2013-004 04_ TOWN OFQ UEENSBURY
•
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130004 Date Issued: Wednesday, January 23, 2013
This is to certify that work requested to be done as shown by Permit Number P20130004
has been completed.
Location: 183 PITCHER Rd
Tax Map Number: 523400-308-014-0001-052-000-0000
Owner: ARC COMMUNITIES 14 LLC
Applicant: ARC COMMUNITIES 14 LLC
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 ("-- e,t,eyk0
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board ir
Director of Building&Code Enforcement
or Zoning Board of Appeals.
yam` TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130004 Application Number. A20130004
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: ARC COMMUNITIES 14 LLC
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 COMMUNI I IES 14 LLC Mobile Home In Park $30,000.00
PO BOX 61102
CHICAGO IL 60606-0000 Total Value $30,000.00
Contractor or Builder's Name /Address Electrical Inspection Agency
RAYMOND JONES
424-0508 P.O. BOX 702
BALLSTON SPA.NY 12020-0000
Plans&Specifications
2013-004 68 Briwood Circle
Mobile Home Marlene Serial #
$136.80 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday,January 04,2014
(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 To of Q en bt4 FF uary 04,2013
64,
SIGNED BY �.GJ IrkS4� for the Town of Queensbury.
Director of Building&Code Enforcement
, r
•
OFFICE USE ONLY '
3 ,11- 1 -5 1 ,
NO
TAX MAP O. PERMIT NO. 3-O j DATE ISSUED:
PERMIT FEE PPROVALS: ZONING TOWN CLERK Jl�N C u 2013
,
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: RaunoM -)O ruA Name: �,C Propry5 .
Address: P.6 . x
(G `bo, Address: It3 Poiche rRa
a11s-:3f a. , n (, Dr.0
Phone No. 61g/ "07- d v Phone No.
Parcel Information /
Proposed Date of Placement: /- . -/3 Property Location: fip 6 r/ tdC L ye l e
{{��
Road, Street, Avenue
Name of Mobile Home Park: ''-4--(.71_5(''-4--(.71_5( k—POLi��jj� (if applicable) Tax Map Number:
Mobile Home Information Zoning Information
Approximate Value of Home: $ ,W,0IJ�v1i1 0 Zoning Classification: `r-�n��
New Home: [Yes Ell
No Size of Property: (On ft. by lJ ft.
Replacement Home: '9 Yes El No r 1/tlb Existing buildings:
Size of Mobile Home: (5 ft. by (( ft. Setbacks: front yard A 0 ft. rear yard 2 ft.
side yards:4D_4D_ft. and 1-4 .t.
Singlewide: Y Doublewide:
Number of Rooms: (exclude baths) Accessory Building(s):
Number of Bedrooms: 3
Number of Bathrooms: '_ Detached garage:01-car EI 2-car n car
❑Gas Fireplace❑Woodstove p Wood Fireplace Attached garage: 01-car 1-72-car 71 car
Foundation Support: Storage building: p]Yes ❑No
Type Size & Depth Other:
Piers
Runners ( �� �'7 ! `` Water Supply: ['Well Municipal
Slab Is Septic Permit Required? ❑YesNo
Continued on page 2
A,--
Town of Queensbury • Communihy Development Office • 742 Bay Road, Queensnuny, iv r i.au4
•
•
Name of Installer or Mobile Home Dealer: Cj` r lsl f. -Y i l l l^Z
Address: P.0 .1607(eV 44)174bPhone: j L -(cO -0 ad to
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number. _
✓ Name of manufacturer:
✓ Plan Approval Number.
✓ Model or Component Designation:
(New home only)
✓ Date of Manufacture:
tyn+vuLnau:av:au:zsnr:su:r•:.:rcr-_r:e:r:r nr:r nnaaa�r�sa:a:rav:rra:r-.r.,rn..r�+asa:ay.aa.*,,,,,,
.1 AFFIDAVIT
Town of Queensbury State of New York s
County of Warren
s
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 9
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.
i
Signature: tai r" —
i Owner, e ' ers Agent,A, hitect, Contractor 1
.x•w�iafJil:JlfJ:ti�iJ-:l'I�w.a.-.J•.r..a.wrJflNlJ(PLaI ••' 1.JrM.XA+J✓lX'i+��tia/ T•."w'JJiJlNJiJiJ:J1i
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
a Town of Queensbury• Community Development Office• 742 Bay Road, Queensbury, NY 12804
Queensbury Building & Code Enforcement — Manufactured I Modular Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart:`G )° am/pm
Date Inspection request received: Inspector's Initials: '
NAME: Pr Re l e PERMIT#. /L. —Lz )
LOCATION: (ag tLLu3`3rS DATE: I 1-1,3
Manufactured Home
Modular Home
Footings Foundation_ Backfill_ Framing—
Comments:
Yes No WA
Foundation support,pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off
Sewer line support @ 4 feet
Heating Crossover[doublewide)off grd.
Dryer vented outside
Skirting ventilated 1 sq.ft.per 1,500 sq.ft. >/
Hot water relief valve piping outside
Deck,porches,steps,railing
Fumace/hot water operating }f
Garage Fire proofing
Fire Door/Door closers \././
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable] >7
Smoke/Carbon Monoxide Detectors/Interconnected ,,f
Final Electrical 1/
Variance required
Data Plate okay
Manufactured HUD seal okay d — –1\frinc ice-1 Tr .
Warranty Seal after January 1,2006
Installers Warranty Seal
18"x 24"access or 22"x 30'attic access t�
Vapor retarder under home 6 mil poly or other
911 Street number
Okay to issue C/C or CIO[Temp./Perm.]
\./
Model# L '.-' l L I 01'.S7PSerial#kl511.19 M.Jc
Manufacturer I" 6 `L'1`. J
Date of Manufacturer 17"1���`-?..„
L1Pam Whiting120101Building Codes FormsWanufaduredModuiar Final Inspection 03 04 10.doc
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