2007-397 TOVN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number. P20070397 Date Issued: Monday, December 08, 2008
This is to certify that work requested to be done as shown by Permit Number P20070397
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 Omer 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: P20070397 Application Number. A20070397
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. Tune of Constructio Value
Owner Address: ARC COMMUNITIES 14, LLC Mobile Home In Park $35,000.00
900 Total Value $35,000.00
PO BOX 790830
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans &Specifications
2007-397
89 Gregwood Circle- John Pinel
$46.80 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday,July 13,2008
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tow 7 eensb la J 13,2007
SIGNED BY �; the Town of Queensbury.
;a
Director of Building&Code Enforcement
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OFFICE USE ONLY
/ TAX MAP NO. PERMIT NO. n 3�Z DATE ISSUED: ,
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PERMIT FEE 10-! APPROVALS: ZONING TOWN CLERK ;
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MOBILE HOME —APPLICATION FOR PERMIT
A building permit must be obtained before placement of mobile tame on parcel. No inspections will be made until a
valid building permit has been issued.
A.pplicantInformation Property Owner/Information
Name: tl.�- � � pie L Name:
Address: G c'l ,P Address:
E Islet,l 'Vell iq ISO'
Phone No. Phone No.
Parcel Information
Proposed Date of Placement: �% Property Location:
Road,Street,Avenue
Name of Mobile Home Park: rC)" S itappocable) Tax Map Number:
Mobile Home Information ' Zoning Information
Approximate Value of Home:$ n_T ) ' Zoning Classification:
New Home: Yes loj : Size of Property: ft.by ft•
Replacement Home: Yes ; Existing buildings:
Size of Mobile Home: ft. by l ft. I Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: Doublewide:
Number of Rooms:(exclude baths) = Accessory Building(s): circle
Number of Bedrooms:
Number of Bathrooms: Detached garage: 1-car 2-car car
Circle: Gas Fireplacestove/Wood Fireplace Attached garage: 1-car 2-car car
Foundation Support: Storage building: Yes No
Type Size & Depth Other.
pctd5 ? Water Supply. well or municipal
Runners T"
Slab is Septic Permit Required? Yes or No
L-... _-__....._..._..._------_.._._.. _ ._.----_ __...__-___._._ __._._.___.__..__. __._._........._.........._...._..._._....
__ __...........__ _.__.._.____. ..._... _.._... _ __ _
Continued on bads
Town of Queensbury• Community Development Office• 742 Bay Road, Queensoury, tv r tz-buq
Name of Installer or Mobile Home Dealer—
Address: df� �tCA_c Vlk 1,_ Phone:
Complete information below found on('a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number. - _2019
✓ Name of manufacturer. V^ ^�-
✓ Plan Approval Number. R d C Q D
✓ Model or Component Designation: SC.,Ll�
(New home only)
✓ Date of Manufacture:
;.r:<._::��«•-«•-«•z.r«-s...�za_z-:n-«•-«•-«•-«•:ram--.ate•-«•:r-:_�«<<c>--«•:r:.r--«--«•«--.rv:r«--«•:a�-�•«•--r-«--.r._•-s«—.rs:_-:.ra:;+
AFFIDAVIT
J
V
Town of Queensbury State of New York
County of Warren x
V
M �f
J
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 y
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
shall be complied with, whether specified o> not, and that such 5
work is authorized by the own r.
Y
z Signature:
r Own r,Owner's Agent,Architect, Contractor c
J
y
x
�,.:�._�cazr:�.-�:..:a.-�._ _ _ _ _ _ _ __._ _A_M�x�.r.'xaw-w.'r.'�.-�:...-�.'�.'r:w'ra�.'x•_ _ _ _ _ __ __ _ _ __ _ _
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
Town of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
(ELTOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 518-761-8201
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.
