2005-331 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. P20050331 Date Issued: Thursday, January 10, 2008
This is to certify that work requested to be done as shown by Permit Number P20050331
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: P20050331 Application Number: A20050331
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. Tyne of Construction Value
Owner Address: ARC COMMUNITIES 14, LLC
Mobile Home In Park $30,000.00
900 Total Value $30,000.00
PO BOX 790830
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-331 84 BRIWOOD CIRCLE
1216 SQ FT 2005 MOBILE HOME
$0.00 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 of Quee bury, M uday, May 23, 2005
SIGNED BY for the Town of Queensbury.
Director of Buildi g&C�Ae Enforcement
Application for Permit— Mobile Home RECEIVED
Town of Queensbwy, 742 Bay Road, Queensbwy, NY 12804 (518) 761-8.16'y ' ' 1005
TOWN OF QUEENSBURY
A building permit must be obtained before placement of mobile home on parcel. No ins;L�C�WW&�"00�ate
until a valid building permit has been issued.
Applicant Information
Office Use
File
Name: -449d 7�69E&-r Permit No. 0 33 (
Address: Fee Paid -,-7
Reviewed By:
-----................
Phone No.
Property Owner Information Parcel Information
*(zeG-r Proposed Date of Placement: a, a---5kz/05
Name: pp'ry- 14w— Property Location: Rn' k16A �ImJe)
Address: LoOC) &RA"-r <->T- /DLAITC q60 Road,Street,Avenue
S5X8 Name of Mobile Home Park: lrozE6-r—vw-K M 14C—
(ifapplicable)
Phone No. Soo � —'Al G Tax Map Number:
Mobile Home Information Zoning Information
Approximate Value of Home: S_,-304 Zoning Classification:
New Home: Yes No
Size of Property: ft.by LW ft.
Replacement Home: Yes No
Existing buildings:
Size of Mobile Home: ft. b. ft.
Setbacks: front yard fL; rear yard ft.Singlewide: Doublewide: Side yards fL and 15 ft-
Number of Rooms: (exclu,e baths)
Number of Bedrooms: Accessory Buildmig(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 51a&DEPTH Water or Supply: well
Piers X we4�iD
Runners X Is Septic Permit Required? Yes or No
Slab X
Further information requested on the reverse side of this sheet
)4 Name of Installer or Mobile Home Dealer: 40165
Address: TO ZoxDot. Ito
Phone No. ('618 _
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number
2_ Name of manufacturer. Q(rY1P,S
3. Plan Approval Number :
4_ Model or Component Designation:
(New Home 0NL19
5_ Date of Manufacture:
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 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:
owner, er's agent,irRhitect,contractor
Special Conditions of Pennit
By.
Form: 11/19/1999sh Code Enforcement Officer
PY
T
;11 f`
'4 1' 777 f-1 A vr-77 I j�-
I
,,3uLDING &
REVIEWED BY
IDATE MM -
ce)
TOWN OF QUEENSBUIRY BUILDING DEP3RTMEN1
Based . on, ISE
c=3ne 'th our comments shall
not cons rued as indicating t>e
plans and s rifications are !ii fiii,
compliance itt-i
of lay w Yr-Al
IJU
e
cl�%o
NOT
ANNORIMr,' r�F ICE lv�.Q!j E pn%IF
tJ
RECEIVE
-TOWN Of QUF—ENSBU
BuiLDiNG AND CODE
i
OD co z Amy
20 J
Z"T
�c
Zm
oz
MODEL 1680-2 o W a) r"n 0 3 BED ROOM,28ATH m�
m N061VINAL SIZE: 16'x 80' "<
�r ACTUAL SIZE: 15'-2"x 76'-0"
TOTAL AREA'. 1153 SQ.FT.
co
Ln
Co
O
z
x
Q
r T — — 23-3 — -- — -- 52' -
I r I I
F MASTER DINING , BDRM#3
BEDROOM s's'x 7'-6" , Y, LIVING
13'-3'x 14'-2" — ' ROOM
15'-8'x 14'-2" B D R M*2
CD \ / I I 9'S x 1 4.-2"
cn
_ - ; I KITCHEN I
CD
r
� .-- ---- zr-s•lia" �
co
Lc)
CV
C:D
E—
Ln
CD
CO DAP7A SEAL PAODIFICATlONS -MOGEL'.1 C O!y-r) .;EET:
-- - - -_-- i 680 G .
1b'x'JO'3htn". L_'10 1
TITAN HOMES - --- LITERATURE PLAN
Q PRQPRLEfAR53fDCONFIDENe1AL DR-UhPfSY:GAFF ?D.��TF14 - --
MHE9EDPAV04GSAND3FECIFY_'APON3 ARE!H1L:wi - 22{L3
.._ _
F:30FS-IICI K--f UCCWF EN7L^LMATFRALSr_FCHbArRCN-
P.O.BOX 17'7 �1'.12&2 SANGQiF1ELD NY 13455 caFraLCHre ILRGY.U561'CH.V.4l,ri oL.RI....rm"_1'-0
t U-CIC)0 NtA
FINAL INSPECTION REPoWr
MOBILE / MODULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
QueerWx", NY 12804
(518) 761-8256
ARRJVE:�D DEPART: INS
DATE INSPECTION REQUEST RECEIVE
D
NAME:
LOCATION:
DATE
PERMIT# 13
MOBILE ROME —Y, MODWAR HOW
Foo'nNGS— FOUNDATION BACKFUL— FRAMING
NIA YES 1*1110 1. foundation support, pier 1/
per manuf. ...........spacing..........
