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RC-0524-2018TOWN OF QUEENSBURY 742 Bay Road, Queensbury, NY 12804-5904 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: RC-0524-2018 Date Issued: Monday, May 6, 2019 This is to certify that work requested to be done as shown by Permit Number has been completed. RC-0524-2018 Tax Map Number: Location: Owner: 308.14-1-52 72 Briwood CIR FOREST PARK MHC, LLC Maggie GannonApplicant: This structure may be occupied as a: New Manufactured Home 1120 s.f. 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 other issues and conditions as a result of approvals by the Planning Board or Zoning Board of Appeals. Director of Building & Code Enforcement - ' TOWN OF QUEENSBURY , rs.,4v" 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: RC-0524-2018 Tax Map No: 308.14-1-52 Permission is hereby granted to: FOREST PARK MHC,LLC For property located at: 72 Briwood CIR- 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 Owner Name: FOREST PARK MHC,LLC Mobile Home $40,000.00 Owner Address: 183 Pitcher RD Total Value $40,000.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Combs Trucking 96 VAN DUSEN RD Queensbury,NY 12804 Plans&Specifications New Manufactured Home 1120 s.f. $ 224.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday,August 20,2019 (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 da e.) Dated at the Town o ueen ury; o I d..yy'I gust 20,2018 t SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement Office Use Only '. _ i MANUFACTURED HOME Permit#: �C ' �' ` '� \Y I PERMIT APPLICATION Permit Fee:$ 2- ' , o Town ofCZuccnsbwy 2 742 Bay Road,Queensbury,NY 12804 Rec Fee:$ ki/)-1 P:518-761-8256 www.queensbury.net D ECE 0VEI ice#: 61LeLI AUG 14 2018 id) TOWN OF QUEENSBURY (�� �S`Z Project Location: I2. 6WQOti Circ fie_ �1_BUILDING&CCTINSVlap ID#: 3 U`1° Name of Park: FOres1-Park mW-c.i Proposed Date of Placement: glNl ig CONTACT INFORMATION: • Applicant: Name(s): m(1rQ,1 eI 6 allillal Mailing Address, C/S/Z: 1 3(Laker Vfi., ( b' 121309 Cell Pho e: (518 ) 0 .SD 1t 11 O Land Line: (51 ) -7L{5 P 7�r Email: fOre.SrnaYk Ca rki0-3ro !e liCS<, e:osrYt . . i • Primary Owner(s): Name(s): P (IS 0-10D1re Mailing Address, C/S/Z: , Cell Phone: ( ) Land Line: ( ) Email: • Contractor(s): Business Name: eOVYlb5 rl,lCVin0 ih, 1-Huvv s Howie &&rvdt c Contact Name(s): ( 1A(' (eo1111is / ivi i-iu v f Mailing Address, C/S/Z: 1( \kl/1 Niise.VI kra 0519\1 I L/O griuOvey) QCI Qs J t Cell Phone: (518 )`lq(p -4859 CCl'IaiiiA 44 t Line: (518 ) 3&l - 2R31 (► Ab►�1 Email: (jkk awl. Contact Person for Building & Code Compliance: n Q La Ci.61dir v Cell Phone: (518 )t‘?3e -lq 1O Land Line: (518 ) 1'-15- 1116 Email: forestpar« ? rho- prt ier-Fics, COry Town of Ctueensbury Building&Code Enforcement Manufactured Home Application Revised May 2017 MANUFACTURED HOME INFORMATION: (INFORMATION FOUND ON THE PLATE OR STICKER LOCATED IN THE HOME): Insignia serial#: Name of Manufacturer: CAW bh1 Place approval#: 121 Model or component designation (New Home Only): 'L".Z7 • Date of manufacture: 20Is ADDITIONAL INFORMATION: 1. Approximate Value of Home:$ Ao, 2. Is the home NEW V or a REPLACEMENT ? "n 3. Single-wide \ or Double-wide ; Size: (Li ft.X -10. ft. 4. Foundation support(choose one): Size Depth Piers: 4 ' • Slab: / 5. Is the home being placed on a private lot? No \/ Yes (if yes,you must provide stamped engineered drawings of the permanent foundation plan) 6. Total#of rooms(exclude bathrooms): l� ;#of bedrooms: 1 ;#of bathrooms: 2- 7. Additional heat source? No V Yes Choose one,if yes: gas fp^ woodstove- wood fp_ 8. Are there any other/existing buildings on the property? No V/Yes ; Explain: 9. What is the water source? UBLIC PRIVATE WELL 10. Is the parcel on SEWER or a PRIVATE SEPTIC system? 