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2003-825 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20030825 - Application Number: A20030825 Tax Map No: 523400-308-014-0001-052-000-0000 Permission is hereby granted to: PATRTNA C;T,ARK: For property located at: 183 PITCHER Rd m 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: ARC4BFND, L.L.C. PROPERTY TAX DEPARTMENT Mobile Home In Park $13 00 0 Total Value $13,000.00 PO BOX 13244 EL PASO, TX 79913-3244 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2003-825 PATRICIA CLARK 8 BRIWOOD CIRCLE 1994 MOBILE HOME (1064 SQ FT) AS PER PLOT PLAN SPECIFICATIONS $38.84 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 14,2004 (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 thk o of Qu asb ry; esday,October 14, 2003 SIGNED BY for the Town of Queensbury. ry. Director of Building&Code Enforcement H Application for Permit-- Mobile Home Torn of Queeznbwy, 742 Bay Road Oueensbury, NY 12804 (518) 761-82.56 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 Office Use Name: �E`�1 f CI Ct� Clax '� _ File Permit No. 0 's rAddress: y -- },e i j Tond Q, y'( Fee Paid 0 S Gansef u ce KIV I r� J� Reviewed B � � �t.1 Y. 9 ,1 Phone No. 'g Q 8 - Parcel Information Property Owner Information *(Zec- ' Proposed Date of Placement: t9-9 p Name: ekeff GP4D t-.L,C . i�b ( '"w : ►�e) NC,, — C��i4N�" ST. 5u tTE qb0 Property Location.: � P)f,l wad Urcic Address: t o UO Road;Stet,Avenue '-j>EMUCP- C C) S( :2 8 Name of Mobile Home Park: lroge6T PAW M HC..- (if applicable) �r Phone No. &o l Tax Map Number: WS.I+ /-( - / Mobile Home Information ! �� Zoning Information Approximate`Value of Home: iJ k- Zoning CIassification: New Home: Yes No �L� 6- Size of Property: 54- ft.by 3 ft. Replacement Home: (X-ed No y Existing buildings: SfC OtLnc I7"?t✓'�* Size of Mobile Home: 14 ft. by �O ft. Setbacks: franc yard $; rear yard ft. • Singlewide: Doublewide: Side yards 5 rl fL and bO ft. ,Number—)R. fns;,{exclude baths) (1Niamber`af'Bedrooms: Accessory Building(s): circle �Nurriberof Bathroam�s: �_ v Detached garage: 1 car; 2 car, , car circle: Gras Fireplace/Woodstove/Wood Fireplace Attached garage: . I car, 2 car, car Storage building: Yes No Foundation Support: Other: S�&DEPTH Water Supply. well or unicipal Runners x Is Septic Permit Required? Yes or No Slab s Further information requested on the reverse side o,f this sheet � Name of Installer or Mobile Home Dealer: Address: (P VcLn C u n Phone No. `1�C — 5'115� Complete information below found on a"plate"or"stickez"which is affixed to the mobile home. 1. Insignia serial number j 2. Nam%_bfiiianuf6tibret 3. r._Plan..Approval Number 4. �-1Vlodel or Component].Designation: f'l. (New Howie 01YL1'�___ .. 