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2004-519 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: P20040519 Date Issued: Wednesday, August 17, 2005 This is to certify that work requested to be done as shown by Permit Number P20040519 has been completed. Tax Map Number: 523400-308-014-0001-052-060-0000 Location: 80 BRIWOOD CIRCLE Owner: ARC COMMUNITIES 14, LLC . Applicant: BONNIE GAUS 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 Enfo eme 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: P20040519 Application Number: A20040519 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: BONNM C'TATTS 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' 600 GRANT St 900 Mobile Home In Park $32,000.00 Total Value $32,000.00 DENVER, CO 80203-0000 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-519 80 BRIWOOD CIRCLE 980.SQ FT MOBILE HOME $35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,August 23, 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 To o eens o ugust 23, 2004 SIGNED BY r for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbwy, 742 Bay Road, Queensbury, IVY 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 In formation Office Use Name: �File Permit No. � 9 Address: 7A2 dt&Kan Pik-,+ice Fee Paid , p _ Reviewed By: Phone No. 2fc� -66't� ��--- --- Property Owner Information Parcel Information Name: Proposed Date of Placement: - :e f"D.�S�7L �� - - Property Location: A6 Re./-Z&Idd Address: Road,Sired,Avenue Name of Mobile Home Park: 56e&r7L lza>4e i a 1:eable -Phone No. - _ .. _ _... . . Tax Map Number: Mobile Home Information.,-. Approximate Value of Homer Zoning Classification: New Home: Yes No Size of Property: ft.by ft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: ft. by 7 d ft. Setbacks: front yard fb; rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) ,s Number of Bedrooms: 3 Accessory Building(s): circle Number of Bathrooms: .2,_ 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 municipal Piers X Runners X Is Septic Permit Required? Yes or No Slab X Further information requested on the reverse side of this sheet C80- Name of Installer or Mobile Home Dealer. Address: Phone No. 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 ONLY 5. Date of Manufac Ilre: € _ AFFIDAVIT 'Town of -- = -- :: - . _._ .. _... __.._.... .. —.StateafNew-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: J— Zf'r'4' owner,owner's agent,architect,contractor, Special Conditions of Permit By Form: 11/19/1999sh Code Enforcement Officer MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 y ARRIVE: DEPART: °'4'�iNSP: DATE INSPECTION REQUEST RECEIVED: NAME: V J LOCATION: SO 19,q l Cl?--ef�)(o (2U C LC— DATE: �� 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 .............. / �7 Model #AC- o�� Serial Manufacturer CO t-01U tf Date of Manufacturer OKAY TO ISSUE�9 t YES NO Comments: 'r FINAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building &Code Enforcement 742 Bay Road ,�--� Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART' ,r� INSP: !ul. i DATE INSPECTION QUEST RECEIVED: NAME: LOCATION• DATE: PERMIT# L4 MOBILE HOME MODLTLAR HOME FOOTINGS FOUNDATION BACI4ILL 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 a 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.)..... - — — — 15. smoke detectors . P 16. final electrical 17. variance required ..................... — 18. data plate okay ....................... 19. mobile HUD seal okay .............. r _ - Model #_ j 'd 7-`" Serial# Manufacturer c Date of Manufacturer 4 OKAY TO ISSUE C/O YES NO Comments: S 1 NOTICE ` - oME _ I FILE. OF MOB ILE N �j�� .ANCHORING tY> PER FRAME IS REQUIRED tUFACTURERS SPECIF JAZ10N5 MAN I O i Asl TivEIVEt��.�.,�ems,. �� ,t""y>.,,� n !a� ,,f , ta�y� 3i . I.JUL. 0 6 2004 BUILDING ® PT. TOWN OF QUEENSMAY BUILDING AND CODE i REVIEWED BY DATE t ! TOWN OF-QUEENSBURY BUILDING D5PARTMENT Based on oUr limited examination, s compliance with our comments shall not be construed as indicating the t I plans and specifications are:in full compliance with the Building Codes f of Now York State. i --... --.._..- i i c �f I COLONY HOMES SPECIAL UMITED-SINGLE WIDE 5`-a' t0`-3• t4'-D' t6•-0" 6'-0' 4`-B' - a'--;--~ C73 \ YAULTED LE I L IA OOT. Thee:-our T MA5y 8! 2 n m 5'--DR k ly ,LliEN ! ;Y I NG .j 6!� 3 j ;i r room. AF503—A 1472 (6&) Approx . 929 5q . fir . 'STANDARD FEATURES Brown Shingled Roof 309 Roof Load Fvbblestone. Clay Dutch Lap Vinyl Siding '/z" Blackboard Sheathing '.. 34X76 Blank Housetype Front Door 3276 l3lamk Rear boor �'---,---1ZLGreen Louvered. Shutters on Doorside :vinyl Low-E Windows lmulation R-I4 Floor, llt-19 Walls, !-,�-LS Roof s '1" Floor Decking WLne or. Green Carper W/Pad Stippled Ceilings Plumbed & Fired far Washer s UD U Wire For Dryer C ' 0 30 Galion Electric Water Neater -7 � MI-MB077 Gas Furm.ee (Oil Available as an Option) I4' F.F. Refrigerator Q D q 30" Gas Range Stainless Steel Kitchen Sink h in't--Bikios 110 ***CIO OPTIONS AVAILABLE*** Model DOES NOT qualify for Rebate Plateaus, Rebates, Trips or any Advertising or Sales Allowances. Lneludes Material Casts as of 1/10100. Surcharges will be assessed only for httu€'e increases if any. Note: Available for a limited iizm%Ybl v vim.'.sl your S � � .. � � `i :i. �00