� 3
Signature: ' l ; U Date: 7
Mobile Home Owner, Owner's Agent, Mobile Home Contractor
Signature: Date:
Town of Queensbury Code Enforcement Officer
"HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE"
SETTLED 1763
FINAL INSPECTION REPORT
MOBILE / MOOULAR �7
Town of Queensbury CC)VA
Building & Code Enforcement --
742 Bay Road
Queensbury, NY 12804
(518) 761-82.56
ARRIVE:DEPART: 144 1 -
DATE INSPECTION REQUEST RECE�yG
NAME:
LOCATION_ Fn G6�1�L11fYlF� l RC`�
DATE: ,7-- PERMIT# -
MOBILE HOMK MODULAR HO=
F00nNcS_ FOUNDATION` BACKFIL ., FRAMING
N/A . YES NO
1. foundation support pier spacing
per manuf. ........................ �L/r✓
2 anchoring per manuf.
water line shut off ...................
4. sewer line support a 4 feet ..
S. heating crossover(dblewide) off grd.
6. dryer vented outside ..:................... —
? , v ti a.
8 hot water relief valve piping outside _
9 deck, porches, steps, railing ........ —
10. furnace/bot water operating _
11. garage hire proofing ..................
12. door closers ...........................
13. plumbing fixture ......................
14. foundation insulation (if appl.)...... _
15. smoke detectors .......................
16. final electrical
17. variance required .....................
I8_ data plate okay .......................
19. mobile HUD seal okay .............. — —
Model# Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
FINAL INSPECTION Repoprr
MOBILE / MOOULAR
Town Of Query
Budding &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
'2804
ARRIVEAV-36DEPART: INS
DATE INSPECTION REQUEST RECEI
NAME: t.�C—A
LOCATION_ <R�_ A G
DATE:KOIJILZ KOMR it
F0071NGS— FOUNDATION BACKFILL— FRAMING
NIA YES NO
1. foundationsupport, pier spacmg
per manuf. ........................
2. anchoring per manuf ...............
3. water fine shut off ...................
4. sewer line support 0 4 feet .......
5. heating crossover (dblewide) off grd.
6. dryer vented outside x...................
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. deck, porches, steps, railing .....
10. furnacelhot water operating ........
11. garage fire proofing ..................
12. door closers ...........................
13. plumbing fixture ......................
14. foundation insulation (if appl.)......
15. smoke detectors .......................
16. final e4ectrical ........................
17. variance required .....................
18. data plate okay .......................
19. mobile HUD seal okay ..............
Model# Serial#
Manufacturer
Date Of Manufacturer
OKAY TO ISSUE CIO YES NO
it 'p-
-71-ALA -L775-
FINAL INSPECTION RepopM
M0931LE / MODULAR
Town of Queensbury
BuikFing &Code Enforcement
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
12804V
ARRIVEZ INS
DEPART.-2-- -lb-
'j
DATE INSPECTION REQUEST RECEI
NAME:
LOCATION-
'DATE:
PERMIT#
MOBILE HOMY MODULAR HOUR
FoornNas— FOUNDATION BACKFU.L— FRAMM
N/A YES No
I. foundation support, pier swing
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 ..<...................
7. skirting ventilated .....I..............
8. hot water relief valve piping outside
9. deck, porches, steps, railing ........
10. fitmaceAmA 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 seat okay ..............
Model# Serial#
Manufacturer
Date of Manufacturer
4
OKAY TO ISSUE CIO YES NO
Coinments: V_kl,
FINAL INSPECTION REPORT
' 1081LE / MODULAR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbtuy, NY 12804
(518) 76141256
ARRIVE: k(�- EPART: JLJ�-W INS : �
DATE INSPECTION REQUEST RECEIVj
NAME: �C�/�in, ) �P l
LOCATION:
DATE: (� PERMIT r�
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION RACKFQL 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(dblewlde) off grd. — _ —
6. dryer vented outside ...................... _
7. skirting ventilated .................... — VE
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. phunbing 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 CIO YES NO
Comments:
� � d
FINAL INSPECTION REPORT
MCM31LIE / MODULAR
Town of Queensbury
WkIM &Code Enforcm"
742 Bay Road
Queensbury, NY 12804
(518) 76141256
ARRIVE:101-qb DEPART- INSP:
DATE INSPECTION REQUEST RECEIV
'OW
'7"wc'0mm
y12804
.1_56 T C I INSP�
RE E V
NAME:
LOCATION:
DATE: PERW
MOBILE HOICK MODULAR Hot=
FOOTMas— RXJNDATION BACKWL— FRAMM
N/A YES NO
1. foundation stippoft, pier swing
per mmuf. ........................ V/
2. anchoring per manuf. ...............
