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2003-705 TOWN OF QUEENSBURY 742 Bay Road,Quemsbury,NY 12804.5902 (518)761-8201 Community Development,-Building&Codes (518)761-8256 CEIRIL IFICATE OF OCCUPANCY Permit Number: P20030705 Date Issued: Monday, NOW 06,2003 This is to certify that work requested to be done as shown by Permit Number P20030705 has been completed, Tax Map Number: 523400.308-0141-0001.052-000-0000 Location: 1 TIMBER LANE Owner: ARC4BD,L.L.C. Applicant: JEFFREY ELLIS This structure may be occupied as a: By Ordet of Tows Board Mobile Home In Park TOWN OF QUEENSBURY Director oWudQ&Code rce t TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDMG PERMIT Permit Number: P20030705 Application Number: A20030705 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: IFFFREYFTJJS 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 BuildIing Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: ARC4BFND,L.L.C. MobileH' ome In Park $18,500.00 PO BOX 13244 PROPERTY TAX DEPARTMENT Total Value $18,500.00 EL PASO, TX 79913-3244 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2003-705 JEFFREYELLIS 8TIM[BERLANE 1064 SQ FT MOBILE HOME AS PER PLOT PLAN SPECIFICATIONS $38.84 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 10,2004 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queenshury before the expiration date.) Dated at the T4% _uesday, September 10,.2003 SIGNET}BY for the Town of Queensbury. 'V- Director"of Building&Code Enforcement G Application for Permit-- Mobile Home Town of Queensbury, 742 Bay Road Queensbwy, NY 12804 (518) 761 A building permit must be obtained before placement of mobile home on parcel. No inspectid l,be �le until a valid.building permit has been issued. �DWN -r nn. nv F i iOF na Applicant Information :�\ Office 11 ��d �"�f���Ct�� j Name: File Pe M11, No. 03 705 ^Y Address: z Fee Paid :DO- F E ctL.0al1 f Reviewed By: Phone '�` t rope "termer'Information Parcel Information 1�) ace—T T:ro0 seaAate ff Placemeirt: iP Name: R Off a Fnll> t-.L— _ , Property Location: 8 —Fi rnbp r �- Address: tGQO aRANT' ST. 5tA LTA qd�j Road,Street,Avenue Name of Mobile,Home Park; MpgE:6-r 7NW M kC (if applicable) Phone No. 800 c;� 5 —416 Tax Map Number: Ui Mobile:Home Information Zoninglnformation tppro..,d n to Value ofHo`Y3ie-$',/Ws2o Zoning Classification: 69-" New Horne: Yes No o�p f Size o£Property: (D 5-- -ft.by 1`;5-1 ft. Replacement Home: (. :- ' No �I C 6u t rsnF -t:.cv-)1+ t � I Existing buildings: O-WkQ�me-M Size of Mobile Home: . 1 `tom ft. by 0 ft. Setbacks: front yard fL; rear yard A A ft. Singlewide: Doublewide: t `�/ Side yards � fL and ft. NEr-ibez of Rooms-(exclude baths) (l'Iumber.of-B.edroonis ,.� Accessory Building(s): circle ��tumber_of Ba�irogins:_� - Detached garage: 1 car, 2 car, car circle: Gas Fireplace t Woodstove 1 Wood Fireplace Attached garage: I car-, 2 car, car Storage building: Yes No Foundation Support: Other: E S� Water Supply well or unicipal ers x Slab x is Septic Permit Required? . Yes or No Further information requested on the reverse side of this sheet (Name of Iiistalle or Mobile Home Dealer: -Y ` v�C2 led r P- o e JN Complete information below found on a"plate"or"sticker"which is affixed to the mobile home. 1. Insignia§�e�riif ddi6en] 1 V - 31 q 2- Name of HiaffufWfffe— r- 6 Ti7 6 Lo PO 13oX 1`3tf� 3. Plan Approval Number: 4. Model or Component Designation: (New Home OAET) 5.- Date 6fMin--qfdC--tUr-d*3 3 AFFIDAVIT Town of Queenftry State of New York County of Warren z z I swear that to the best of my knowledge and belief the statements z contained in this application together with the plans and specifications submitted, ale 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. Signature: JLM(Qu an� owner,owno's a6ent,architect, tftactor .......... ............... Special Conditions of Permit By: Form: 11119/1999sh Code Enforcement Officer Flrnv.osl�.. ��s��crllor.lr s=t,C7r "Ir nAvM#t_M .