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2003-122 TOWN OF QUEENSBURY 742 Bay Road,QueensbuM NY 12804-5902 (518) 761-8201 Community Development- Building &Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Pernut Number. P20030122 Date Issued: Friday, September. 16, 2005 This is to certify that work requested to be done as shown by Permit Number P20030122 has been completed. Tax Map Number. 523400-308-014-0001-052-000-0000 Location: 10 WOODLAND RATH Owner. ARC COMMUNITIES 14, LLC Applicant: MARILYN SMITH 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 Bui ing&Code Enfo men 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: P20030122 Application Number: A20030122 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: EDYTHE ALDRICH 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. TUe of Construction Value Owner Address: ARC4BFND,L.L.C. PROPERTY TAX DEPARTMENT Mobile Home In Park $14, 0. 0 PO BOX 13244 Total Value $1490000 EL PASO, TX 79913-3244 Contractor or Builder's Name/Address Electrical Inspection Agency Plans&Specifications 2003-122 EDYTHE ALDRICH LOT 10 WOODLAND PATH; FOREST MOBILE HOME PARK 14' X 70' SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $33.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,April 14,2004 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the of Que sbury; onday,April 14,2003 SIGNED BY for the Town of Queensbury. Director of Buil ' g&Co e Enforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, NY 12804 (518) 761-8256 A building permit must be obtained before placement of mobile home on parcel. No inspections will be made until a valid building permit has been issued. Applicant Inf ormation Office Use Name: 4e­ &6111­11A File Permit 2, Address: Fee Paid Reviewed Py: ............................................................. Phone No. (":9 "rowtv 0. 2003 81JILD Fe/VSj 3 3-7 -Parcel In o /VD CO3DICY Property Owner Infortna "-P,ropbsed Date of Placement: Name: IL Property Location: Zif 16 e2,,4Z_ Address: 'Rona,Sft=,Avenue Name of Mobile Home Park: x", Phone No. S -7-7 (if applicable) 36P ILI Tax Map Number: I Mobile Home Information Zoning Information Approximate Value of Home:$ Zoning Classification: New Home: Yes No Replacement Home: es No Existing buildings: ova Size of Mobile Home: ft. by ft. Setbacks: front yard I rear yard ft. Singlewide: Doublewide: Side yards ft.and ft. Number of Rooms: (exclude baths) gL Number of Bedrooms: Accessory Buil * g(s): circ Number of Bathrooms: 2. Detached ra e car; 2 circle: Gas FirepA oodstove irepl c D Attached e I car; 2 _car inu Storage b 0 Yes Foundation Support: Other: TYPE SEE&DEPTH Water Supply: well or m cipal Piers x e Is Septic PermitRequired? t Yes or 10 Further information requested on the reverse side of this sheet W -Name of Installer or Mobile Home Dealer: Address: 7'z-J�J-\ �Z Phone No. 7 a Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. \- j I. Insignia serial number. D , -3 2: Name of manufacturer. 3. Plan Approval Number: 4. Model or Component Designation: (New Home 0AU) 5. Date of Manufacture: AFFIDAVIT Town of Queensbury State of New 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: downer;.owner's agent,architect,contractor Special Conditions of Pennit By: Form: 11/19/1999sh Code Enforcement Officer 7 r a FINAL INSPECTION REPORT. MOBILE / MODULAR. Town of Queensbury Building & Code Enforcement . 742 Bay Road Queensbury, NY 12804 ,'��1 ARRIVE: DEPART: �Lh51�'I P: ti DATE INSPECTION REQUEST RECEIVED NAME: LOCATION: � - r -=' A DATE: l O—OS- PERMIT# V 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, porches, steps, railing ........ 10. fumace/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 TdISSUE C/O YES NO Comments:. 1�; �0 FINAL INSPECTION REPORT MOBILE / MOOLILAR Town of Queensbury Building & Code Enforcement 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART: SP: DATE INSPECTION REQUEST RECEIVED: NAME: L b 0-1 .� G-- LOCATION: _ DATE: ✓ PERMIT# MOBILE HOME V1 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. — — 86. dryer vented outside ..a................... _ . 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.)...... — 5 smoke detectors ....................... final electrical ........................ _ 17. variance required ..................... 18. data plate okay — — mobile HUD seal okay .............. Model # Serial # ManufacturerG��oy�i Date of Manufacturer 1 L OKAY TO ISSUE C/O YES NO Comments: i l —FINAL INSPECTION REPORT MOBILE s MODULAR Town of Queensbury Building & Code Enforcement \( I 742 Bay Road v / Queensbury, NY 12804sg (518) 761-8256 W3 ARRIVE: DEPAR�0�. 61NSP: V ^ ~ 5 DATE INSPECTION REQUEST RECEIVED: \� NAME: LOCATION: ) DATE: V v PERMIT# 03 -J Xo MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFML 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, pouches, 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 .. >/5 ,D3 — 17. variance requir 18. data plate okay ....................... _ 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O YES NO �C��• �/a"� �a621<�Is(7 V VC--N1 Cme(03 it • t'3 /nd5'I/4L� �6C-.n!�Cfl S K12Tf/JC�J R���- E,��e Pr�ou 1 MAW. FINAL INSPECTION REPORT MOBILE / MODULAR Town of Queensbury Building & Code Enforcement ®��� /l�� 742 Bay Road Queensbury, NY 12804 on,) (518).761-8256 ' ARRIVE: DEPART:/" ; 2 INSP: ltvv DATE INSPECTION REQUEST RECEIVED: 0-0�2 ` 22 NAME: —I--�, LOCATION: DATE: `a 1 PERMIT# MOBILE HOME V 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 ..ti................... _ 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 C/O YES NO Comments: ��1 �� , y y I ! ! 03 `i\ 'NOTICE APR 0 1 2003 ANCHORING OF MOBILE HOME FRAME FS REQUMED PER TOWN OF QUEENsBU y MANUFACTURERS SPECIFICATIONS E�UILDtNlG AND CODE s r i i r,. reC y- I � y y O I�.�'f i�, r_.�4:1=�S�t1R�QUILCi�G DEFARTPiE, 8-wed on our limited examination, s- co^npliance with our comments shall not be construed as indicating the plans and specifications are in full OPY TOWN v O1- QUEEENSEURY BUILDING C S EIT REVIEWED B DATE ` IJ 4—� \ �AI��I�I�I��'�1�1�I�AI�1�1� s 3 i 00�- RECEIVED n S e r R 1 'I 2� 3 TOWN OF QUEENSBURY IUR,D!Klr. AND CODE lv/Y 1 �Y