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
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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
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TOWN OF QUEENSBURY
IUR,D!Klr. AND CODE
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