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2004-828 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518).761-8256 CE-'LD%.""-vLI.FI CATE OF OCCUPANCY Permit Number: P20040828 Date Issued: Monday, June 06, 2005 This is to certify that work requested to be done as shown by Permit Number P20040828 has been completed. Tax Map Number: 523400-308-014-0001-052-000-0000 Location: 183 PITCHER Rd (32 WOODLAND PATH) Owner: ARC COMMUNITIES 14, LLC Applicant: FOREST MOBILE HOME PARK 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 Enforcement Planning Board or Zoning-Board of Appeals. Application for Permit— Mobile Home Town of Queensbury, 742 Bay Roue 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 Office Use Name: 01 r6P-Es-r File Permit No. Address: Fee Paid - Reviewed By: ✓ :- , Phone No. J Property Owner Information Parcel Information , dtla Pr Proposed-Date of Placement:Name. Ooperty Location: �J Q Address: �� 1/�( j c�/. �il l�� Road,Suet,Avenue Name of Mobile Home Park: o� � AC-3 - Phone No. - Tax Map-Number -.4 Mobile Horne lnforrttation.;...__.._ ,. Zoning-Info n Approximate Value of Homer Zoning Classification-c`-I. New Home: Yes No OCT 9 2004 Size of Property: ft.by ..n,$� I t'F QUEENSBURy Replacement Home: fes) No FIL111-8-��'1 `D CODE Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard Z ft.; rear yard /,5 ft. Singlewide: _ Doublewide: Side yards $.and in ft. Number of Rooms: (exclud 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 unicipal Piers s Runners x Is Septic Permit Required? Yes or No Slab s Further information requested on the reverse side of this sheet CIO* 1 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 ONL19 5_ Date of Maniifacfiure: € AFFID-A VIT - - Town of -- _.. ,.. _._.. .. .. .__.._.- •.. .. _. _.State'af�New=Yor�c County of Warren - 1. 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: owner, ees agent,arcTfitect,contractor Special Conditions of Pennit Form: 11119l1999sh Code Enforcement Officer TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040828 Application Number: A20040828 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: FOREST MOBIT,F,HOME,PARK 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 900 Mobile Home In Park $18,000.00 PO BOX 790.830 Total Value $18,000.00 SAN ANTONIO, TX 78279-0000 Contractor or Builder's Name /Address ;2 Electrical Inspection Agency Plans&Specifications 2004-828 32 WOODLAND PATH 2004 MOBILE HOME (924 SQ FT) $30.44 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, October 29, 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 Tow 'of Que nsbu F 'a . saber 29 2004 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement 742 Bay Road / r Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: =Z IN ` J E DATE INSPECTION REQUEST RECEIVE NAME: �I 1 \ GAY LOCATION: 3a �z kx DATE: "'IQ1 / PERMIT MOBILE HOME MODULAR HOME FOOTINGS _ FOUNDATION _ BACIFILL_ 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. 7 6. dryer vented outside ...................... _ J 7. skirting ventilated .................... 8. hot water relief valve piping outside — 9. deck, potches, 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 oka _ Model # 7J 7 A Serial# - —� � -2- Manufacturer Date of Manufacturer ' N-71276 OKAY TO ISSUE C/O ". S Comments: 9 NAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building &Code Enforcement- 742 Bay Road Queensbury, NY 12804 - (51.8) 761-8256 f - ARRIVE: :DEPART: INS DATE INSPECTION REQUEST RECEIVE 4&A NAME: - LOCATION: DATE: C)6- PERMIT#Y . MOBILE HOME MODULAR HOME FOOTINGS' FOUNDATION BACKF 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, potches, steps, railing ......., — 10. 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 Comments: y . a 413 a 0 h 4 F11. F. -COPY _ - _.. ': TOU`Jili OF CUEEi!"�ll�Y rl!I!�i��!C DES; til PdIEIJT Based on (m+r limited cyaminaiicm, Comppliance.with our coni cents stall not be construed as indicating the Mans and spArjrcaflpns are in full !� comp lianc 1 tin the, Building Codes„ Ot 14 S4 lrarl(vf�i�, it OCT 9 2004 00 NOTICE 5 ANCHORING OF MOBILE HOME o v _ p FRAME IS REQUIRED PER r a .: ..u..,_.—:: .__ ,. Q MANUFACTURERS SPECIFICATIONS REVIEWED - - - *�yC7rS.D1iRl ' k rt 2 r.11ijrf 9 r Tr.l �1 EI7W_SSFAI �� I i i LF4sP MML Do 4IDtn 61fi1TD4 �S ~� L:�DLE•Al2_°7 _ •� I&M IS N=3 ._ 1 �W, } -h �1 p� FOLK FAtf R11l7CsK ' R2 1 !� �LIm4s [ y - L3liSW�YC [ �1Fib_ _ PAG 'Wlst7 r •!TJ _ CIMMER Ams f �� •tip 1 is ♦• ` L i``�� r. �I 1 q•- ICShTK16E: StPFORTPS:T 1 1.ErA1S l�fn 4� um 17CR 11'M[9 I I I Y - �tti3& y1;dS 9r ` w-17R' T-1.7 L.9' OC / ,r� �iy �•f 51!' � R>771GtPJF6 'Sd TI• L+•alc' - LYt+3:ICt . 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