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2004-805 TOWN OF .QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development -Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20040805 Date Issued: Monday, November 08, 2004 This is to certify that work requested to be done as shown by Permit Number P20040805 has been completed. Tax Map Number: 523400-308-014-0001-052-000-0000 Location: 27 BRIWODD C11WLB Owner: ARC COMMUNITIES 14, LLC Applicant: ROSEMARIE COLE This structure may be occupied as a: By Order of Town Board Mobile Home In Park TOWN OF QUEENSBURY Director of Building&Code Enforcement ' A TOWN OF QUEENSBURY F, 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040805 Application Number. A20040805 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: ROSEMARTE COLS 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 900 Mobile Home In Park $18,000.00 Total Value $18,000.00 PO BOX 790830 SAN ANTONIO,TX 78279-0000 Contractor or Builder's Name/Address Electrical Inspection Agency Plans &Specifications 2004-805 ROSEMARIE COLE 27 BRIWOOD CIRCLE 924 SQ FT MOBILE HOME (2004) $60.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, October 25,2005 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of ee ury; and � Vct ber 25,2004 6 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit— Mobile Home Town of Queensbury, 742 Bay Road, Queensbury, NY 12804 (518) 761-8256 A building permit must be obtained before placement of mobile home on parcel. No inspech wiiilll be made until a valid building permit has been issued. Applicant In Office Use 0CT 08 Name: 0.5 e. _ File Permit No. ®� � �N DF �O04 QU Address: _l�� I p� Fee Paid , (Dl���� �(IR} - DE Reviewed By: . Phone No. q 26;L— I� Property Owner Information Parcel Information rb / 'In Proposed Date of Placement: Name:• L ar-A u o C' MTM) Property Location:9 1 Bri Road,Street,Avenue r r Address: ame of Mobile Home Park: bS Phone No_ Tax Map Number: Mobile.home Information :Zoning.Ircformation: :: Approximate Value of Home:'$ ' Zoning CIassification: ---1A New Home: es No (�a c{S f Size of Property: ��ft.by_O$. Replacement Home: Yes No l�/ Existing buildings: Size of Mobile Home: ft. by ft. Setbacks: front yard ft_; rear yard�ft. Singlewide: Doublewide: Side yards and ft. Number of Rooms: (excI d baths) ' Number of Bedrooms: Accessory Building(s): circle Number of Bathrooms: Detached garage: 1 car, 2 car, car circle: Gas Fireplace/Woodstove/Wood Fireplace Attached garage: 1 car; 2 car, car Storage building: Yes No Foundation Support: Other: TYPE SIZE&DEPTH Water Supply: well or municipal Piers x Runners x Is Septic Permit Required? Yes or No Slab x Further information requested on the reverse side of this sheet Name of Installer or Mobile Home Dealer. 7q6,u 4,- Address: Ba J12620 Phone No. Complete information below found on a"plate"or"sticker"which,is affixed to the mobile home. 1. Insignia serial number. 2. Name of manufacturer. F7) 3. Plan Approval Number: 4.' Model or Component Designation: (New Home ONLY) 5. Date of Manufacture: - ... . .--- AFFID-AVIT_. . Town of -- nsbury __.._. ::..—StatebfNcv=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 BUELDING 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. Signature: own ,owner's agent,architect,contractor Special Conditions of Permit Form: 11/1911999sh Code Enforcement Officer FINAL INSPECTION REPORT MOBILE / IMOOLILAR Town of Queensbury Building &Code Enforcement 742 Bay Road Queensbury, NY 12804. (518) 761-82,56 ARRIVE: .DEPART: JSINSP: 4 DATE INSPECTION REQUEST RECEIVED.-- NAME: rC92G"'dl� t,4'(ti Lc LOCATION: Jd DATE: t t PERMIT N MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKF•ILL FRAMING N/A . YES NO 1. foundation support, pier spacing per manuf. ........................ 2. anchoring per manuf. ............... 3. water line shut,off ................... . — _ — 4. sewer line support 04 feet ....... — 5. heating crossover (dblewide) off grd. — 6 dryer vented outside ...................... . 7.• skirting ventilated .................... —_ 8: hot water relief valve_piping outside _ _ — 9. deck, porches, steps,'railing ........ — R1 f imace/hot water operating ........ 1 . garage fire proofing .................. 12. door closers ........................... — — — 13. plumbing fixture ...................... —_ 1` foundation insulation (if appl.)...... — .— smoke detectors..........:::. 16. final electrical — — 17. variance required ............:........ — — — 18.,data plate okay ....................... — 19. mobile HUD seal okay .............. Model # Serial# Manufacturer Date of Manufacturer OKAY TO ISSUE C/O 00' YES NO :..Comments: V(00 �?� FINAL INSPECTION REPORT MOBILE / MOOULAR Town of Queensbury Building &Code.Enforcement-. 742 Bay Road Queensbury, NY 12804 (518) 761-8256 ARRIVE: DEPART:' `. INS DATE INSPECTION REQUEST RECEIVED: NAME: LOCATION: DATE: PERMIT# C 0 MOBILE HOME MODULAR HOME FOOTINGS FOUNDATION BACKFML FRAMING N/A . YES- ,NO 1. foundation support, pier spacing per manuf. ........... _ V _ 2. anchoring per manuf. ............... — — 3. water line shut off .................... _ 4. sewer line support a 4 feet ....... _✓ _ 5. heating crossover (dblewide) off grd. 6.:dryer vented outside .................. — . = i 7.- skirting ventilated .................... _ 8. hot water relief valve piping outside — 9. deck, porches, steps, railing ......:. — 10. furnace/hot water operating .... _ 11. garage fire proofing ......:........... — — — 12. door closers ........................... — — 13. plumbing fixture ...................... — 14, foundation insulation,(if appl.)...... 15. smoke detectors �� _ 16. final electrical - 17. variance required ..................... 18.,data plate okay ........, ............. — . — 19. mobile HUD seal okay .............. mow:4No PAA 1 Model # � Serial#FA Manufacturer �C k&'S Date of Manufacturer kdo 1641 OKAY TO ISSUE C/O. YES NO P1XY&e KkU5T Jc-Al—I 1 d DFZ-- t/-Ai�2 CommentsQ �0T'(1JATb12 /Vow f.Vo2141^3& 3 3�TIk P-j► . y�oKC DC--( 4lor l�vT�r2Ca,�/.�/E-cT�J7 cAi.L/ OZ 8 01 00• t. (7 t t TOW i BU FY 2"'J!L TA NG Dcl? i NicNT 0 CFLS limited examination, R C��sYt ?ess YdUi our comments shall x=. not c om_rue;d as indicating the plv nd spsc;fcations are in full er coi. ;,,;ance with the Building Codes 1 of.h .,� York State. p _ REVIrL -D BY _ - ' OAT rd i s . ; lk . i »\ c i t , l G OCT-30-2002 11 :04 AM ForestParkMHC 5187450808 P. 01 F7 2� N 4 IPF DV R9 L9 -Eg gg L -9z JZ cul r ' VI Oct 82p� I 1�? r, 'L !. 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