'e0----I 11. Do you need a septic permit application? No / Yes DECLARATION: 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 NYS Building Code,the Zoning Ordinance and all other laws pertaining to the proposed work shall be completed with I have read and agree to the above: PRINT NAME: Marr&- U�ail.lrtol J SIGNATURE: P / ,Wi \,Q, DATE: Sl ) 1 Town of 11ueensbury Building&Code Enforcement Manufactured Home Application Revised May 2017 . ,•• i .... _ • , 1 3087F 20 ri r1smi w4t a-op1no-au5drf2akcc • cvn-rrpiT t. k,a,. ,o, ,,c RC-0524-2018 ANCHORING OF MOBILE HOME itrured Home 1120 s.f. FRAME IS REQUIRED PER . New MANUFACTURERS SPECIFICATIONS --- , ,4 ,,^ ••, i 7 4` .. .,-,. 1 , A i ! i . raw aq e. MASTER ., t II "I— ,-9,_6"- uviNG , BEDROOMO / BEDROOM • !, : .4-! •:, ROOM Ee-rx11T-3" , ' I'l " " . „ ! e,. k i l BAH T".; 1 0'-'i 0"x 14%2" UT 13'-'11x1,1c2 BEDROOM#2 ILITY " . I MY I i „., WAO i ra lel El Bo BATH .: v - ), 0 toTh.'H • = 1 1i N .„.„.„.„_ L ....„,„ \ jA. OPT - , : I 1 .-,. MODEL 122-L-26007 • LINO T/O i ,_gz TOWN OF QUEENSBURY . ,,,,,z, cc ItU 3 BEDROOM,2 EATH NOIVIINAL SIZE:16'X 74' BUNG DEPARTUFNI Based on our limited e,°,:amination,compliance PRELIMINAR t ' A143 ;(°°. ts,1 mo, , r--------1 w 0, ACTUAL SIZE:158-2'X 70'''0" With our comments slla;oot be construed as ' FOR REVIEW LY4- TOTAL AREA: 1062 BEL FT, , =• ', indicating the plans and specifications are in CID 1 full compliance with the Buffing Codes of OF (Iv,r_2_v 9J-„, r, ri,,:w New York Stake. _ i_k_ kk_ik.gg 1 li ,`,,•- ! WI ' IIALit D PAil G 0.1? CODES LOPPI, -, _1 ___ RSOF:'4,9S(11 P,) g' 17- fi 1 a---I v 1 -:_ __I 4 • Date. , _.............._ --1 b3i tt'fl 10,P 1.0 * i_ 11 22-1,-26007 isuRATuRE L-101 }: • • i I I . JUAUU fACIU Kt 0 BIMUTI NW' i Lioxlia,lat_._ i ! i,j.:t;tut__ 4CM E. Iry., ------it -'''''`?...r: t.', ,',%zq..'„•'''"-' 1,;•,;,,I. ,,,1,:::.- -. ,.; :'.: ..':. 1 '',"V'N.6fe&dtket)ITATION5ff-Anitidri7faittifeleri-4.5,17.mApis011 vit,LAGE.LoT i'.1,4.3.13.i 7,f rom-Topekaiwg,9,1 112017 12:la A 2 PM.DWG.rd a LIF.pc3 • 1 I I I�'T NOTE;ALL DROPS SUBJECT TO CHANGE UPON COMPLETION OF PftODU,CTION PRINTS PRELIMINARY PIER P R I N t :'estGN CRITr:RIA: iI j ONLY THIS PFIINT FiAS.REEN DERIVED FROM D A Pi FOR-REVIEW O!�tLY APPROVEpDESIGNS 2.REFER TO'T'HE 1NPPROVEIT INST.ALI_AHON • MANIIAL FOR THE FOLL.OWIN.G SIT E;7_T4KS TTOSE COMP{END ITV•;IdEINSTA:.S.EIEI MANUFACTURER DISCLAIMER NOTICE A SITE PREPARATION 65OIL E ES„RIN r CAPACITY PLEASE .................................. PLEASE READ AND UNDERSTAND THE FOLLOWNG INFORMATION C.FOOTING DESIGN AND S. G. CIIA;,1PI0N HOME RUELDERS,DOES NOT PERFORM ANY SITE WORK FOR HOMES Frio I'ittG'S:.'.r•,;,,,,,,,,,,,,,,,,,_...,_,m.....................,...._.....,................................ IT 1"ALL bE THE RESPONSIBILITY OF THE DEA'(.I'RISITECONFRe\i,TOP'i'O ItE,;URE T _ ` D PIER CONST'RU4"IUN TI1AT"AL.S..SIT'L=WORN LL CORRELATE WITH'THR UNI ORDERED EI ANCHORING . TOOtIN,TSPACING;,,, 3�dFilS PIER SUF'YOR'I^UE51GN HAS t3E:f•,Nti;R1,:;1'tEL) tcOA'+'ui.F:'7EON!Yit'OFF a'ttE'Nr'F•'I;;:tis>io'Atit�� ALL DIMENSIONS.SIIALL RE VERi!