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2005-330 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE (".)"Ju" OCCUPANCY Permit Number. P20050330 Date Issued: Thursday, January 10, 2008 This is to certify that work requested to be done as shown by Permit Number P20050330 has been completed. Location: 183 PITCHER Rd Tax Map Number. 523400-308-014-0001-052-000-0000 Owner. ARC COMMUNITIES 14, LLC Applicant: FOREST PARK 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 Enforcement 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: P20050330 Application Number: A20050330 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: FORF,ST PARK 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 900 Mobile Home In Park $30,000.00 Total Value $30,000.00 PO BOX 790830 SAN ANTONIO, TX 78279-0000 Contractor or Builder's Name / Address Electrical Inspection Agency PIans&Specifications 2005-330 15 GREGWOOD CIRCLE 1216 SQ FT MOBILE HOME $47.96 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, May 23, 2006 (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 T ueens ry; 0 ay, May 23, 2005 SIGNED BY for the Town of Queensbury. Director of Building&Code nforcement I Ap plication for Permit— Mobile Home Town of Queensbwy, 742 Bay Road, Queensbu7y, NY 12804 (518) 761-8256 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 Inf ormation 0 ce Use Name: Q. FO k a-,:: r File Permit No. NED Address: Fee Paid wv 5 . d�JF TOWN O O Review 1161)ING UEENSBURY AND C_ODE Reviewed By: TOV Phone No. ��t8 �� Property Owner Information Parcel Information *QCGT Proposed Date of Placement:. Name: PPrV_ NW_ Property Location: 6 OwJe, Address: LcCO &V-ANrr6T- 6CAI-TEq60 Road,S49KAvenue 1>EfJock : C-0 SE;X8 Name of Mobile Home Park: 'r0V_C,5T--NV-K PA 4C✓ (if applicable) Phone No. Boo ,>46 !-Al G Tax Map Number: 3bi Mobile Home Information Zoning Information Approximate Value of Home: S 4J6 , Zoning Classification: New Home: Yes No Size of Property: ft.by laft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard fL ; rear yard 20fL Smiglewide: Doublewide: Side yards 1 and 1.5 ft. Number of Rooms: (exclu a baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: I car, 2 car, car circle: Gas Fireplace Woodstove/Wood Fireplace Attached garage: I car-, 2 car, car Storage building: Yes No Foundation Support: Other: TYPE S=&DEPTH Water Supply. well or Piers X 4��iD Runners X Is Septic Permit Required? Yes or Slab X E) Further information requested on the reverse side of this sheet r Name of Installer or Mobile Home Dealer: Address: Phone No. 8 Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number. 2. Name of manufacturer. 3. Plan Approval Number: �., / 4. Model or Component Designation: (New Nome OAZI? 5. Date of Manufacture: AFFIDAVIT Town of Queensbtuy 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 A;2)1 A *e , er's agent, hitect,contractor Special Conditions of Permit By: Form: 11/19/1999sh Code Enforcement Officer loto' ub W FINAL INSPECTION REPORT TO"o MOBILE / MODULAR Town of Quemsbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVEA6,1bDEPART- - I DATE INSPECTION REQUEST RECEI NAME: np\cl E�Z� LOCATION: DATE: PERMIT# MOBILE moms \)L MOWLARHOPM FOOTINGS— FOUNDATION — BACKFIL— FRAMING NIAYES 0 I- foundation support, pier spacing per manuf. ........................ 11IN 2. anchoring per manuf ............... 3. water line shut off ................... 4. sewer fine support @ 4 feet ....... 5. heating crossover(dblewide) off grd. 6. dryer vented outside ..,:................... 