2013-153 It TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130153 Date Issued: Tuesday, July 08, 2014
This is to certify that work requested to be done as shown by Permit Number P20130153
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
181 Adirondack St. TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, 1�
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.
0.4 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130153 Application Number: A20130153
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 Demolition
4294 ROUTE 5 Total Value
CALEDONIA,NY 14423
Contractor or Builder's Name/Address Electrical Inspection Agency
ROBERT LAWRENCE
585-303-5211
PO BOX 4070
184 ADIRONDACK St
OUEENSBURY NY 12804-0000
Plans&Specifications
2013 181 Adirondack St.
DEMOLITION
$30.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, April 22, 2014
(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 sbu M'.t i a/ A122,2013
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TAX MAP NZ 06i,9 �-'1 OFFICE NOSE 0NLY1,3,1 52 —FEE PAIf 3O
Permission is he .y g -nted t;/e aim ; - ed Applicant to demolish the building(s)
described her: as s-t forth th- A•pi .n elow. APR 1 =1 2013
ire•or of Building&C•des � e
APPLICATION FOR DEMOLITION PERMIT:
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
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. `` I 11 1
APPLICANT/BUILDER: Robev—ll LA�t-e-v1Ci._ OWNER: I-kory es-kAA
ADDRESS: ) c (-{ ;rnncL <. - ADDRESS: L{,3(-. 5+ 24 S c A qn (}` N y
PHONE NOS. .ES-- 303 - 5021k r PHONE: 55s--- .27L - /S v e/ j� ,3/`/
PERSON RESPONSIBLE FOR WORK: (2obev'( PHONE: ,� �.�C.7j -6 _//
LOCATION OF DEMOLITION: 447a 8 ( rC.CIA(ac k 54. 14Oncle 5te.'a -\
J
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? --a..)01\--a..)01\ S-te.A
ASBESTOS INFORMATION:
• Is there any asbestos within the building to be demolished? YES NO X
✓ If YES, our office needs the following information:
o Name of firm removing the asbestos:
o License number of firm:
o Indicate where the asbestos material will be disposed:
NOTE: A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s) will be demolished: RESIDENCE X GARAGE BUSINESS_
STORAGE BLDG. X OTHER
✓ Size of structure: / 1/ X 70
✓ Number of stories: /
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED •
✓ Structures(s): WILL BE REPLACED )( WILL NOT BE REPLACED
UTILITIES INFORMATION:
0. I
✓ Indicate utilities for this structure: GAS X ELECTRIC x PROPANE
PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES_NO X
Have all utilities been disconnected: YES 2< NO,
QUESTIONS? CALL 7614256 OR EMAIL
codosequeensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburv.not
SIGN , TURE OF APPLICANT
Town of Queensbury• Community Development Office . 742 Bay Road, Queensbury, NY 12804
O"(\fIii e
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pmDepart: 7:2S—am/pm
742 Bay Rd., Queensbury, NY 12804 Inspectors Initials: -
NAME: 8S-S~J-erv.� PERMIT NO.: �, 3
LOCATION: INSPECT ON:
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
dr
Okay to Issue Certificate of Compliance
_tel v
Demolition Inspection Report 11 27 12
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/p Depart: / ., i am/pm
742 Bay Rd., Queensbury, NY 12804 11 Inspectors Initials: c
NAME: t"g .� eaA PERMIT NO.: –
LOCATION: 1 ` ♦ . Q,ta. INSPECT ON:
Comments and/or diagram
Y N N/A
Gas Shut-off Y
Water Shut-off
Electric Disconnected 'V
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance 41.j- 1Li- _
M V3 --
Demolition Inspection Report_11 27 12
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