3. water line shut off ...................
4. sewer line support 0 4 feet ....... 7
S. heating crossover(dblewide) off grd.
6. dryer vented outside x...................
7. skirting ventilated ....................
8. hot water relief valve piping outside
9. deck, porchics, steps, railing ........
10. funmce/hot water operating ........
11. garage fire proofing .................. 1z
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# Serial#
Manufacturer
Date of Manufacturer
4
OKAY TO ISSUE CIO YES NO
,EF—D
I
C—A 16Lv—
0�37-7
FINAL INSPECTION REPORT
MOBILE / MODULAR
To" of Queensbury
Building &Code Enforcement
0
742 Bay Road
Queensbury, NY 12804
(518) 76141256
ARRIVE DEPART: <
DATE INSPECTION REQUEST RECEIVED
NAME:
LOCATION:
PERMIT#
MOBILE HOME MODULAR HOME
FOOTINGS FOUNDATION RACKF&L FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf.. ........................ — — —
2. anchoring per manuf I ............... — — —
3. water line shut off ...................
4, sewer line support 4 feet .......
6.
6. dryer vented outside x...................
7. skirting ventilated ..............
8. hot water relief valve piping outside
9. deck, porches, steps, railing ........
10. ftu-nace/hot water operating ........
..................
C=W.. ...........................
13. plumbing fixture ......................
4,44. foundation. insulation (if appl.)......
15. smoke detectors .......................
16. final electrical ........................
18. data plate okay .......................
a9. mobile HUD seal okay ..............
-70%LVC-3f-4,0-:71-
Model # Serial It
Manufacturer
Date of Manufacturer T7
OKAY TO ISSMertO YESES NO
Comments:
FINAL INSPECTION REPORT
MOBILE / MOOULAIR
Town of Queensbury
Building &Code Enforcement
742 Bay Road
Queensbury. IVY 12804
(518) 761-8256
i
ARRIVE: EPART: I P:
DATE INSPECTION REQUEST RECEIV
NAME: 1.�
LOCATION:- (SP— O0
DATE: — PERMIT#
MOBILE HOME MODE LAR HOM
FOOTINGS _ FOUNDATION _ BACKFHI-_ FRAMING—
N/A YES O
1. foundation support, pier spacim8
per manuf. ........................Q. — —
horing per manuf. ...............
3. water line shut off ................... /
4. sewer line support a 4 feet .......
5. heating crossover(dblewide) off grd. —
b. dryer vented outside ..:...................
7. skirting ventilated _�
k:k,4V0
f valve piping outside sue• rading .......
10. furnace/liot water operating ........ —
11. garage fine proofing ..................
12. door closers ...........................
13. plumbing fixture ...................... _ ✓ _
14. foundation insulation (if appl.)...... _
15. smoke detectors .......................
16. final electrical ........................P. variance required ..................... _ —
18. data plate okay .......................
19. mobile HUD seal okay .............. — —
Model # Serial i
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
Comments:
WNW^
FINAL INSPECTION REPORT
MOBILE / MOCULAIR
Town of Queaisbt" kv.,C)C)
Building &Code Enforcement
742 Bay Road
QuoerW)ury, NY 12804
(518) 761-8256
ARRIVE: J DEPARTAAD l—Llj��
DATE INSPECTION REQUEST RECEIV
NAME:
LOCATION: C, C Of-1 it
DATE: _? PERMIT#
Meaux HOME MODWAR HOME
FOOTINGS— RXJNDATION— BACKEML— FRAMM—
N/A YES
1. foundation support, pier spacing
per inanuf. ........................
