2004-838 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: P20040838 Date Issued: Friday, November 26, 2004
This is to certify that work requested to be done as shown by Permit Number P20040838
has been completed.
Tax Map Number: 523400-308-014-0001-052-000-0000
Location: 83 BRIWOOD CIRCLE
Owner: ARC COMMUNITIES 14, LLC
Applicant: ELIZABETH KILLMARTIN
This structure may be occupied as a:
By Order of Town Board
Mobile Home In Park TOWN OF QUEENSBURY
Director of Building&Code Enfo ement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040838 Application Number: A20040838
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: RT,TZ,ABF.TH K1T,T,MARTTN
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. Tyke of Construction Value
Owner Address: ARC COMMUNITIES 14, LLC
900 Mobile Home In Park $34,000.00
Total Value $34,000.00
PO BOX 790830
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-838 ELIZABETH KILLMARTIN 83 BRIWOOD CIRCLE
928 SQ FT MOBILE HOME
$30.68 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, November 08, 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 To ueens ry; nay, November 08, 2004
SIGNED BY for the Town of Queensbury.
Director of Building •Code nforcement
Ain for Permit— Mobile Home
Town of Queensbwy, 742 Bay Road, Queensbury, NY 12804 (518) 761-8256:
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.
App`icant Information : >,
Ir
-"r Office Use
Name: "'i< -> File Permit No.
Address: %t'7 rl 1pi-f— Fee Paid
/ C F7 V. D
Reviewed By:
Oct z 0 20 4
Phone No 7%3""/a (,o(se TOWN Or 1,;f--EP,JS3URY
13UILDlit]G'Ai-M CODE
Property Owner Information Parcel Information l (�
Proposed mate of Placement: 3/ . 00 /
Name:
`' Property Location: dS �J
Address: I��� R �`� Road,Sheet,Avenue
n Y 04qame of Mobile Home Park: w, ea.1
_..
(i applicable)
Phone No.
Tax-Map-Number: ..._.._ /
Mobile Home Information.,- —._. -. Zoninglxrformation: -.
Approximate Value of Home:� �
oo-Q -
Zoning Classification:-m.I�. �a•L�
New Home: Yes No
Size of Property: ft.by $.
Replacement Home: Yes No "l
Existing buildings: nc) t%A-
Size of Mobile Home: /10 ft. by S8 $.
Setbacks: front yard &; rear yard ft.
Singlewide: _ Doublewide: Side yards &and
Number of Rooms: (exclude baths) y'
Number of Bedrooms: 91 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 ornNo
Slab x
Further information requested on the reverse side of this sheet W
Name of Installer or Mobile Home DealerC/,�
Address: /,-�;,oZ f
Phone No. / ,�/d'� 7 93
Complete information below found on a"plate"or"sticker"which is affixed to the mobile home.
1. Insignia serial number. 4�
2. Name of manufacturer ..:T-- n,
3. Plan Approval Number:
4. Model or Component Designation: A
(New Home ONZI)
5. Date of Manufacture: d
AFFIDAVIT-
Town of Queensbury. —State of New . .._.. .. .. _.
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 such work is
authorized by the owner.
Sigoature:�/ i�/LC
owner,owner's agent,architect,conbi or
Special Conditions of Permit
Form: 11/19/1999sh Code Enforcement Officer
FINAL INSPECTION DEPORT
MOBILE/ MODULAR
Town of Queensbury '
Building & Code Enforcement 3�
742 Bay Road
Queensbury, NY 12804
(518) 761-8256
gar;
ARRIVE: DEPART: INSP- _
t
DATE INSPECTION REQUEST RECEIVED:
NAME: \ rc\Q r\
LOCATION: > W o C)(-
DATE: _ PERMIT i/
M®ISHLE HOME J MODULAR ME
FOOTINGS FOUNDATION BACKFILL FRAMING
N/A YES NO
1. foundation support, pier spacing
per manuf. ..................... — —
2. anchoring per manuf. ............ .. _
3. water line shut,off .............. .... . V
—_
4. sewer line support ®4 feet ...... —
5. heating crossover (dblewide off grd. — —
6. dryer vented outside ....... ..............
7.- skirting ventilated _ —
8. hot water relief valve pi ing outside
9. deck, pouches, steps, r iling ........
10. f imace/hot water ope ating ........ _
11. garage fire proofing ................ _ —
12. door closers ....... ................ _ —
13. plumbing fixture . .................... ! _
14. foundation insula on (if appl.)...... — —
15. smoke detectors
16. final electrical -
17. variance requi ed ...... ..............
18. data plate o ....................... -
19. mobile seal okay .............. — —
Model # Serial# 'a5 71'%�'
Manufacture A-P
Date of M ufacturer � ,� U
OKAY TO ISSUE C/O YES NO
Comments:
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REVIEWED BYIn.
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Y ��..�FILE P `,,P,T E OCi � 0 2004
TON OI= QiJFEf�SBURY i
W �� BUILDING AjI'D CODE �
To��i��: . �s tr;:�li c �'RTMENT
C-.f, ,,t, :f :{ents shall
r,n ,,nd.cating the
are In full
CIO
c� with ti`el Building Codes
1
TWIDE FLOORPLANS
MODEL 19-176
2 BEDROOM,1 BATH -------- ® --
NOMINAL SIZE 16'X 54'ACTUAL SIZE: 15 2'x 34-0' CH EN
TOTAL AREA:759 SQ.FT. `� a�'Qd
MASTER LIVING ROOM A
I BEDROOM " BED#2 10'�X 14•T DININGCu
�a-o•x�r-�r a-s•xa 0�
EC V7r
OCT 0 2004
TOWN p;=C?
CUtLDI 'LEidSPURY
i�C;,e�r',,;D CODE
i
16x58
TITAN
pier and tie down placement
r
plywood pads (pressure treated) placed on plastic barrier
piers every 8 feet using 8"xl6" blocks
tie down zone 1 every 11'6"
vinyal skirting w/vents
steps with landing ' "�� E-HD
OCT Z 0 2004
TOV,$1 OF OUEENSBURY
12LDING'P'ND CODS
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