of u ensbury Cod forcement Officer
"HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"
SETTLED 1763
/l 1 / t6
IMAL INSPECT101y REPORT
MOBILE / MOr"°ULAR
Town of Queen;
;bury
Budding &Code Enforcement
742 Bay Roar
tQueensbury, NY 12804
(518).761-82%
ARRIVE: .b 'DEPART-
DATE
t
DATE IMPECITON REQUEST RtCE1VE
NAME:
t
TION -- PERMIT# - SZ
11[OBILE HO MODULAR HOME
FOOTINGS ^ FOUNDATION RACKFILL FRAMING
N/A YES NO
1. foundation support, pies'spacing
per manuf. ......................•.
2. anchoring per manuf. ............... —
3. water line shut off ...................
4. sewer line support a 4 feet ....... _ —
5. heating crossover(dblewide) off grd. — — —
6. dryer vented outside .x...................
• 7. s—kirt1!^a -.,enw�3ted -- —_
8. hot water relief valve piping (mtside — — —
9. deck. porches, steps, railing ........ —
10. f irnace/hot water operating ........ — —
11. garage fire proofing .......... ....... — — —
12. door closers .................... ...... — — —
13. plumbing fixture ...................... — —_
14. foundation insulation (if app3.I......
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 CIO YES NO
Comments: /� ��
FINAL INSPECTION REPORT
MOBILE / MCOULAR
Town of Quemsbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVE4' 10 DEPART- INSP.
DATE INSPECTION REQUEST RECEIVED:
NAME:
U)CATION-
DATE: 2 Q PERMIT#
MORILLE HOME Wa=
MOEKnAR Hotm
FOOTINGS FOUNDATION— BACKFIIJ-— FRAMING
N/A YES NO
I. foundation suppolt pier spacing
per manuf. ........................
2. anchoring per manuf. ...............
3. water line shut off ...................
4. sewer line support 0 4 feet .......
S. heating crossover(dblewide) off gid.
6. dryer vented outside x...................
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. deck, porches, steps, railing ........
10. fiumce/bot 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#70 r� klk r- -1201rw # I Z--Z t OP-2
Manufacturer 506
Date of Manufacturer
YES NO
Comments:
DEPARTMENT
Q *�
Based an auE limited examination,
compiiancc tivith our comments shall *
not. be construed as indicating the cif
plans and specifications are in full
compliance with the Building Codes of �
�. New Yore Mate � �
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