-1f:1.BEFORE.CONSTRUCTION L`P'E„ IFICAI.LY FOR THIS SERIAL.HOMER • NOTICE TO ALL iiOrJ1E INSTALLERS; I:idlNiIFACDLIPIST lOVES WEIGH SEVERAL PIEN Li• TONS.DO NOT'ATTE ATTEMPT TO INSTALL HOME ON$3TE WITH OUT HAVING 4 PIERS ARE'DOORS RREQUIRED AT BOTH SIDES- EXPERIENCE,KNOWLEDGE AND UNDERSTANDING OF ALL INSTALLATION ' EXTERIOR D NOT 1N I.IRE DEA RING SIDE.VAVAL N, >t,,niMI {,Flp pi ER i0.yl s, lIEQ(IIREMENTS FAILURE TO MEET'THESE R1IUUIREMENTN MAY RE5UUt.:C;N Z PIERS ARE N11T IIR SUPPORTD IN'rEr LOAD LEAKING SERIOUS INJURY,OR DF ATI I TO AN INEXPERIENCED INSTALLER.PLEASE READ' END WALLS)"P!EIt IM1i' FDOil PJAPIr't A. EI. ,_,-,,,,,_,,, . AND UNISI;E STAND TI'IE,'.SET UP AND It4STALLATION MANUALS SUPPLIED WTI I PAGE FL€l'1. ['pa(MAY ONLY RE USED ON DOORS LESS THAN 4SIIWIi E) b. '- THIS HOME BEFORE ATTEMPTING INSI'ALLA'lION OF ANY MANUFACTURED HOME. S E LCICHINI IS ALSO RE01.1IRLTS AT BOTH SIDES Or OPENINGS 48"OR LARGER'IN LOAD BEARING ._..—__ FRAMESUPPORT SIDEWALLS OR MATE WALLS L --� POINT LOAD SiiPP€3RT' • 5 E'-3" 1 WATER INLET 41. - g2' EXTERIOR POOR LOCATION 2 :'.=. •.,; I-BEAM , , , , • I , , , -4'T_.10:E;';Ii:f---:i , , _ ... I - I-�I .. ; ... ! ..._. ._._..._. ...-._7...1 . 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'H M El 0 N, 1 as I-a nn 1 PIER FOUNDATION PLA _ F-10 ....................._ M F♦UTACTUREU 9LAl1T1 PUEiY` I :.ttt411",01440 tt.,lr ae.t,n w ^4' 'M H1.IM)ftiU M(47PDJIIAi 5 %I r.a ni.r...,»<,u,na,Ts.'>,Pr:!<«, t fl _ _.._.. ire_ .,,,, "N'AbgG{Or `t'r3El:.De tIdt`111:f-P27i5iV17 ENotaMER 4-5.17-MA I ION VILLAGE-LOT 1 rJ4•3•13-17•Frnrn.Tepe1,.ltvg:'E,114!2D17 12:13A7 PM,©4V,G To PDF.pc3 • /166 .. 1(Qt ERMIT LI=AN i HAVE PERSONALLY MEASURED THE DISTANCE I FROM THE PROPERTY LINES TO THE PROPOSED STRUCTURE(S)OR SIGN(S) ,.o ° ` i J 211(4 SIG 4ATt E DATE 1 . () 1 c i \ 7 1a i 1 1 ; . a i � AUG 14 20$ _ �__ �____`_ry_ _-__ TOWN OF SS BUlLDtNGQUEEN& URY ss libq 1LrLrccst b T DI STALL J) t , ST88 L,'�;8 0- ET Ne i[f 18. !i 1 DE WIS r Rtiat 87 elF 83i, �i�'' ' { `, , OTC�08.3 Ui E tenF E i-J`,H g&E T I: �` , Ts `F� ROP ? O `Tl`E DEP,1LMENT O STATE I M"I'.1871.8)S8 1 RELOCATED v "-G"8OTLF U FJD CODE) 1 I f A. Manufacturer's name:e: 1. k oc),04100.7si-rset B® HUD label number: ' t -,y Hi_ Serial number: - D ae Retailer's address: kk ;-N - ,4- , - ^ % "" C. Re- ler's icertific tito : t"..- 3 ' " Telephone`"o e g{ '-1-7 J �V :. ..A , � sIlerPss � t i � a S H. Installer's Certification#o Telephone n�® i 44 o b q Municipality issuingbuilding permitC: k — I ` 1 Scit Ow Village} I i I. Customer name and physic address ( s I)wherehome is ccstdlled: \'�q 1 v, " t 4 �" �. .as+ � ,NeWYO If BY attaching this SEAL to this manufactured home,the rndersigceed Installer of this manufactured home warrants as follows: 1. That the installation of this manufactured wed home meets the str rcierds of the New York State Uniform Fire Prevention and Building f Code. 2. Mat at the Installer is certified as a n installer by the New York State Department of State. The foregoing warranties are in addition to and not in derogation of ether rights and privileges which the consumer may have under any I other Law or instrument The foregoing warranties are en adonthon to,and not en limitation of or substitution for,any need all other warmer ties,express or implied,given or made by t ie in saltier, theth pr eortiactually or by operation of law. b I` �I i LLu ted Name ofPersonSi Seal: t l Signature of installer or s ‘t i 1--- .. ' :;held tot era_ 4_ �,. — - 1- Rf you have a Laschiem with your home,you should first contact your installer or retailer.if the problem is not resolved hy the installeror Retailer you can c®catact the iloepartrie,nt of State at(515)474 4073, 005-51C00(Rev.03102) 10eCCCSn©04,31 DQW2WrarotOL'In C-EvEsc©o0y R0t02c0 2 fr WM1QG�©cffci0 o , 1