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��
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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.
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OCT a s 2004 C -
` TOWN!Or QUEENSBURY
BU8LMNI G AND CODE
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