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2010-084 41111111b) TOWN OF QUEENSBURY 742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20100084 Date Issued: Friday, July 22, 2011 This is to certify that work requested to be done as shown by Permit Number P20100084 has been completed. Location: 183 PITCHER Rd Tax Map Number: 523400-308-014-0001-052-000-0000 Owner: ARC COMMUNITIES 14 LLC Applicant: HOMESTEAD VILLAGE L P 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 f" e� �- xfiz , 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. i 30,3 OFFICE USE ONLY ;* # "f� TAX MAP NO. or✓ PERMIT NO. ,2-0/0 --O I' DATE ISSUED: PERMIT FEE 7L.) APPROVALS: ZONING TOWN CLERKI { 6 21 lg ILi, • Y , Bull i)Nc4.& GODS 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 Property Owner Information Name: /it/'/rulr'i �;z�i6k•� Name: �/ ��z- AIia �le�c5� Address: Jf 3 Address: /c 3 "c #4/4Y ``/ 0uT1s 4417 ,rfe'cr' 1,2 r(-)(r- Phone �`iPhone No. (±(Y ) 74/S- 777( Phone No. 369 7Ys '777(, Parcel Information Proposed Date of Placement: Property Location: 3 6,-A74 c,ie (? ,:c Road,greet,Avenue Name of Mobile Home Park: Fo ,.1 (if applicable) Tax Map Number: Mobile Home Information Zoning Information Approximate Value of Home: $ g' ,4(A)1 Zoning Classification: New Home: es No Size of Property: ill ft. by 4G ft. Replacement Home: Yes €) Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard 30 ft. rear yard 33 ft. / side yards 3y ft. and AO ft. Singlewide: ✓ Doublewide: Number of Rooms: (exclude baths) 3 Accessory Building(s): circle Number of Bedrooms: .3 Number of Bathrooms: J., Detached garage: 1-car 2-car car Circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1-car 2-car car Foundation Support: Storage building: Yes No Type Size & Depth Other: Piers Runners Water Supply: well or rncipal Slab Is Septic Permit Required? Yes or (No Continued on page 2 - Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804 Revised March 2010 I Name of Installer or Mobile Home Dealer: pt, d S Address: Phone: - ,5"-- o�/s Complete information below found on a "Plate" or"Sticker" which is affixed to the mobile home: ✓ Insignia serial number: 4/ aJ'j ✓ Name of manufacturer: c'•`kri)-1- Cre,.5 < h 6 .> ✓ Plan Approval Number: ✓ Model or Component Designation: /02A-03 a( (New home only) ✓ Date of Manufacture: ,R00 i AFFIDAVIT f Town of Queensbury State of New York County of Warren o\ t \ N10(0.hau 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. Installer Warranty will be pr. "sed at time of Certificate of Occupancy. Signature: Owner, Owner's Agent, Architect, Contractor SPECIAL CONDITIONS OF PERMIT By: Code Enforcement Officer aft Town of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804 Queensbury Building & Code Enforcement— Manufactured / Modular F' -I Inspection Office No.(518)761-8256 Arrive: — •arE Irina Inspection request received: Inspector's Ia . 1 NAME: Cc) t)04 PERMIT - %0 — ©�--1 LOCATION: ' k2 (� C-R E)._C O \RC E DATE: ' 1 -7A-1\ Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing_ Comments: Y No MIA Foundation support,pier spacing, Per manufacturer Anchoring per manufacturer 2'from ends Water line shut off V \/ Sewer line support @ 4 feet Heating Crossover[doublewide}off grd.Dryer vented outside /1),\/Skirting ventilated 1 sa.ft.oer 1.500 sa.ft. Hot water relief valve piping outside Deck,porches,steps,railing i Furnace/hot water operating Y Garage Fire proofing Fire Door!Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[rf applicable] ,� Smoke/Carbon Monoxide Detectors/Interconnected / Final Electrical Variance required vv Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal 18"x 24'access or 22'x30'attic access Vapor retarder under home 6 mil poly or other 911 Street number 13t7 Okay to issue CIC em P Model# 6C.17 Z(-C)` Serrial# \vZ��� )--s-e�t��Z7- A Manufacturer ,tJ\�r\N Date of Manufacturer 01 — 1–et L:1Pam Whiting120101Building Codes Fonms\Manufactured Modular Feral Inspection 03 04 10.doc / Queensbury Building & Code Enforcement - Residential Final Ins action Office No. (518)761-8256 Arrive: am/pm De rt: am/pm to Inspection request rceived: Inspector's Initials: & NAME: 1/ �C)S5 • PERMIT#: , f LOCATION: .3 f DATE: -TYPE OF STRUCTURE: _ 77/ _ Comments: He WA 4' Building Number Address visible from road i i �= J Chimney Height/'B'Vent/Direct Vent Location ` I Fresh Air Intake 3 inch Plumbing Vent through roof minimum 6 inches Roof Complete/Exterior Finish Complete Platform at all exterior doors Handrail 4 or more risers Guards at stairs decks •= los more than 30 inches above .rade Guard at stairwell at 34 inches or more Guard at deck,porches 36 inches or more Handrail Termination at Newell Post or Wall interior/Exterior Railings 34 inches to 38 inches Deck Bracing/Handicapped Ramp Compliant Grade away from foundation 6 inches with 10 feet 8 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18 inches above grade Interior privacy/trim/doors/main entrance 38 inches Bathroom/Kitchen watertight Safety glazing/Window in - :,: =‘... • , interior Smoke Detectors(arbon Mon. •= _'ors Every level: E -"'s T•- Outside every bedroom area: Inter Connected: Battery backup Attic access 30 inches x 22 inches x 30 inches(height)in accessible area Crawl S.=ces 18 inch x 24 inch access 1 ..ft.-150 =..ft.vents Bathroom Fans,if no window Plumbing fixtures Foundation insulation/Insulation Certification Floor truss,draft stopping finished basement 1,000 sq.ft. Emergency egress below grade Gas Furnace shut-off within 30 feet or within line of site Oil Furnace shut-off at entrance to furnace area Fumace/Hot Water Heater operating Low water shut-off boiler Relief Valve(s)installed/Heat Trap/Water Temp 110 Enclosed Stairs Sheetrock Underside minimum IA'Gypsum Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/%hour fire door/door closer Duct wort Sealed properly Gas Logs in Sealed or Glass Enclosure Final Electrical Final Survey Plot Plan Arc Fault Breaker in Bedrooms Flex Gas Pipe Bonding_ As Built Septic System/Sewer Dept. Inspection Sticker Site Plan /Variance required Flood Plain Certification,if required Okay to issue C I C or C/0[Temporary/Permanent] L:\Building&Codes Forms\Building&Codes\Inspection Forms%Residential Final Inspection Form_revised_100405.doc;Revised January 7,2008;Revised 6/28/08 2-4 Mo Queensbury Building & Code Enforcement-- Manufactur adular Final Inspection Office No.(518)761-8256 Arrive: 3~ Its a ., s ��=-rt ?)" a -rpm Date Inspection req t received: Inspector's Initial NAME: ;� `(E � PERMIT , /40 Q iF4 LOCATION: r _ bid .!a DATE: 3 Manufactured Home Modular Home Footings_ Foundation_ Backfill_ Framing Comments: Yes No WA Foundation support,pier spacing, / NPV--6PPrt- 7-�. )V b 1'�1.� T'O C. .-D5 Per manufacturer Y `C) \\ Anchoring per manufacturer 2'from ends I Water line shut off f Sewer line support t 4 feet Heating Crossover[doublewide}off gni. Dryer vented outside Skirting ventilated 1 so.ft.per 1.500 so.ft. Hot water relief valve piping outside Deck,porches,steps,railing Fumace/hot water operating Garage Fire proofing Nj/ Fire Door/Door closers Plumbing Fixture/3"Vent through roof[Modular] Foundation insulation[if applicable] Smoke/Carbon Monoxide Detectors/Interconnected Final Electrical Variance required Data Plate okay Manufactured HUD seal okay Warranty Seal after January 1,2006 Installers Warranty Seal , 18"x 24"access or 22"x 30"attic access Vapor retarder under home 6 mil poly or other 911 Street number Okay to issue C/C or CIO[Temp.!Perm] Model# Serial# Manufacturer Date of Manufacturer L:\Pam Whiting\20101Building Codes Forrns Manufactured Modular Final Inspection 03 04 10.doc