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2004-665 T 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. P20040665 Date Issued: Friday, July 20, 2007 This.,is to certify that work requested to be done as shown by Permit Number P20040665 has been completed. Tax Map Number. 523400-308-014-0001-052-000-0000 Location: 183 PITCHER Rd Owner. ARC COMMUNITIES 14, LLC Applicant: MARK SCHAEFER This structure maybe 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: P20040665 Application Number: A20040665 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: MARK SCHAEFER 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 $43,000.00 DENVER, CO 80203-0000 Total Value $43,000.00 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-665 MARK SCHAEFER 5 BRIWOOD CIRCLE 1216 SQ FT 2004 MOBILE HOME $47.96 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, September 07, 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 Town••of Oueensb Tu sdday�, September 07, 2004 SIGNED BY 6 t"+ ! for the Town of Queensbury. Director of Building&°Code forcement Application for Permit— Mobile Home Town of Queensbwy, 742 Bay Road, Queensbury,-NY 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 forrnation Office Use �l Name: C r S CL'1 O�Q f_f' File Permit No- Address: 5 jj 6 w o od Fee Paid . Reviewed By: Phone No. rs 18) 7q, —/S F 7 Property Owner Information Parcel Information Name: /14 2C P R C E I V E D Proposed Date of Placement: Property Location: 5 /3 i'i c,_)o oc✓ C'irC/e Address: A!1 G 2 7 2 n 0 4 Road,Sweet,Avemie TOWN OF QUEENSBURY Name of Mobile Home Park: Xo rP s-/ Pa-.--_ B c a lieable _. .._..... ._.._ _.... - ....- _.. _... (i PP Phone No. 'IqS _ 7,7-7- T _ . ax Ma Number: Mobile.Home.Irformation -.__.._-... Zoning.Itformation _ Approximate Value of Homer Zoning CIassification: New Home: es No J4 Size of Property: ft.by ft. Replacement Home: Yes No Existing buildings: Size of Mobile Home: /4, ft. by ft. Setbacks: front yard ft.; rear yard ft. Singlewide: ✓ Doublewide: ;Side yards ft.and ft. Number of Rooms: (exclude baths) 5 Number of Bedrooms: _ 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 municipal Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet W Name of Installer or Mobile Home Dealer. S kO LO Co-S.e �-k rm.e-s Address: ,� 7/,1- i2� 9 a l ea- Al l�-O Phone No. 5 K 7 - !a 7 b/ Complete information below found on a`plate"or"sticker"which is affixed to the mobile home. 1. Insignia serial number. 2. Name of manufacturer. '/P P ft,4jo,0 o/ 3. Plan Approval Number: 4- Model or Component Designation: 63 (New Home OM19 5. Date of Manufacture: .= _ _. 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. G Sigtiature: owner,o4mer's a t,architect,wnti mr Special Conditions of ermit By Form: 11119r1999sh Code Enforcement Officer ' FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE:AU`1P DEPART: INSP: �Z DATE INSPECTION REQUEST RECEIVED: NAME: 2 LOCATION: DATE: PERMIT rx o q/�7 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.)...... — — — 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 JCIO YE NO Comments: FINAL INSPECTION REPORT MOBILE / MODULAR �!` l �h� Town of Queensbury i � ' ). Building & Code Enforcement 742 Bay Road ��Cl Queensbury, NY 12804 (518) 761-8256 ARRIVE: .DEPART: INSP: � DATE INSPECTION REQUEST RECEIV NAME: Gl LOCATION: 5 it DATE: ) D- I ^ D PERMIT# D 4-� M0131LE 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 Comments: FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury AXBuilding & Code Enforcement 742 Bay Road Queensbury, NY 12804 . (518) 761-8256 ARRIVE: DEPART: r IN DATE INSPECTION REQUEST RECEIVED,., LA N: /a 9 . DATE: 7 c Cad PERMI # L� MOBILE HOMZ MODULAR HORSE FOOTINGS FOUNDATION BACK'FILL 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 f ..... — heating crossover (db a de) off grd. _ 6 er vented outside ... ............. 7 ' g ventilated ....... ............ - 8. hot wate lve outsi J — 9 k aches rail Q. ce t water opera tin ..... .1 . ga re proofing ......... ..... 12. door closers 13. umbing fixture ...�+.►..�+�... .�� — •� 14, foundation insulation (if appl.) ..... 9 — 15 smoke detectors .......... . — 16. 1 electrical _ variance required ......../............ 18. data plate okay ....................... 19. mobile HUD seal okay .............. Model # ��4' ( _ Serial# V L q ,.CV"C1 Manufacturer I�L— Date of Manufacturer OKAY TO ISSUE C/O YES NO Comments: FINAL INSPEOTION REPORT 'MOB / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518 761-8256 ARRIVE: 1fW DEPART:2W.INSP: DATE INSPECTION.REQUEST RECEIVED: NAME: /�YQ /\ LOCATION: DATE: PERMIT# MOBILE HOME MODULAR HOME - FOOTINGS _ FOUNDATION _ BACKFII.L_ 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: Af 441IF1 . . . Ah . 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