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2004-804 TOWN OF QUEENSBU. RY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 J. CE IFI ,CTOE _ F OCCUPAN Y _Perrirnit Number ..'_ P20040804 Date=Issued:_. :Wednesday,.December 01, 2004 _.. This-is_to._cerdfy-.chat work,requested:_to=he-done as shown:by R,ermit Number P20040804 has been completed. -:_ Tax Map Number: 4: .-. 523400-308-014-0001-052-000-0000 Location: _ 183 PITCHER Rd Owner: ____ ARC COMMUNITIES 14, LLC Applicant: WALTER FLEMING 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: P20040804 Application Number. A20040804= Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: WAITER FLEMING 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. Tyne of Construction Value Owner Address: . ARC COMMUNITIES 14, LLC 900 Mobile Home In Park $18,000.00 Total Value $18,000.00 PO BOX 790830 SAN ANTONIO,TX 78279-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2004-804 WALTER FLEMING 21 WOODLAND PATH 924 SQ FT 2004 MOBILE HOME $60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, October 26,2005 (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 of ensb Tu' d , October 26,2004 SIGNED BY for the Town of Queensbuiy. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbury, 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 formation Office Use Name:}����, LAM I�!'� File Permit No. $d /Q9� ' Address: l 6�-l'r OLE_ rbQAE , Fee Paid y Tp�N D� 820 04 Reviewed By: BUICDIP�Q E SOD RY E Phone No. Property Owner Information Parcel Information Name: , jQ, b�, %9'))0_P roposed Date of Placement: j® ' T ��l l�� goo Property Location: W Address: 60 Q C 7!, �7 Road,Street,Avenue Name of Mobile Home Park: � � _ .. (i app icable) _.. 1? R - - Phone No. 0 ��� / - -T. Tax MaP-Number: / �' 11Mobile.Home Information . --_.._-... -: _Zoning Information:::., - - Approximate Value of Homer Zoning CIassification: -�j -- A New Home: es No l r' 9 q d� 5 Size of Property: ft.by $. Replacement Home: Yes No Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard PQQ fb; rear yard /6 ft. Singlewide: _ Doublewide: .Side yards _L 1 and JD ft. Number of Rooms: (exclu e baths) , 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 s Runners x Is Septic Permit Required? Yes or No Slab s Further information requested on the reverse side of this sheet 280- Name of Installer or Mobile Home Dealer. /t- u Imes Address: Tr a a Bnx2a /` 6a, .. l Z20 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 _ ®Q(°� 3. Plan Approval Number: 4. Model-or Component Designation: (Neiv Home ONLI) - Date of Manufac 11re: - _..., ._. AFFIDAVIT. . - -- -Town of -- nsbury. __.._ —State of New Yoilc . 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: own r, er's agent,architect,contractor Special Conditions of Permit B Form: 11119/1999sh Code Enforcement Officer FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury , 1 Building &Code Enforcement . 742 Bay Road Queensbury, NY 12864 (518) 761-8256 ARRIVE: DEPART: SP: / DATE'INSPECT'IOONN REQUEST RECEIVED- Z D NAME: r ai2f� /Q'f2 I LOCATION: 2 WUU bid ' DATE: Z U L PERMIT# MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKF LL FRAMING N/A YES NO . 1. foundation support, pier spacing per manuf. ........................ — — 2. anchoring per manuf. ............... , 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, potches,.steps, railing ........ fiunace/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- Commen n FINAL INSPECTION REPORT f -MOBILE / MODULAR ' [/ Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 i � .ARRIVE: DEPART: y INSP?c�F� 4 DATE INSPECTION REQUEST REC ED: NAME: LOCATION: . DATE: �— PERMIT 00 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFII.L FRAMING N/A YES O 1. foundation support, pier spacing per manuf. — 2. anchoring per mani f. ...:........... _ _ 3. water line shut,off .................... 4. sewer line support ®4 feet ....... — 5. heating crossover (dblewide) off grd. 6. dryer vented outside...:................... _ �0 _ 7.• skirting ventilated .............. ..... - 8. hot water relief valve piping outside = _ 9. deck, potches, steps, railing ........ — 10. fiunace/hot water operating .........I I.-garage fife proofing .................. 12:door closers ........................... — 13. plumbing fixture ...................... — — 14. foundation insut. illil o (if appl.)...... — ✓ — 15. smoke detectors 16. final electrical — 17. variance required ...................... 18. data plate okay ........................ 19. mobile HUD seal okay ...' Model # Manufacturer 2 / Date of Manufacturer TC dUl.�. OKAY TO ISSUE C/O YES V NO Comments: R N A& MO. �C-C�1� A�PRoUA� �vl� ��✓�K�� 73 v {f _ � S u`R.p 1.`� —,f-- :_6u..4.......�_,a ? �``i N".,. <•r��r.�t4 l UU 9 REVIEWED BY.. �i DATE TOWN OF OUEENSGURY BUILDING DEPARTMENT: Basec' or, odr limited examination, conpliance wb our comments shall nat lie construed as indicating the: glans and s ecilications are in full . --- -" compliance with the Building Codes � of New YotA State. � ail . py MIN , a RECENEU OCT a s 2004 C - ` TOWN!Or QUEENSBURY BU8LMNI G AND CODE } - cip 05 s.. , L F.G E M a RMUTA E - . 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