2011-604 TOWN OFQ UEENSBURY
1 742 Bay Road,Queensbury,NY 12804-5902 (5 8)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20110604 Date Issued: Tuesday, January 03, 2012
This is to certify that work requested to be done as shown by Permit Number P20110604
has been completed.
Location: 183 PITCHER Rd
Tax Map Number: 523400-308-014-0001-052-000-0000
Owner: ARC COMMUNITIES 14 LLC
Applicant: RAYMOND JONES
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 ...„;;'. ,` a' •
other issues and conditions as a result of approvals by the Planning Boardw
Director of Building&Code Enforcement
or Zoning Board of Appeals.
1
itak
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
FOS
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110604 Application Number: A20110604
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: RAYMOND JONES
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 Mobile Home In Park $38,000.00
PO BOX 61102 Total Value
CHICAGO IL 60606-0000 $38,000.00
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2011-604
5 Briwood Circle - 1216 sq ft mobile home- Raymond Jones
$145.92 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,December 27, 2012
(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 Qu ensb> ; , Titlysdiy,December 27,2011
SIGNED BY `-r-'` ""} V for the Town of Queensbury.
Director of Building&Code Enforcement
103114--/ c2._ a: p
OFFICE USE ONLY ' r 1E t T 1 i `'
TAX MAP NO. PERMIT NO. 0 ' DATE ISSUED:
DEC 1, 2011
PERMIT FEE APPROVALS: ZONING TOWN CLERK 11 ,
T+WN OF *UEENSBU-Y
__pU}L-D NG&COVES
MOBILE HOME —APPLICATION FOR PERMIT:
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 t Property Owner Information
Name: � Q YTIU fd SU Y Q Name: Pet Prop ,
Address: Imo, 0 2 (yX 10 O Address: /g3 R-9-610 12c
-60l\ ,S (- 40 , \\ I log) (, u.rflfl f c/'(1 ,_� , /,--9 ,4
Phone No. Er! -q q-O5 g Phone No. 5 lc - 741 J5— -71 1
Parcel Information .
Proposed Date of Placement: Property Location: 5 8r7 w and e4A 4
nn nn ���� Road,Street,Avenue
Name of Mobile Home Park: I'�ln-- (if applicable) Tax Map Number:
Mobile Home Information Zoning Information
Approximate Value of Home: $ i6'�0U Zoning Classification:
New Home: FNY,2,s ❑No Size of Property: ft. by ft.
Replacement Home: Ees El No 6.2-_ , ,.-' Existing buildings:
Size of Mobile Home: f/i ft. by ft. Setbacks: front yard ft. rear yard ft.
side yards ft.and ft.
Singlewide: 'C Doublewide:
Number of Rooms: (exclude baths) 5 Accessory Building(s):
Number of Bedrooms: 3
Number of Bathrooms: 0, Detached garage:❑1-car 02-car ❑ car
0 Gas Fireplace❑Woodstove 0 Wood Fireplace Attached garage: 01-car 02-car D car
Foundation Support: Storage building: DYes ❑No
Type Size & Depth Other:
Piers Water Supply: ['Well ❑Municipal
Runners 30'1)( 74P isi'
Slab Is Septic Permit Required? ❑Yes ❑No
__.._ Continued on page 2
CITown of Queensbury • Community Development Office • 742 Bay Road, Queensnury, iv i 1L6Uzi-
Name of Installer or Mobile Home Dealer: .JJ iLl S
Address: p. t, 76 , l l lin r Phone: 5/ 7
lily JOU
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number: a V-69,365 •
✓ Name of manufacturer: r:6114 RI ye r
✓ Plan Approval Number:
✓ Model or Component Designation: gla N / 56 (9Z3c
l (NNwl o me only)
✓ Date of Manufacture: O/7
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
y shall be complied with, whether specified or not, and that such
v work is authorized by the owner.
1/
Signature: ''•
Owner, rs Agent,Ar itect, Contractor
i
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
CITown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
Community Development Office
Town of Queensbury • 742 Bay/Road • Queensbury, New York •12804
PROCEDURE FOR PLACING AND OCCUPYING A MOBILE HOME
OR MODULAR HOME:
1. Application is submitted and reviewed.
a. Two (2) copies of plot plan and two (2) copies of layout must accompany
application, along with septic application (if needed).
2. Permit is issued.
a. Permit card is placed on property.
3. Footing forms are inspected before pouring concrete (Outside mobile home park).
a. Home is placed on foundation or piers.
4. Arrange for electrical inspection
5. Septic Inspection if needed.
6. Final Electrical Inspection.
7. Stairs and platform covering door width and door swing with handrails on both sides of
platform and stairs are required for all exterior doors.
8. Final Inspection by Building & Codes Department.
9. All mobile/manufactured housing must be anchored to the ground upon which they are
sited per manufacture requirements.
