2007-764 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building &Codes (518) 761-8256
CERT IFICATE OF OCCUP-A-N- CY
Permit Number. P20070764 Date Issued: Friday, February 08, 2008
This is to certify that work requested to be done as shown by Permit Number P20070764
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 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 Enforrement
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: P20070764 Application Number. A20070764
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. Tyne of Construction Value
Owner Address: ARC COMMUNITIES 14, LLC
Mobile Home In Park
900
PO BOX 790830 Total value
SAN ANTONIO, TX 78279-0000
Contractor or Builders Name 1 Address Electrical Inspection Agency
Plans &Specifications
2007-764
82 Alpine Dr : 1456 sq ft mobile home in park
$87.36 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday,January 17,2009
(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 Quee I
ay,January 17, 2008
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
j.............w.......r.rr.r.r.rr...... .............................. F.......<.........<
OFFICE USE ONLY ;
TAX MAP NO. PERMIT NO. DATE ISSUED:
PERMIT FEE _ APPROVALS: ZONING TOWN CLERK
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I. .e......... .................................................. -.................�.
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: v!'' Name: �'�
Address: ' 1:> .. /t- Address: .ti �'
Phone No. ' 1� 1� —r'v/Jv' Phone No. `>
Parcel Information
Proposed Date of Placement: r.. Property Location:
R Street,Avenue
Name of Mobile Home Park: //()r�P,%'. rF;0& VZZI.fie.T (ifapp►icabie) Tax Map Number:
............
Mobile Home Information' ' �%%. Zoning Information
Approximate Value of Home:$7`�--- Zoning Classification:
r
New Home: es No = Size of Property:' ft.by
Replacement Home: (S�D No ,/ Existing buildings: �'`�✓"�f
Size of Mobile Home: = ft. byv` ft : Setbacks: front yard f ft rear yard
side yards Z5 ft.and
Singlewide: Doublewide:
Number of Rooms: (exclude baths) : Accessory Building(s): circle
Number of Bedrooms: s
Number of Bathrooms: Detached garage: 1-car 2-car car
E t
Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Type Size & Depth Other:
PI__ eC$ Water
Un
SuPPIY= well or uniPal
Slab Is Septic Permit Required? Yes or
Continued on back
'' Town of Queensbunf• Community Development Office • 742 Bay Road, Queensounj, iv r iLou4
Name of Installer or Mobile Home Dealer --
Address _ :.r;,✓ .`; Phone:
Complete information below found on a`Plate'or`Sticker'which is affixed to the mobile home:
0 ;<-4
✓ Insignia serial number. L✓> i _ r.yj.Z,-7 1
Name of manufacturer_ Z-'--�WA/
✓ Plan Approval Number,
✓ Model or Component Designation: 74
(New home only)
✓ Date of Manufacture: '`
} AFFIDAVIT
Y
Town of Queensbury State of New York
County of Warren
J
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Y
i
I swear that to the best of my knowledge and belief the v
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 a
ORDINANCE, and all other laws pertaining to the proposed work
J
shall be complied with, whether specified or not, and that such w
work is authorized by the owner. 9 �'
r Signature: u
V` er,Owner's Agent,Architect, Contractor a
Y191,11
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SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
Town of Queensbunj• Communihj Developnwnt Office • 742 Bay Road, Queenshury, NY 12804
FINAL INSPECTION REPORT
MOBILE / MOOULAiR
Torn of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256 CnJ
ARRIVE: DEPART: A INSP:
elLJD
DATE INSPECTION REQUEST RECEIVED:
NAME: t
LOCATION: Z ` �'► I -��
DATE: Z 1(.0d01?�;� PERMIT if
MOBILE HOME _ MODULAR HOME
FOOTINGS FOUNDATION $AC[EIIL FRAMING
_ N1A . YES /NO
i. foundation support, pier spacing /
per manuf. ........................ — -
2. anchoring per manuf. ............... _ _
3. water line shut off ...................
4. sewer line support®4 feet ....... _ _
heating crossover(dblewide) off grd. _ —
dryer vented outside .x................... _ � —
skirting ventilated .................... _
8. hot water relief valve piping outside
9. deck, porches, steps, railing ........ —
10. fimiace/hot water operating ........ —
11. garage fire proofing ..................
door closers ........................... —
3. umbing fixture ......................
foundation insulation (if appl.)..... — —_
15. smoke detectors ....................... — —
16. final electrical
17. variance required ..................... —
18. data plate okay ....................... — —
19. mobile HUD seal okay ..............
Model # Serial #
Manufacturer
I)ate of Manufacturer
OKAY TO ISSUE C/O YES. NO
s: ��
NFINAL INSPECTION REPORT
MOBILE / MOOLILAR J
Town of Queensbury �
1
Building &Code Enforcement
742 Bay Hoed
Queensbury, NY 12804
(518) 76141256
ARRIVE: DEPART INSP:
DATE INSPECTION REQUEST RECEIVED.:
NAME: ILC
LOCATION:
DATE: �� yD PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION RACKFI L FRAMING
N/A . YES NO
1. foundation support, pier spacing
per manuf. ................. — —
2. anchoring per manuf. ............... _
3. water line shut off ................... _
4. sewer line support a 4 feet ....... — Az —
5. heating crossover(dblewtde) off grd. —
6. dryer vented outside .x................... —
7. skirting ventilated .................... _ _
8. hot water relief valve piping outside _ —
9. deck, porches, steps, railing ....... — —
10. furnace/hot water operating ........
11. garage fire proofing .................. —
12. door closers ........................... _✓
13. plumbing fixture ......................
14, foundation insulation (if appl.)...... _
15. smoke detectors .... —
16. final electrical ......Q .. . Q
17. variance required ..................... —
18. data plate okay ....................... — —
19. mobile HUD seal okay .............. —
Model # Serial _ JooI
Manufacturer \Yy�rry \c�'A�.`�7
ugDate of Manufacturer lJ
OKAY TO ISSUE CIO YES NO
Comments:
COMMONWEALTH ELECTRICAL INSPECTION SERVICE.INC.
Main Office 176 Dft Run Road-Mtnbelm,PA 17545 j
MUNICIPAL CERTIFICATE - ELECTRICAL APPROV L
Permit No........................................Celt, N2 9 4 1 3 z cut-in card No...,........................
.,.......
Owner...................... ........_._..._..__.........................,-...--...._................,,,.......I..........
Location................R.1 f............................. ..................
Installation Consisting of__.. .,..... .r'......................
----•...........................................................................................................................:...................................
Installed By A-- - Lic No_
The conditions following governed the issuance of this certificate,and any certii3cati prcviously issued is
cancelled:-
This certifcate only covers the electrical equipment and installation conditions as,of date_ Upon the 1
introduction of additional equipment or alterations,application shall be promptly madb for inspection.
Inspectors of this Company shall have the privilege of making inspcctions at atiy time, and if its
rules are violated,the Company shall have the right to revoke this certificate.
Date.....,,
Member NAP A,I.A.E.I.
Z0 3E)Vd oiswnW NOd b89Z8GL G7.:7.T s�ara� {era tin
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 In 7's
Initials:
e
NAME: Z�YYIe. PERMIT#: o
LO CATIO 4t INSPECT ON:
TYPE OF STRUCTURE:
Comments
Y N N/A
ootings
Monolithic Slab ` -�� tom.` VJL
Reinforcement in Place
The contractor is responsible for _,�^
providing protection from freezing U '� u -Mf
for 48 hours following the placement
of the concrete. "
Materials for this purpose on site. �� C t�• 1
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofmg
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\lnspection Farms\Foundation Inspection Report-doc
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