2005-766 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20050766 Application Number: A20050766
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: T,ORRTF, CORKF,RN/ROBF,RT ROT TCHARD
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 $34,000.00
Total Value $34,000.00
PO BOX 790830
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2005-766 LORRIE CORKERN/ROBERT BOUCHARD
6 TIMBER LANE
1344 SQ FT 2005 MOBILE HOME
$55.64 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, October 06, 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 Town nsbury Th r d , October 06, 2005
�/
SIGNED BY for the Town of Queensbury.
Director of Building&C e En cement
Application for Permit— Mobile Home
Town of Queensbury, 742 Bay Road, Oueensbury, NY 12804 (5I8) 761-82S6
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 Irrforrnatian Office Use
Name: A1JAVA,0D File Permit No.
Address: Fee Paid �?
Reviewed B -�
JF
Phone No. P
Property Owner Information Parcel Information
oaCGT Proposed Date of Placement: R Q
Name: ARe�13FnlD t-,�.0 . cllbl0� 'rr��K r►t NC,
Property Location:
Lai)e� -
Address: Lava &RAN r ST. 5u l'TE 60 Road,Street,Avenue
Name of Mobile Home Park: iroV.jEST-ARK M 14Cr
(if applicable)
Phone No. Boo c;46 —154 1 S Tax Map Number: / 5A
Mobile Home Information Zoning Information
Approximate Value of Home: $ '� LJ
Zoning Classification: 6 9," i
New Home: Yes No
r� ¢ Size of Property: ��ft.by�$.
Replacement Home: Yes No
Existing buildings:
Size of Mobile Home: ft. by �'
Setbacks: front yard ;2D ft. ; rear yard 20 ft.
Singlewide: Doublewide: aS Side yards_ft.and j
Number of Rooms: (exclud baths) f
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 unicipal
Piers s
Runners x
Slab x Is Septic Permit Required? Yes or No
Furtlier information requested on the reverse side of this sheet
Name of Installer or Mobile Home Dealer: ilLo
Address: Tv q(&1%
Phone No.
(,6 B) 49N= 06W
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number PA EL522Apj6MCM P`3
2. Name of manufacturer.
3. Plan Approval Number: )4P-U
4. Model or Component Designation: q 3 AS
(New Home ONLY)
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 WELDING 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.
rniiSignature
o r, er's agent, hitect,contractor
Special Conditions of Permit
By:
Form: 11/19/1999sh Code Enforcement Officer
,—;,)J r r cq (,IcTo,(rr 6 ' "U6
FINAL INBPECTICN REPCRT
MOBILE / MODULAR
Town of Queensbury 110 / KS
Building &Code Enforcement
742 Bay Road
Queensbury, NY 12804
((5511�8)) 761-8256
ARRIVEI �/ DEPART: INSP:
DATE INSPECTION REQUEST RECEIVED:
NAME:
LOCATION:
DATE: PERLIT#
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. f imace/hot water operating ........ —
11. garage fire proofing .................. — — —
12. door closers ........................... — —
13. plumbing fixture ...................... _ —
14. foundation insulation (if appl.)...... — —IS. 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:
/*
OidVr C7- CaC UA
7116/Highland Park#12 2/7/05
ALEE7WOOD. Highland Park Series Model4483A
3 Bedrooms • 2 Baths • 1 ,311 Square Feet
-Y- 1�,'A"T, 121
"4
Te F,
al�
V
F�� r�PY
46-0"
LINEN'777.77: r5HELF1
--- ------- -- -- 71-1
UTILITY
.. ........
DINING --1
-M
OAT'H' C, BEDROOM#2
T
12'-11"X 11'-4"
0 F-1 �.�I-,� �!T f � :
4 1-
-77+77, :77
7
WALK IN
_4
----------
1-!CLOSET .
DIW
27"411
OPENING uNEN I....
NOTICE 0
-i -T.
AWHORING Of MOBILE H%* LIVING ROOM i BATH
MA5TER
FRAME IS REQUIRED PER BEDROOM
VANUFACTURERS SPECIFICATIONS W-O"X 13'4"
0 UE NS UPY OEDROOM#3
11'-7"X11'-2"
T(,--AfVN
ENTRANCE
pi-llt-OING 0
OPT.4'!5TRErCH
(DINING AREAILIVINAREA/LIVINGROOM)
1,421 SQUARE FEET
Fleetwood Homes reserves the right to change colors,prices,specifications,models,dimensions and materials without notice.Rendering and diagrams are meant to be representative and,in keeping with Fleetwood's policy of constant
updating and improvement, may vary from the actual home.All dimensions are nominal and approximated.Square footage is measured from exterior wall to exterior wall,and is an approximate figure,Length indicated in floorplans is
floor length only.The length of the hitch is not included.(Add four feet to arrive at transportablelength.)Ask your retailer for specifics.PRICES AND SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE OR OBLIGATION,
:�-
"-
. _
�. a�' � ��
�a4
y
.�
�-
�- `� �
P�' �
� �
L .�
�� � ����
� � �- �
�`- s
r c� �� ';
�-
�--
� �,
,o-
�-
_-
OC7-30-2002 11 :'64 AM ForestParkMHC 5187450808 P. 01
I---- --Val,,Ulon Rf- -..t - - --A
77
Fa 1h,
L9 CA
—E- 0
1 �
f
h
4
V
s_
CA 6q