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2003-625 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761.8201 F Community Development-Building&Codes (518)761.8256 E �FOCCUPANCY CERIL'IFELdal Pe='t Number: P20.030625 Date Issued: Thursday,November 06,2003 This is to certify that-work requested to be done as shown by'Permit Number P20030625 has been completed. Tax Map Number: 523400-308-014-0001-052.000-0000 Location: 4 G90001D CIRCLE Owner: ARC4BFND,L.L.C. Applicant: ROBERT HARRINGTON This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN of QUEENSBURY Director of Building&Code Enfotcement TOWN''OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20030625 Application Number: A20030625 Tax Map No: 523400-308-014-0001-052-000-0000 'Permission is hereby granted to: ROBFRT HARRINGTON 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. Tne o.f Construction. Value Owner Address: ARC4BFND,L.L.C. Mobile Home In Park' $12,000.00 PO BOX 13244 PROPERTY TAX DEPARTMENT Total Value $12,000.00 - EL PASO, TX 79913-3244 Contractor or Builder's Name Address Electrical Inspection Agency Plans&Specifications 2003-625 ROBERT HARRINGTON 4 GkEGWOOD CIRCLE 924 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $35.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 13,2004 (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 r 2Vb;F aW adneday,August 13,2003 SIGNED BY for the Town of Queensbury. V Director of Building&Co e Enforcement Ni Application for Permit— Mobile Home = Town of Queensbw)4 742 Bay Road, Queensbury, .NY 12804 (5.18) 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 Information Office Use Name: File Permit No�_�y Address: Fee Paid �. �asag Reviewed By: Phone No. (hit ) r 1 AU G 0 6 2003 Property Owner Information Parcel Information TQVV6V OF QUEENSBURV - t2CST Proposed Date of Placement: J ! -f .*_!4111D CODE Name: Apcff(;PtJD t-J_c . 0 -ppoeK,A4 W,. (s rF r.�"f"" Ti , rvu t 4U Property Location: L' r �W d C',e o C. Address: 1,0()o rta&d,stzeet,Avenue �E,�Ii�El2 Cb $oZo� 5z� Name of Mobile Home Park: irmesT 0AP.K M 4.4Cr (if applicable) Phone No. "�5 1 Tax Map Number: �A. I Mobile Home Information Zoninglnformation Appro.-dmate�l:of Home:$-I _ Zoning Classification: New Home: Yes o Size of Property: by Replacement Home: Yes No I, Existing buildings: see AbLaci�,ed Size of Mobile Horne: ft. by - Setbacks: front yard ~ft rear yard ft. Singlewide: Doublewide: Side yards ''3 _ft.and Number of Rooms: (exclude baths) Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car-, 2 car, car circle: Gas Fireplace 1 Woodstove 1 Wood Fireplace Attached garage: 1 car, 2 car, car Storage building: Yes No Foundation Support: Other: SIZE&DEP H Water Supply- well or unicipal x 14 Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet W Name of Installer or Mobile Home Dealer: Address: LP c teensour� 1 C1 1 Phone No. Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. LIiisignia serial-fit be-r , 76 l 13 EK 1211 6,S P-o i*10—W,-- S f 2. QName-of_manuf f (b a-! 3. PIan,Approval 4. Model or Component Designation: (New Home OAT I) t. 5. Date of Manufacture: 0 D AFFIDAVIT Town of Queens]u, 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: ) owner,owners a t,archit ntmctor Special Conditions of Permit Permit By: Form: 11n9i1999sh Code Enforcement Officer t��NAtL •!\Si�i�i��"'�'��Rf RI+�PORT Town of Clue+ansbury Muiiding 8L Comma Enfcarc8rn4ant 742 BeLy Rc►aci N- C;Wa nsbury►,- NY 12804 5� -761-8256 v 4 DATE-I NSPEC'I'IDN REQiJEST RECEN D� NAME: LOCATION: DATE: _ PERMIT # � ` 3'COTINCsS FC?Z3NIa.A'TIC3N B.A��T t F.I2P►.A+T�fTG _ N/A "Y.ES T--Tc► " 1. foundation silpp<-tirt, pier spacing t per- , , •-•uf:. .........I.. ............. 2. axiclz+cyring per r3rianuf. ............... 3_ water line shut,off ------------------ - - 4_ sewer line support Q 4 feet _ 5_ lreatirng crossover (dblewide) off .grd_ 6_ dryer vented outside ______________________ . 7_ skirting ventilated -------------------- S_ tiot water relief valve piping outside 9- deck, potclies, steps, railing -------- AO. fiarrzacelliot water operatiaig ........ 11_ garage Fire proofing ------------------ 12. door closers --------------------------- 13. plutu'bing fi ctur<. ...................... 14, fouxidAticiri iazsulation, <W appl.)------ ILS. smoke detectors ....................... 16. final electrical ............. ........... 17. variance required --..:---------------- 18. data plate okay ..------ ------------- V/-,Oo, 19. mobile 14LJD seal okay .. ............ Mcidsl ## - Serial ff Manufacturer - - Date of IVlanufacturer C7KAY '1'© ISSUE C/C� _� YES NC3 _ Cornx�ents: Bu_ riding 8L- Cckd*gt :Enf6 rcg+m4ant Bay Road_ - - z Qu4aensbury,---MY- -.1280 ARRIVE. DEPART- DATE: PERMIT # _ Mt���Z. IiE-I+CL1M� -. T30Pi+i ►Z7��.?3.A!! .HtlML�' CGS Ft3LIP�TDA3`IC>1`s. 8A F�AhriIPTG? -_- 1_ foxxyxc aticaa support, pier- spacing- per13 aliftif• -------- , ._---_--__•_.• _ - _ 3- Water,,llile shut;tiff' ................ ...-. .....----- 4- somvf r lire sxsppcsrt (W 4 feet ....... 5. fe ting crossover (dlilewids -aff grcl _- 7-- - skirting ventilated -.-__ _ _ ------------ 8_ hot vcister relief valve -piping outside - 9. deck, pof chest steps, railing _-__-_•- - - _ -1Q, furxxace/tiot wat+-r cxp-rating - 1 - 12. dc�►er closers_ .-_ ... .._.-. 43. plurimbing mature ._-:-_--_......: ----- = 14, Fummadaticsn i=xs ilRtion- - 15; smoke detectors - ---__ _ •=---=------ _ 15- final electrical- ---------- ---- _ ---- - _ 3'7a -`rariance` required---=----------------- AS data plats okay •-:.. -._- - ------- A-9. mcybile FIXJID seal t3olcay .-. .. r h/JCod_ el #` Seri1 # . 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