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2004-391 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: P20040391 Date Issued: Wednesday, July 07, 2004 This is to certify that work requested to be done as shown by Permit-Number P20040391 has been completed. Tax Map Number: 523400-308-014-0001-052-000-0000 Location: 183 PITCHER Rd Owner: ARC COMMUNITIES 14, LLC Applicant: BRIAN BESWICK This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040391 Application Number: A20040391 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: 13RTAN BF,SWTC;K For property located at: 183 PITCHER Rd in die 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 Mobile Home In Park $35,000.00 600 GRANT St 900 Total Value $35,000.00 DENVER, CO 80203-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-391 LOT 24 WOODLAND PATH 14' X 56'MOBILE HOME $22.04 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, June 16, 2005 (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��/ f Que bu ; dnesday, June 16, 2004 SIGNED BY for the Town of Queensbury. r .Y Director of Building&Col Enforcement Application for Permit— Mobile Home Torn of Queensbwy, 742 Bay Road, Queensbury, NY 12804 (518) 761-82.56 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 In Office Use Name: Alum � ic��rc1� File Permit No. Address: IS F!7PTLI �iL Fee Paid � O e, ED 61 e"os If-4 k ./Vy /Z-®/ Reviewed By: J UN 0 3 2004 nin i., Phone No. 775 � �- BUII_l�t l�`D CDQF Y Property Owner Information Parcel Information *tzc-GT Proposed Date of Placement: vpe x6c� Name: ¢1Re.ff apaD i-•L.0 . ���vlGt -PFqe� A4W Property Location: e� �/arty . 1/0 Z, Address: toUO aQAK1 i ST. 5u ITE U) Roan,StmKAienue DEn1l�El2 : Cd 8�20� 5�-g Name of Mobile Home Park: lroge,6T Vw-K M I4C- (if applicable) Phone No. 8CO a46 —04' 15 Tax Map Number: obi• /- l ' / �� Mobile Horne Information Zoning Information Approximate Value of Home: -)S'a 000 • Zoning Classification:A" i New Home: Ye No Size of Property: ft.by ft. Replacement Home: Yes N® Existing buildings: Size of Mobile Home: /1 ft. by ft. Setbacks: front yard fb ; rear yard ft. Singlewide: _ Doublewide::� Side yards ft.and ft. Number of Rooms: (exclude baths) 7 Number of Bedrooms: "Z Accessory Building(s): circle Number of Bathrooms: / Detached garage: 1 car; 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE SIZE&DEPTH Water Supply. well or unicipal Piers x Runners s Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet Name of Installer or Mobile Home Dealer: Address: 27/2- 9,;L7e / X /-z-()W Phone No. .S' O— /3(-S Mt $ � 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 Home ONLI) 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 BUELDIlVG 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,owner's agent,architect,contractor Special Conditions of Permit By. Form: 1111911999sh Code Enforcement Officer FINAL INSPECTION REPORT MOBILE ® MOOLILAFI Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 n (518) 761-8256 ARRIVE: DEPAR?P.# INSP: DATE INSPECTION REQUEST RECEIVED: NAME: l;� - _SC.^ i r 'r LOCATION: Lr DATE: PERMIT N D M0131LE HOME MODULAR HOME FOOTINGS FOUNDATION BACIU LL 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. fiumce/hot water operating ........ _ 11. garage fire proofing .................. — 12. door closers ........................... — — 13. plumbing fixture ...................... — 14, foundation insulation,(if appl.)...... 15. smoke detectors ....................... _ (066 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: i 1<;7t—� R o VS FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bey Road Queensbury, NY 12804 ,a (518) 761-8256 U J ARRIVE: DEPART"/ SP: DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: 150` PERMIT# ._- _ MOBILE HOMEMODUL&R HOME FOOTINGS FOUNDATION BACIU LL FRAMING N/A YES O 1. foundation support, pier spacing per manuf. ........................ 2. anchoring per manuf. ............... — 3. water line shut,off ................... . _ 4. sewer line support ®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. f imace/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 ....................... _ Y — 19. mobile HUD seal okay .............. Model # Serial# — G� Manufacturer pf C2 tj AS Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: GENE JUiN 0 3 2004 .. TO N OF QUEENSB BU LDING hIND CODE Y v VA J �eu-� ; OTIC� A{1C''.0 a4 MOBILE HOINE TOWN OFQUEENSEURY BUILDING DEPARTMENT �I QU Based on odr limited examination, ;S �' I�;ED PER con fiance with our comments shall MANf� 1 ��;� E SPECIFICATIONS not ge construed as indicating the plans and specifications are in full compliance with the Building Codes of New York State. IV RY ri T014 1A U 1- 0;U L BUILDING G S U.0 REVIEWED BY —DATS--� _ O i 37 43 41 39 37 35 33 31 29 27 25 23 21 19 17 3 4 347 R� Oto ca i mN �r cn rCD 6� d C) N am r � oM00n f CD CN Cr o c £ °a cr o cl- S, a G CN CD CD CD (D C !s CDo M Uy CO c �LU m CVd J L ® �J J C7 r jL_O�1JJ tL Cc • a cc (c col •cn 0 0% ." �� 0w I 0 c v Affordable Residential Communities FOREST PARK WC , ,183 PITCHER ROAD �� s QUEENSBURY, NY 12804 0 7J 114 96 6 ti6 mN J6C PITCHER ROAD C \■EEll \I' NEI IBEQ 9181 i a 0 •• II ■. _ .-ir ■■■■ I ■\�IJI(t ■■■■■■■■■I ice■ •• \�11 7 �I -�• Mani L : ■i t ■■■■■t OI■■■■■■ I rk ■\ ■■ . FINE■ 1■■■■R�- ■■■ a -9!Ng-.• - �` ■■■■""7■■■■■■■■■ II .-.. MCS,�IN■■■■■fir— N►7■■■■INEE go I ij7■■■■■I �j