2. anchoring per manuf I ...............
3. water fine shut off ...................
4. sewer line support 0 4 fed .......
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. furnace/hot water operating ........
I I- garage fire proofing ..................
12. door closers ...........................
13. plumbing fixture ......................
14. foundation insulation (if appl-)......
15. smoke detectorsi�J ...f .1�Q1 '
16. final electrical ........................
17. variance required .....................
18. data plate okay .......................
19. mobile HUD seal okay ..............
Model# Serial#
Manufacturer
Date of Marnifichwer
OKAY TO ISSUE CIO YES NO
Comments:
Town of Queensbury Fire Marshal
742 Bay Road
Queensbury,NY 12804
761-8205/761-8206
fax 745-4437
Factory Built Wood Burning Fireplace/Stove Inspection Report
Notice:New York State requires that all UL Listed,factory built appliances be installed according to the instructions and
specifications contained in the Installation Manual accompanying the appliance.No deviation from the manufacturer's
instructions or specifications is allowed.
.r
Permit#_ Schedule Inspections Time t/ pm anytime Inspector _
Name f al Address { '/ :` f �-i 1 t Rough In Final
Appliance Manufacturer Model# 0
Masonry Chimney Factory Built Chimney Flue Size Double Wall. Triple Wall Insulated
Yes No -NIA Comments
Floor Protection
Clearances to Combustibles (all sides)
Safety Strip Installation (fireplaces only) ^
Firestop(s) Vertical Chase �l
Wall Penetration._ + ,S-�' C 1 t }
Chimney Clearances to Combustibles Grp k
Chimney Termination
3 feet above roof penetration;2 feet above
any combustible construction within 10 feet
Combustion Air
Hearth Extension Or-
Mantel(height above f/p opening)
Fireplace Doors /Screen (required)
White-Buflftg Dept. YeUO - mer Pink-Fire Marnhal
f
FINAL INSPECTION REPORT
MOBILE / MOOULAN
Town of QuewWxiry
Building &Code Enforcement To Nk O o
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
ARRIVEAMDS DEPART: INS
DATE INSPECTION REQUEST RECEIV
NAME: ` E� _
LOCATION: 1
DATE: —Z-�1 y 1, PERMIT# -�
MOBILE HOME MODW AR HOME
FOO TH40S FOUNDATION_ BACKIZI.I, FRAMM
N/A . YES NO
1. foundatiioa support, pier spacing
per manuf. ........................ —
2. anchoring per manuf. ............... —
3. water line shut off ...................
4. sewer line support a 4 feet .......
S. heating crossover(dblewide) off grd. —
6. dryer vented outside .x................... _
7. skirting ventilated .................... _ _S. hot water relief valve piping outside —
9. deck, porches, steps, railing ....¢
10. furnace/hot water operating *S;" — —
11. garage fire Proofing —
12. door closers ........................... ✓
13. plumbing fixture ......................
14. foundation insulation (if appl.)...
(�k�'�— —
15. smoke detectors .......................
16. final electrical ........................
17. variance required ..................... —
18. data plate okay — —
1.9. mobile HUD seal okay .............. —
Model # Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE C/O YES NO
—n3-063Cc,
Comments:
FINAL INSPECTION REPORT
MOBILE / MOOU.LAR C) ESCT-EJ,)D HEirT' TRPu:z (3K,) t Lw
Town of(2ueerastwry CS EvJER 1--11.�E �uPC�
Building &Code Enforcement (:w6 N6
742 Bay Road t 04TA 1 1 Y EOTi LPT�7-O 6y, t R`T,k-% P6
Queensbury, NY 12804 p` l�J.�E�
(518) 761-8?.56 Q FRRME \tJ P'kn
�T�C�10(Z
ARRIVE: DEPART: IL:!:k) INSP:
DATE INSPECTION REQUEST RECEIVED
NAME:
07
LOCATION:
Q F��oF� ,►�v��,oiJ M� C3E�, .�
DATE: \�'-Zj_-_[�� PERMIT I<
MOBILE HOME MODULAR HO>I<[B
Qj
)tea _ FOUNDATION _ BAClcial._ rRaMltvo_ ��-�.lLRsJ ri--W'J
N/A . YES NO 1►:ST ER1t� V��P-�1� 1 1���J GQFLa�!