7. skirting ventilated .................... 8. hot water relief valve piping outside 9. deck, porches, steps, railing ........ 10. furnace/hot water operating ........ 1 1. garage fire proofing .................. 12. door closers ........................... 13. plumbing fixture ...................... K foundation insulation (if appl.)...... 15. smoke detectors ....................... 16. final electrical ........................ 17. variance required ..................... 18. data plate okay ....................... �- 19. mobile HUD seal okay .............. Model#. \9Z bS—�—M Serial# Manufacturer Date of Manufacturer 1 171-A n%I OKAY TO ISSUE CIO YES NO Comments: OfirC4 Ind GS 7-OOG FINAL INSPECTION REPOFIT MOBILE / MOOULAR Town of Queensbury /10 Building &Code Enforcement 742 Bay Road /ASPQueensbury, NY 12804 ` (518) 761-8256 ! I ARRIVE:/��/DEPART: INSP: DATE INSPECTION REQUEST RECEIVED: NAME: Q� LOCATION: I S -air DATE: Z PERMIT# MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACKFILL_ 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 @ 4 feet ....... 5. heating crossover (dblewide) off grd. — — — 6. dryer vented outside ...:................... 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 ........................ — — 17. variance required ..................... — — 18. data plate okay ....................... —_ 19. mobile HUD seal okay .............. Model # Serial # Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments.-rhp j 0^& /.J 5 P c-L aJ r.tL3n�LrL3% ��rr�n�IrT] 5 BY THIS CERTIFICATE OF COMPLIANCE THE D 5 S NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 cS 5 TY 40 FULTTON STBUREREET EETTF NEW NY 10038 5 5 c5 5 CERTIFIES THAT 5 5 5 5 Upon the application of upon premises owned by 5 5 cS 5 5 SHAWN ARRUDA AMERICAN RESIDENTIAL COMMUNITY183 PITCHER RD. 5 S QUEENSBURY, NY 12804 183 PITCHER RD. 5 QUEENSBURY, TN, NY 12804 S 5 S Located at 15 GREGWOOD CIRCLE QUEENSBURY,_TN,NY 1.2804_ Application Number: 3043078 Certificate Number: 3043078 5 5 5 5 Section: Block: Lot: Building Permit: BDC: A239 S S 5 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 5 electrical devices and wiring, described below, located in/on the premises at: 5 5 5 5 First Floor,Outside, 5 5 5 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 5 authority having jurisdiction, and found to be in compliance therewith on the Day of 5 16th August,2007. SName ( TY Rate Eating Circuit Type 5 5 Miscellaneous 5 no new equptment 5 5 Panels 5 5 1 100 20 5 Service 5 5 1 Phase 3W Service Rating-100 Amperes S SService Disconnect: 1 100 cb 5 5 Meters: I 5 5 An as built inspection,of the delineated electrical installation,determined that an obvious hazard is not present and the installation is believed to Sbe in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. 5 S 5 5 5 5 5 5 5 S seal 5 S 5 1 of 1 5 5 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 5 5 ® ��W��EMU r4l ��rPLP�&P�� o APR-14-2005 THU 02:56 PM TITAN HOMES INC FAX NO. 315 841 4660 P. 08 m 7 > 0 0 E:mo 0 > p;u > r- 0 m u o m F4 > M N- Cc) x �u 0—4 t4 x, -110m p 93 Qnj co N o- -x,—, I- Cc) rn —na ........... 33no qO NMOI WTI-il ANng§N, , 7mpr AVN C13AI303N Z,21: 0 .0< 9 N�! oVZ 2! RT O ry 'GiaiS col MAN 10 sapoo buippe atg qjjm GouejldWoo linj ui aje suopogods pue sueld w4f 6ui eoipu! su, perulsuoo aq jou c: lleqs sluawwoo ino Low oweildwo3 luo!leulwexo popwil ino uo *ee ----- N:mi8Yd3a 9NI01InS A nOSN33no jo w0i > z .13 3 Mows :� r cZ t �J Qi ('n r' L RECEIVED May TOWN OF QUEENSBURY � BUILDING AND CODE -- s 1^ i (24 i P {