5. Date ofManiifacture: + � AFFIDAVIT s 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 such work is authorized by the owner. Sigtlature: owner,own cos s a ent,architect, tractor Special Conditions of Pennit By: Form: 1111911999sh Code Enforcement Officer ' ��FiEN1 L_ •N�3.PECT�ON Fim5m -- T - 1%ACMl MlL..E / N. tc=CM JL Aft&R-- Tc► n-' of Queensb►ury = Building SL t :cwdo RnfOrcoarricmt 742 _Say Ftoarci ` Queensbury, NY 12844 (Sy 8) -76 1-82S+6 ARRIVE: ��C717EPART: - ���INS : _ - DATE INS E �C�N'` :EQUEST ,E7_C��l�T ' DATE: PERMIT ## "�G7 FOOrI'INGS F©UNI3ATIQI�T BAGLL FRAZ4�I3�EG - NIA YES NCB 1_ fcaundation support, pit--r spaci"g perrriinuf. :_- --- ---_-_----- 2. anchoring per rx ailLxlf- ..... .......... 3_ water l.irie shut off ' ......... .......... 4_ sewer lime support @ 4 feet ------- CS -------------- ---- - 7_ skirting ventilated- - .----------- -------- 8_ h©t water relief valy - - outside 10_ 11_ garage fire prcx>fcng ____________ _____ 12_ door cic+sers _ =-------- ----------- - -- 13. plumibino fixture -_.-_- . - - -------- -- -- 14. fou.ndatiora insWaticsn (if apppl.)..... . 15_ s3moke detectors ----- --------- --- ------ 16_ final electrical ------ ---- -------------- 17- variance required - -------------------- 18_ data plate okay ---- - ------------------ 19_ mobile HUD seal c�kaY --------_----- r Model # - Serial # Manufacturer - . Bate cxf Marnxzfacturer CAY TO ISSUE .C/C? Comments• - - ` ��N.�.L ii�i��►ll��T�®N f�Ell��li�'Y". Town of clu nslaury wilding e& Code Enforcern4ant 742 Bay Flc ad Clueensbury, NY -12804 IaA'TL 'INSPLCTI+C?N n]EQI_T]ES-r NAME: LOCATI©N: PERMIT ## _ I=C�K7�f'INGS - FC3LTNZ�.A'i'iC�N BAt=KFILL Frt s+.AfiING N!A_ YES NQ �1_ f©uridation suppc3rt, pier spacing j per -rrummiaf_ ---- - ------------ / 2. ancheari.rig per aiianuf- --------------- / 3. wate ne u r li sl� t,c>ff ------ ------------- - ' 4. sewer line support +K ► 4 feet ....... �✓'" Grosso ff grd_ _ vented [7i3tside _ sue. _ - - 7_ skirting vex -- ---- ------------- S_ h©t water relief valve pip!,Ra outside ,10_ furnacellir�t water olrserating ._... 1 1_ ,garage fare presofr.r s .................. 12. cicx.>r clearers ........ . .................. . 13- lurYibina fixture _.. 4- fciuradation insii 1 S_ srn6Re detectors ----.--- ----- _ _ z�-- 16_ electrical; _ j�� 17. variance regzurr.ei ------------------ 18. data plate okay ........... . ........... 19. mobile llur)3 seal okay .............. Mendel # IlA Manufactau-er �L ��i5 7�� OL Date of A/Ianufacturer �� - <Dow AY TCJ I,S^UF- C/C7► YI.iS ` Nth► ' Corn�ents: �►=� ► ' - ('��i W RU[! 1.IJCC.��c % �`. � .',,. `°'�'�;' �`• {����� �: �MrIMN!- �` Mw� r �+"- rw .�rr�r �,..�� � a. .....-ice. �.�.•-�..w..�w� 41 ll , ��r�- tjir'E;,�l.'.g4 r, r:�sJ"l.'•'J ! ;, 1 agloom m u% II IN I looloomilimill I REMENE I MEN m NEOCENE NIEMEN I oil it IN MENNEN MENOMONIE 11 MEMNON logo go IN IIIIIIII Nil I I IN MINIM mom 0 1 111111 Ell No Nil loommelm Nil I 1 9 11 MINI moll MIN --*" I'l 1111 NINON MENOMONIE I I MINION NINON MINION WOMEN mm -' ' 0 -1 , ' ' own NINE loolimmomm No IN mommomp OMNI MENNEN I I MEMNON mimmi MINI II MINION MENNEN go OMNI go II NINONgo ONION OCT-10-2003 11 :04 AM ForestParkMHC 5187450808 P. 01 I L1S� s� 1! q `7 F(e woo aokn CA 8 Sri l C� 4 va o3 C> r ,�.,