�- 1Mlcrlcsv, -AAILFM Town of C)ueensbury 8uilciing & C�odo Enforcemant 742 B 3y Il c>cacf C)uecnsbury, IVY 12804 (51 8) 76-1-8256 ARRIVE: DEPART INSP: .- DATE INSPECTION REQi_.7E.ST RECEIVE. -'� � Q� NAME: I3A'I'E: '� PERMIT # 14�fa►SIZ.E H+[�ME Mtl17EJL.AR H47►ME F'C7C7I'INGS F€7LJNrSATZC�N BACKFII z - FRAMING N/A YES Ii7+iC� 1_ foundation support, pier spacing Permanluf- ------------------------ 2- anchoring per mmrluf- --------------- 3_ water lixie shut off ---- --------------- 4. sewer line siupport CW 4 feet ..-_.. . s_ heating crossover (dblewde) off grd- 6_ dryer vented outside . .�------------------- 7. skirtirzg ventilated -------- ---- -------- S. hot water relief valve piping outside 9. deck, porches, steps, railing ----- -- - 10. fiirnacelhot water operating ........ 11- garage fire prc3<Ai"a - ---- - -- -- --- ----- 12. door closers --- -------------------- - --- 13. pluYnbing fixture - - -- - --- -- ------- - ---- 14. foundation insulation (if appl-)----- - Is. smoke detectors -------------- --------- 16. final electrical ------ ---- -- - ----------- 1.7. variance reclu.ired ------------------ --- 18. data plate okay ---------- -- -- - - ---- --- 19. mobile HiJD se-"' okay ______________ Model # Serial # Mariufacturer IOate of Mamufacturer COKAY TC! ISSUE CICO YES NCO �_omments _ ff%^CMiMI'.M ! S%ACMi=L.JL-AAkfM Yl rOWn of C luatansbury Building +&. GCx:fa i=nforcament ----y 742 Ray FRosd Queensbury, NY rt 28+C?4 (518) 761-8255 ARRIVE: DEPART: y «� 4 I�A'TE INSPECTION R.EQLIE.ST RECEIv DATE: c> PERMIT # -;S- R��Bi�B.E �-,it'I'►A�[� �t7►�lLT3.J�.R Hf►?1►�E v >cyrINGs00, Fc7L32vL7AT'YC►N BA KF'Tr-T F RA rfEINC,7 N/A YES fJ - 1. foundation support, pier spacing per runs uf- ------- --------------- - 2. ariclioi-ing per rraan►uf- --------------- 3. water 1 shut off --_-- - �4- isc-:wer liru-- suprport ...... --4 fee . ...... r e g cr ver (dbli�wide) Gaff grd_ 6. dryer vented outsides -7. - skirting_vontila.tea 43�-_�_ S. lic►t water relief valve piping outside 9. deck, pc>f-ches, steps, railing -------- 10. fuY c elhot watcrr operating ------.- .11. garage fire proc>fin.g ......... ... . ..... 12. door closers -------- - ---------- -------- _-- 13- plumbing fixture ---------------------- 14, foundation insul aticm of a.ppl:)------ 15: srrzoke detectors ...................... . _ - 16. firml electrical ------------------- ----- , :L 7'. variarice required --------------------- 18. data plate c>"y ........... ............ 19. mobile H-EJI3 seal okay .............. Mcidel # - Serial. # Manufacturer -_ Date of Manufacturer - OKAY TCJ ISSUE C/© YES NO T 5 FirijAL 1rVORECIrlam I Ep C3647 MC301L E mC30UL.A►M _ Town of Queensbury' ' a Building:-& Code _enforcement - .742 Bay Road - Queensbury, NY .12804 (518) 761-825+6 ARR DEPART; .- 1 S , DATE INSPECTION REQUEST RECEIV NAME: LOCATION: 41'T' it MOBILE HOME MODULAR HOME FOOTTN+GS FOUNDATION - BACEIZI L FRAMING ' - N/A YES Nth . 1. foundatioxi support, ,pier spacing ' permanuf. . ............:.........w. 2. anchoring per manuf. - 3. water line shut,off ....:.....:......... . 4. sewer line support 0 4 feel ........ 5. heating crossover (dblew ide) off grd. 6.- dryer vented outside ..: w.:.........:..... . + ■ i . .skirting ling ventilated •..i..i i...w w w....i w. j .� 1 8. hotL water relief valve piping outside 9. deck, porches, steps, railing ....:... 114. furnace/hot water operating ........ . i garage ;ire lf /yprof'n Y` .....,........... rV !i...........w!!.i......i.• ' a -... ry e a • �1 t RY Tot BU LDI G REV EWE 0Y DAT � � � JG�EP�RT��EN our wrnmenis shell, got Ise wosojod as mdicallog the .nd 5pocllipllons are in full Jj4p wllh the Building Cods �J Of Now YO$lk GV N OMB LOS r �' 0 p jl ". l .. 60 Lo, 1 J t,5 c ,. z !' 9 �rru'3F 44 f 1 ccz), / 1 � �t 1 3 19 11 3 a1 1 ^J r A 0)N A QI r a a � , n l 1s J St N37 Olt 1 1 S �0 f Affordable Residential Communities.' c FOREST PARK WC 183 PITCHER ROAD QUEENSBURY NY 12804 6 �6 E6 PI CHEF R040 . . � _ �3 ... ___. �� _. _ . 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