2013-089 TOWN OF QUEENSBURY
AI°khaki.
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130089 Application Number: A20130089
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 Fireplace
PO BOX 61102 Mobile Home In Park
CHICAGO IL 60606-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-089 43 GREGWOOD CIRCLE
Mobile Home - 16 x 76; Fireplace - Wood burning
$145.92 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,March 11,2014
(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 Tow of Que nsbu /f M; id./ A . ch 11,2013
SIGNED BY II if • for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
^y 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20130089 Date Issued: Thursday, September 03, 2015
This is to certify that work requested to be done as shown by Permit Number P20130089
has been completed.
Location: 183 PITCHER Rd
Tax Map Number: 523400-308-014-0001-052-000-0000
Owner: FOREST PARK -- 65 GREGWOOD CIRCLE
Applicant: RAYMOND JONES
This structure may be occupied as a:
Fireplace By Order of Town Board
Mobile Home In Park TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property (7.1),,„P 4
owner of the responsibility for compliance with Site Plan, Variance, or
other issues and conditions as a result of approvals by the Planning Board Director of Building& Code Enforcement
or Zoning Board of Appeals.
•'•
OFFICE USE ONLY
' 3 v S .
\ _l^ , •' •
TAX MAP NO. PERMIT NO i 3,Q I DATE ISSUED:
.( J r� TOWN CLERK• i i ;
PERMIT FEE ROYALS: ZONING , MAR 0 8 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: C ‘'Y1n n(- ,OfoS Name: 4 2C Prop erIys
Address: {�, •C) <<30,c i o n, �3 A /die Address: / i �1P/ Rdod
LS4-011 S' ‘nLi pia0 ( (Aeei 4)ci rq( , n ci, / gni I
)j(r Phone No. 6 q). -14.94-050?' Phone No. 6 I g - q67 ~ %7/-7&
Parcel Information /� e
Property Location: 43G1P (J0Cd C.C' C', r
Proposed Date of Placement: Road,Street,A enue
Name of Mobile Home Park: 'A-OreSf Pa-Y V\ . Of applicable) Tax Map Number.
_..�_....
....._._.....-----
Mobile Home Information • Zoning Information
Approximate Value of Home:$ Q 0 1
000 Zoning Classification:
Il� ft by le-)0 ft.
New Home: ❑Yes [moo i Size of Property:
Replacement Home: @Yes ❑No Existing buildings:
Setbacks: front yard _39.0 ft. rear yard raLl ft.
Size of Mobile Home: I�.ft. by Co ft side yards a:g, ft.and -_,Q,C ft.
Singlewide: x Doublewide:
!
Number of Rooms: (exclude baths) 5 Accessory Building(s):
Number of Bedrooms: 3 ': car
Number of Bathrooms: al
Detached garage:0 1-car 02-car
0 Gas Fireplace❑Woodstove Wood Fireplace Attached garage: 01-car 02-car ❑ car
Foundation Support: ?
Storage building: ❑Yes 0 No
i l
Type _ Size & Depth Other:
Piers Water Supply: ❑Well MMunicipal
Runners r-1.5 ' LcL [�
Slab Is Septic Permit Required? ❑Yes No
L.....7_____________
_.._. _.._...___..._..�`_.._.. L Continued on Page 2
QTown of Queensbury• Community Development Office • 742 Bay Road, Queensbury,iv r 1zaui
Name of Installer or Mobile Home Dealer: l h r t' -IYl D SC\ul �Z
Address: a .OL 99C.X re_ 4- `•CSC\ ,Qxtl` AnnS ThQne: `�Ig -(405-69,9(0
Complete information below found on a"Plate"or"Sticker"which is affixed to the mobile home:
✓ Insignia serial number: 1R Of 0 1`..
✓ Name of manufacturer: k L ve r
✓ Plan Approval Number: JJJ
✓ Model or Component Designation:
(N
9 ew home only)
✓ Date of Manufacture: 20 1�1 L>✓ ��,ec
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 .ch
work is authorized by the owner. /
Signature: i / 46.‘a/
Owner, Own-is fent,Art hitect, ontractor
SPECIAL CONDITIONS OF PERMIT
By:
Code Enforcement Officer
aTown of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804
ef + 3'O g j MAR 0 8 20d .
Revised 4/14/2010
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building & Codes Office for the issuance of a Building & Use Permit pursuant to the
New York State Fire Prevention & Building Code. The applicant or owner agrees to comply with all applicable laws,
ordinances, regulations, and all conditions that are part of these requirements and also will allow all inspectors to enter
premises to perform required inspections.
Important Note To Applicant: Rouqh-ln and Final Inspections Are Required:
Owner:: �.�(� �'S�(�m !)� Installer/Builder: LC' C 1'QQ
li Iger
Address: GcPC}Lt d rU\Cb Address:
C wee crn hie 1-c nu l go, t
Phone Nos.: (._o --4 � C '"1 (C nn Phone Nos.:
Location of Property: �C reg/_ UUC1O Subdivision Name:
Location of Proposed Construction and/or Installation:
Contact Person for Building & Codes Compliance:
Fuel Burning Applicance Wood Coal Pellet Gas Oil
Information
Stove
Fireplace Insert
V Fireplace, factory built* �!
Fireplace, Masonry
Furnace, (Garage Only)
* If Factory Built, Please Provide: ManufacturerName: CIve r Model No.