10.If anchoring is not possible due to weather conditions or any other item, a Temporary
Certificate of Occupancy will be issued.
a. Fee: $10.00
b. Deposit: $100 (refunded when all items are complete)
QUESTIONS? CALL 7614256 OR EMAIL
codes(a queensbury.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.quensbury.net
B 9-LTR 11-05
CITown of Queensbury Building & Codes Fee Schedule
Activity Fee
1 &2 Family Dwelling (includes septic system permit) $0.12 per sf
Additions: Commercial $0.14 per sf: Minimum$100 fee
Alterations: Commercial $0.12 per sf: Minimum$ 50 fee
Additions: Residential $0.12 per sf: Minimum$75 fee
Alterations: Residential $0.10 per sf: Minimum$40 fee
Boathouse w/Sundeck $50
Building Permit Renewal: Extends permit for period of 1 yr. $25
Certificate of Compliance &Use $20
Certificate of Occupancy No fee
Commercial, Industrial, Public Assembly, Day Care Center,etc. $0.15 per sf: No Maximum
Commercial/Industrial: Unheated structures (i.e,warehouse) $0.05 per sf: No Maximum
Deck, Porch $0.10 per sf: Minimum$40
Demolition $20
Dock $30
Fire Marshal Inspection
$25 per inspection
(Includes Solid Fuel burn permit, installation of chimney/wood
stove) $100 per special projects
Floodplain Development Permit $25
Garages $0.10 per sf: Minimum$30
House Moving Permit $30
Mobile Homes (includes septic system permit) $0.06 per sf
$25,Above Ground;$35, In-
Pool Ground
Septic Systems: Alteration or New System Only $25,Residential;$35,Commercial
Septic Variance (requires Town Board of Health review) $50
Sheds/Storage Structures, Pole Barn, Picnic Pavilion,Misc. $20 per inspection
Signs: Permanent $2 per sf
Signs: Temporary $ 10 per 12 days/$50 cash deposit
Townhouse, Condo,Apartments, Multi-family $0.14 per sf: Minimum$100
Revised 1-17-07
Community Development Office
' Town of Queensbury • 742 Bay Road • Queenshury, New York •12804
Electrical Inspectors
THE FOLLOWING ELECTRICAL INSPECTION AGENCIES ARE CERTIFIED BY THE TOWN
OF QUEENSBURY TO PERFORM ELECTRICAL INSPECTIONS:
NAME&ADDRESS OF BUSINESS INSPECTOR CONTACT NUMBER(S)
Commonwealth Electrical Inspection Services Donald Loveland Local Office:1-800-562-9934
176 Doe Run Road Ron Mumblo Ron: 518-798-0905
Manheim, PA 17545
Main Office: 1-800-873-6432
Middle Department Local Office: 1-800-479-4504
143 Troy Schenectady Road Ray Novak 518-273-0861
Watervliet, NY 12189 (Office Hours:7:00—9:00 AM)
Ray: 369-6614
The Inspector, LLC Richard Moon Main Office: 1-800-487-0535
4755 McConchie Rd. Douglas R. Hull Local Office: (518)882-6140
Galway, NY 12074 Brian D. Sweet
David J. Irwin
New York Board of Fine Underwriters
40 Fulton Street-6th Street Walter Sonntag Local Office: (518)373-7003
New York, New York 10038
PLEASE NOTE: WE CANNOT RECOMMEND AN INSPECTOR, HOWEVER, PLEASE ASK
YOUR CONTRACTOR WHO HE PREFERS TO INSPECT HIS WORK.
3/28/07
Attention all Manufactured,
Mobile Home Owners
New York State Law requires that all Manufactured
and Mobile Homes have an Installers Warranty Seal
by a Licensed Installer affixed to the Home prior to
the issuance of a Certificate of Occupancy
No Occupancy of a Manufactured or Mobile Home
will be allowed until a Final Inspection has been
completed including the Installers Warranty Seal
affixed to the home. Any Occupancy will be
considered a Violation of Town Code section 88-24
and a Court Summons will be issued for this violation
Any questions should be directed to the Town of
Queensbury Building Department at 761-8256
' Y
Queensbury Building & Code Enforcement— Manufactured / Modular Final Inspection
Office No.(518)761-8256 Arrive: am/pm Depart `,`n I cam/pm
Date Inspection request received: l.2 )) "11 Inspector's Initials: 44,LAZ>__
NAME: PERMIT#: j II-
LOCATION:
/-LOCATION: 5 6.1-4 ; d DATE: ")I
Manufactured Home i./
Modular Home
Footings_ Foundation_ Backfill, Framing
Comments:
ym No WA
Foundation support,pier spacing,
Per manufacturer \/
Anchoring per manufacturer 2'from ends
Water line shut off V
Sewer line support @ 4 feet ,f
Heating Crossover[doublewide}off grd.
Dryer vented outside ✓/
Skirting ventilated 1 so.ft.oer 1.500 so.ft. V
Hot water relief valve piping outside
Deck,porches,steps,railing
Fumace/hot water operating f
Garage Fire proofing V
Fire Door I Door closers
Plumbing Fixture/3'Vent through roof[Modular]
Foundation insulation[if applicable] .�
Smoke/Carbon Monoxide Detectors/Interconnected 1/47
Final Electrical
Variance required
Data Plate okay
Manufactured HUD seal okay
Warranty Seal after January 1,2006
Installers Warranty Seal • /
l /
18'x 24'access or 22'x30'attic access
Vapor retarder under home 6 mil poly or other
911 Street number
Okay to issue CIC or CIO[Temp./Perm.]
Model# e c5 t L Serial# �0.2:3 c
Manufacturer f.-4414.1E-
Date
Date of Manufacturer ic
L:1Pam Whiting%20101Building Codes Forms\Manufactured Modular Final Inspection 03 04 10.doc
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TOWN OF QUEENCiSURY
BUILDING DtloA PT MENT
Based on i.)! r limiteri:-.,<arwnt.°ri.compliance
witl- ow con-II-tells s',all p 1 .,cont.trued as
indicating the olx,s on : -;,:i'A'ations are in
full comp!ai ,,A Int, 3,,,lding Codes of
New York State.
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