2. anchoring per manuf.•
...............
3. water line shut off ................... ✓
4. sewer line support @ 4 feet .......
5. beating crossover(dblevh&) off grd.
6. dryer vented outside ...c...................
�/_
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. fWadatiort insulation (if appl-)......
15. smoke,detectors .......................
16. final electrical ........................
17- variance required .....................
18. data plate okay .......................
.19. mobile HUD seal okay ..............
Model # \\!::0 t 9 se
. #
Manufacturer
Date of Manufacturer
OKAY TO ISSUE CIO YES V/ NO
Comments:
�L�
FINAL INSPECTION REPORT'
MOBILE / MOOULAR
Town of Que"Wry
Building $Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIYE:2^ DEPART: INS
,r
DATE INSPECTION REQUEST RECEI
NAME: A R C PR
LOCATION: -
DATE: A --�A- PERMIT#
MOBILE ROME MODULAR H01tE
FOOTINGS` FOUNDATION i BACKR L` FRAMING
NIA YES NO
I. foundation support, 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 grd. —
6. dryer vented outside . ................... _
7. skirting ventilated .................... —
8. hot water relief valve piping outside — —
9. deck, porches, steps, railing ........ —
10. furnaceAwt water operating ........ —
I I. garage fire proo —
12. door ol�rr„...... Q.. ...SM _
13. plumbing fixture ......................
14. foundation insulation (if appl.)...... —
5. smoke detectors toCo..� -
16. final electrical
17. variance required ..................... —
18. data plate okay ....................... —
19. mobile HUD seal okay .............. —
Model # { t W`T Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C!O YES NO
Comments:
(:ZXp r rtVf lKay Z�S Gam'
FINAL INSPECTION REPORT
MOBILE / MOOLILAR
Town of Queensbury
Building &Code Enforcement n
742 Bay Road y1sr
Queensbury, NY 12804
(518) 761-8256
ARRIVE: L ' DEPART: INSP:
DATE INSPECTION REQUEST RECEIVED:
E
:TION:
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:{
CUT A e--f o 0#6r4iJ AV Esc. /ems
�(f 44.,(- k r)N4L f,�;P� I�b/RI� Y
0 r rL3rL3 r ffl3r[ l�rJcPr.J�cl�r�r�r�cPr�r�r�rJ�c.tr nrJrJ�rJ�r��PrJ�rJ�cP�Pr�r.PrnrJ�cJ''MPL r rL3rJr lL3]'� rJ�r�r.P3PLPL LfflPLLPLPL rLr�r�rJ�r�cCcPrJ� cO
5 BY THIS CERTIFICATE OF COMPLIANCE THE
5 � 5
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
5 SBUREAU OF ELECTRICITY S
40 FULTON STREET — NEW YORK, NY 10038 5
5 5
5 CERTIFIES THAT 5
5 5
5 Upon the application of upon premises owned by
5 c5
5 SHAWN ARRUDA AMERICAN RESIDENTIAL COMMUNITY S
S 183 PITCHER RD. 183 PITCHER RD.
QUEENSBURY, NY 12804 c5
5 QUEENSBURY, TN, NY 12804 cS
SS Located at 5
ted 84 BRIWOOD CIRCLE QUEENSBURY, TN, NY 12804 5
Application Number: 3043073 Certificate Number: 3043073 S
5 S
5 Section: Block: Lot: Building Permit: BDC: A239 S
5 5 Described as a occupancy, wherein the remises electricals stem consisting of
ResidentialP Y g S
Selectrical devices and wiring, described below, located in/on the premises at: 5
First Floor,Outside, SS
S5 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 5
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other
5 authority having jurisdiction, and found to be in compliance therewith on the 16th Day of August,2007. 5
55 Name OTY Rate Rating Circuit Tvpe 5
5 Miscellaneous c5
5 no new equptment 5
Panels 5
5 1 100 20
5 Service c5
S1 Phase 3W Service Rating 100 Amperes S
5 Service Disconnect: 1 100 cb 5
5 Meters: 1 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 5
Sbe in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system.
S 5
5 5
5 5
5 5
5 Sea. ME
5 L
5 1 of 1 S This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. C
5 5
a cncncncncJ�rJ'cncnr.!�FIN]�ncfr�rJrJ�rJ�rJ�r�c2 c '!r.J�rJ�rJ�rJrJ�rJrJ�r1rJ�rJ�MOR 2 �nrrcncncnc ncnctclrn0,12PRRIEL 00,1019, 91MIDEPEEPOPIMPE M