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2014-083 TOWN OF QUEENSBURY Fors742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20140083 Date Issued: Wednesday, December 10, 2014 This is to certify that work requested to be done as shown by Permit Number P20140083 has been completed. Tax Map Number: 523400-309-009-0002-001-000-0000 Location: 200 LUZERNE Rd Owner: HOMESTEAD VILLAGE L P Applicant: HOMESTEAD VILLAGE L P This structure may be occupied as a: Demolition By Order of Town Board {( B (.3( Ads 01 TOWN OF QUEENSBURY Issuance of this Certificate of Compliance DOES NOT relieve the T2anI2 property owner of the responsibility for compliance with Site Plan, Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement Planning Board or Zoning Board of Appeals. TOWN OF QUEENSBURY FON 742 Bay Road,Queensbury,NIL 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20140083 Application Number: A20140083 Tax Map No: 523400-309-009-0002-001-000-0000 Permission is hereby granted to: HOMESTEAD VILLAGE L P For property located at: 200 LUZERNE 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: HOMESTEAD VILLAGE L P 4294 ROUTE 5 Demolition CALEDONIA,NY 14423 Total Value Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2014-083 45 Windsong Drive DEMO mobile home $30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,April 14,2015 (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 Que sbury AMo: . :y iA.ril 14,2014 sV/ SIGNED BY % for the Town of Queensbury. Director of Building&Code Enforcement Town of Queensbury Building & Codes office use Only 1 2014 U DEMOLITION PERMIT APPLICATION Received: 'f.'":? NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit No.: I I -0 $ • Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot boundaries with dimensions and adjacent roads I streets. Show all existing structures Permit Fee: on the property and indicate which are to be demolished. Indicate on the plot plan the location of all utilities. � Date r-/- �� • Demolition Location 'S /4)i 50/1 .tic. ['t,stay Tax Map ID 307 9 -7 "/ Applicant 523 if or'r IYcn Gam.. Owner 15 tf ; Address leer OaAAafi`erwel(kelt fht71 Address °TOO Lu2,-V-Ytt tact. 1R%Ly zscitf ©slay /t) Y I ZiffeCi Phone (seri-") 3 e3 • est f t Phone S$5"-3n 3 —S d f Contact Person for Building&Code Compliance: -- cf oer i LAt.Afe r\c_e- Day Phone:G ) 303-5-211 1. Person Responsible for work: .aced" Ljtt-a•WP-vt, 2. Where will demolition material be disposed? t o t\tJ)5 3. Asbestos Informatsr,: T`c Acbtstcs Removal Report must be filed with our office before demolition begins. a) Is there any asbestos within the building to be demolished _Yes -No b) If Yes,our office need the following information: • Name of firm removing the asbestos: • License number of firm: • Indicate where the asbestos material will be disposed: 4. Structure Information a) Indicate the structure(s)to be demolished:_residence _garage _business A storage bldg. _Other b) Size of structure: /9 x G6 c) Number of stories: / d) Foundation Type: =fullcellar =aawlspace =slab e) Foundation: will be replaced - will not be replaced f) Structure(s): will be replaced will not be replaced 5. Utilities Information a) Indicate utilities for this structure: Gas Yr Electric Propane X Public Water On-Site Well Water Pump _Public Sewer b) Have you notified the Town Water Dept forupublic water and sewer disconnect? "Yes _No c) Have all utilities been disconnected? ✓Yes _No 6. Signatures: Print Name: ' b e Signature: to Date: al- /-� c. . _. . . i • • ��y .��lj `(. `- % /�'^��' �1 ta �'•.1 •UJB l_yI 3JEEFH ll ' • • - L. ,� ` e . a It , 1$ ,. . r ,,eim tal ... . 0 Ira - ot 0 ' Ira 00' ."W CI] C . It-i. 3r� , Il? 9 ; ; !;g �„�. Moir,rj ' 1 ""�s rf P� v , , w p 0 q, :vi Ant ....r4, .h., , z , ... , ,L., 1 : •:11_ ' t-1 k.( Lrr,r�p r � 1 rn lrPy' b ,CEJ„ :, , tIT4 , r ' in mia ' ,&-I ril .4 , ort.tti t-f r ,moi . .v� d�1 .. ofl J : f .a 1.1� ,ti r -- .•'._ _.._ ,�._. .. E , ' Art.t - I t4.:. ' AST 04.1;tie • _ . .. 0 IDS' . 1111:1 ;°J..1 � i ,... Mfiiiill •3- /� . -I., • n 1 i, 1Ilik n of Queensbury Building & Code Enforcement Office No. (518)761-8256 Demolition Inspection Report Inspection request received: Name: `4 Inspected on: --at. Location: 415 k)& q Arrive: a.m.l p.m. Permit No.: I H- 0 g S a Inspector's Initialer Comments and/or diagram Y N N/A Gas Shut-off Water Shut-off Electric Disconnected Asbestos Removed/Documentation Property Cleaned Up and Graded N-- e_t; d\\-•` ���� Okay to Issue Certificate of Compliance DD Lj C\--C-- , Demolition Inspection_11 20 12 Demolition Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building &Code Enforcement Arrive: am/ De art: a /pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: }1'h-ixPERMIT NO.: tJ 83 LOCATION: C/:S' LJ in.A.Ltran INSPECT ON: Comments and/or diagram Y N N/A Gas Shut-off I Water Shut-off Electric Disconnected Asbestos Removed/ Documentation Property Cleaned Up and Graded Okay to Issue Certificate of Compliance eacmtc-2-c,t( - . , 5 --IDpe5L-2-- 4 ft.. ., cca d- 142L1— 9-Cr-L- CZ- I S. aei I ( Demolition Inspection Report 11 27 12 1 • &mi . , wit, . Rot Karl �.cfolf L 5-3 Cir --� s� ��c� • bPti11-0g3 es 15hoe Cci, D 4 to �'�fi'T V "sre,__, I(� t Ll _ Li_-j � (3. 5� LAC(4 oewep Q I' •, . .. ..:•;,:-.t.: -7.: ,..R..y: Car...ND i. T WN OF QUEENSBORY BIgILDING DEPARTM NT 1 Bated on limited examinat o, compliance re indica8n r'hnents shalt not be -onstrued as • ind 9 m plans and specifi tions are in Buildi Net York a & with the Codes of } . t m N ' 1) o i t - 2 1N D 1 1 e- 1 -421