1. foundation support., pier spacing / �p p.EMov� Hot�E MADE �3E-R
per manuf. ........................
>,. anchoring per manuf / FRoM
t. water line shut off ................... _ _ ✓
1. sewer line support 1@ 4 feet ....... — � t 1 \ tJ(j�C'fl I`1� Q)vim— R00(Yl
R i. heating crossover(dblewide) off grd. _
i. dryer vented outside .x................... � Z
1, skirting ventilated .................... _ GD D ETEC,ToR ,
i. hot water relief valve piping outside —
>. deck, porches, steps, railing ........ _ t MAR t 1 -C'10
0. hunace/hot water operating ........
1. garage fire proofing
2. door closers ...........................
_
3. plumbing fixture ...................... _
4. foundation insulation (if appl.)......
S. smoke detectors .......................
6. final electrical ...................... —
7. variance required ..................... —
&data plate okay ....................... — —
9. mobile HUD seat okay .............. —
?odes # Serial #
4anufacturer
)ate of Manufacturer
OKAY TO ISSUE CIO YES' NO
:omments: COMMv►J1Y1 Ac_'C'�nJ -TEFRR`Z
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cJ�c1rJ�cJ�cPcJ�r�cJrJ�cTrJ�rJ��1rJ�r1rJ�rJ�cJ�rJc1rJ�rJcl�rJ�r1rJ�cfrJ�cPrJ�clrJr�cPrJ�rJ�r�r�cJa �PcJcPrJ�r frJ�rJ�c 0.�- ��J�rJ�r trJ�c1�cJ�c1�'IlEry l�®r �
5 5
5 BY THIS CERTIFICATE OF COMPLIANCE THE —7 S
5 NEW YORK BOARD OF FIRE UNDERWRITERS 5
S
5 5 BUREAU OF ELECTRICITY 5
40 FULTON STREET — NEW YORK, NY 10038 5
5 S
5 CERTIFIES THAT 5
S 5
5 Upon the application of upon premises owned by
5 5
5 1 PITCHER RD. 89 GRE
K INNEL
3 S
5 QUEENSBURY, NY 12804 QUEENSBURY,
N, NY 12804 S
5 c5
Located at 89 GREGWOOD CIRCLE QUEENSBURY, TN, NY 12804 S
5 Application Number: 3055391 S
5 Certificate Number: 3055391 5
5 S
5 Section: Block: Lot: Building Permit: BDC: A239 5
5 l i id
5 enta S Described as a Res occupancy, wherein the premises electrical system consisting of
5 electrical devices and wiring, described below, located in/on the premises at: 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
5 herein, was conducted in accordance with the requirements of the applicable code and/or standard
5 promulgated by the State of New York, Department of State Code Enforcement and Administration, or other S
5 authority having jurisdiction, and found to be in compliance therewith on the 18th Day of December,2007. S
5 Name OTY Rate Ratin¢ Circuit Tvne 5
5 Panels
5 1 100 12
5 Service 5
5 1 Phase 3 W Service Rating 100 Amperes 5
5 Service Disconnect: 1 100 mcb 5
5 Meters: I 55
S 5
5 5
5 S
S 5
S 5
5 S
5 5
5 seal S
5 � 5
S 1 of
SThis certificate may not be altered in any way and is validated only by the presence of a raised seal at the Io0fignjndicate� 5
5 S
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NOTICE
ANCHORING OF MOBILE HOME
FRAME IS REQUIRED PER `
VANUFACIURERS SPECIFICATIONS
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