ZolOtte
Listed By: Number:
Chimney Information BLOCK BRICK STONE
Masonry** Check One✓
TILE STEEL SIZE IN
INCHES
Flue Check One ✓
DOUBLE WALL TRIPLE WALL INSULATED DIRECT CHMNEY
VENT LINER
Chimney Material Check One✓
** If Non-Masonry, please provide: Manufacturer Name: r_0(-\\,- c\Yc7 ti/Model No.
ADDITIONAL NOTE: CONSTRUCTION / INSTALLATION MUST CONFORM TO NYS FIRE
PREVENTION & BUILDING CODE AND/OR MANUFACTURER REQUIREMENTS. CONSULT
AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED INSPECTIONS
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: ^` CD a 'p : s )aper/
Date Inspection request received: Inspector's Initials: .._i//
NAME: R C_67- PERMIT '. \
LOCATION: L} E U jV) Cl>< RC DATE: C\ ` —1\c"-
Manufactured Home
Modular Home
Footings Foundation Backfill_ Framing_
Comments:
_Yes o NIA_
Foundation support, pier spacing,
Per manufacturer
Anchoring per manufacturer 2'from ends V
Water line shut off VVVV�
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 J
Deck, porches, steps, railing /I
Fumace/hot water operating
Garage Fire proofing .11///
Fire Door/Door closers
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation [if applicable]
Smoke/Carbon Monoxide Detectors I Interconnected
Final Electrical
Variance required
Data Plate okay
Manufactured HUD seal okay � ` �
✓, � -�C
CA°
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 C/O[Temp./Perm.]
Model# Serial#
Manufacturer
Date of Manufacturer
L:\Pam Whiting12010\Building Codes Forms\Manufactured_Modular Final Inspection_03 04 10.doc
(LA
Queensbury Building & Code Enforcement — Manufactured / Modul. Final Inspection
Office No. (518)761-8256 Arrive: VO_ / m P- art �r/
\ �� P / P P
Date Inspection request received: q't 20,CD Inspector's Initial- .f4114/
NAME: Qj Y tSt QXVIC__) PERMIT# 1
LOCATION: 4-p0 7O O CA Cw Lv DATE: (7112-04,,S
Manufactured Home
Modular Home
Footings Foundation Backfill_ Framing
Comments:
Yes No NIA
Foundation support, pier spacing,
141.(/
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off
!3ewer 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,poaches, steps, railing
1/..; r �1�1�-��- �.zk �,0
Fumace/hot water operating �� rJ1r-
bZ -1,w���
Garage Fire proofing
Fire Door I Door closers f
Plumbing Fixture 13"Vent through roof[Modular] , pit vviv...a
L` /
Foundation insulation[if applicable] ✓ /
Smoke/Carbon Monoxide Detectors/Interconnected ✓ t_ U tA?'E�.
Final Electrical
Variance required
Data Plate okay "rte �� ��"'� Cet)>I—,
Manufactured HUD seal okay /// \ �} '[�j
Warranty Seal after January 1,2006 bt \�-
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 C/O[Temp.I Perm.]
Model# FX1 7 Serial# \ \�p
Manufacturer C_AGLE ft1 J� 1 \C Yir5
Date of Manufacturer
L:1Pam Whiting\20101Building Codes Forms\Manufactured Modular Final Inspection_03 04 10.doc
Queensbury Building & Code Enforcement - Residential Fin. nspection
Office No. 518 761-8256 k T - q"Arrive: =-R) am lirp. a
Date Inspection request received: Inspector's Initials: ..."alea
NAME: C.( bRE Pi R •ER IT#: YEO,t OEM ;
LOCATION: (� -•REC=�c� �) C1 Z- —�7 _
TYPE OF STRUCTURE:
Comments:
Yes No NIA
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches �j�l\L C-D�`� �
Roof Complete/Exterior Finish Complete
Platform at all exterior doors >3 �C eq-- c
Handrail 4 or more risers
Guards at stairs,decks,patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck, porches 36 inches or more � � �� QA
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches CD6J
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim I doors I main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup: EM,,- ��\c iu
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans, if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test 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
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(s)installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum 14"Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/'/,hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
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/C or C/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&CodeslInspection Forms\Residential Final Inspection Form_revised_100405.doc; Revised
January 7,2008;Revised 6126/08; Revised 12/22/10, Revised 04/13/11
—71-15—b%0
Queensbury Building & Code Enforcement - Residential V: - nspection
Office No. (518) 761-8256 Arrive: \= r� - . ;. -part: \ 5 am r
Date Inspection request received: (� spector's Initials: n
NAME: A I�C 4-C` RE ' C E MIT#: t'C'N)‘1\)(--,
L
LOCATION: C D5=13
TYPE OF STRUCTURE:
Comments:
Yes No N/A
4" Building Number Address visible from road
Chimney Height/°B'Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches , ` g C >M �
Roof Complete/Exterior Finish Complete ► �U
Platform at all exterior doors O�'E U r E E��
Handrail 4 or more risers hJ
Guards at stairs,decks,patios more than 30 inches above grade w�TE� D� �/�s�
Guard at stairwell at 34 inches or more C
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
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade ,LE l)
Interior privacy/trim/doors/main entrance 36 inches
Sae1 Kitchen watertight C CMOL`,�O
Safety
glazing/Window in stairwells safety glazing � ` 1
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation to floor/Sticker on Panel
Duct work sealed properly/Blower Door Test 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
Furnace/Hot Water Heater operating
Low water shut-off boiler
Relief Valve(installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/%hour fire door I door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
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/C or C/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codes\Inspection Fomis\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10,Revised 04/13/11