2012-448 el& TOWN OF QUEENSBURY
ifr • 4.7
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120448 Date Issued: Wednesday, December 10, 2014
This is to certify that work requested to be done as shown by Permit Number P20120448
has been completed.
Tax Map Number: 523400-309-005-0001-001-001-0000
Location: 158 LUZERNE Rd
Owner: D&G MANAGEMENT LLC
Applicant: SADERIA INGRAHAM
This structure may be occupied as a:
Demolition
By Order of Town Board
rQb ire 6 k6ime TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
;45t--
propertyowner of the responsibility hfor 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
"742 Bay Ron],Queensbury,NY 12804-5902 (518)761 8201
Community Developinerit- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120448 Application Nurnber: A20120448
`I'.ix -,%lap No: 523400-:309-005-0001-001-0 01-f1000
Pumission is hereby granted to: SADFR]AINGRAHAM
1-,'or property located at: 158 LUZERNE, Rd
in thel"ovvn of Queensbury, to construct or place
at the above.location in accordance with application together with plot plans and other inlorrna6on hereto file(]
and approvedand in compliance with the NYS Uniform Building Codes and the Queensbury, Zoning
Ordinance. Type of Construction Value
Owner.'ddress: D&G NIANAGI-MENT LLC Demolition
PO BOX 2488 "hotal Value
GLENSFALLS, NY 12801-0000
Contractor or Budder's Narne / Address 1,]cctricn1 1nspccfiori,\gcncy
Pt-ins&Specifications
2012-448 3 CRABTREE LANE
Demo / Removal of existing mobile home (14' x 62')
530.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, September 19, 2013
(if a longer period is required,mi application for an extension inust be nude to the code Enforeetuent Officer
of ttie'rown of Queensbury before the expiration(late.)
Dated at the Town of Queensbury; Wednesday, September 19, 2012
SIGNED BY for the Town of Quccnsbur.N.
Director of Building& Code Enforcement
TAX MAP NO. )D—I�]
. �I• ERMI E NOE ONLY I a_.(144 ,
FEE PAID 3DB
Permission is hereb = a ell". he a•.f-
,.• named Applicant to demolish the building(s)
�t. l J4!I)
described herei. -s se on th_�. 'cation below.
i '" /
Dir to o Building : •odes ( f �7
Date
‘r
i
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 / 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. �^
5 /� /r
APPLICAN d :RC)CPl A I�� t\f t\ OWNER: �/ 1 /N c9 tl7
ADDRESS: 3 C_ i-3T Q_EE r�E ADDRES : - ��r9,� /Wee., 1-flrc-fes
PHONE NOS. 7 9 Z- 4 ZL --• E:
PERSON RESPONSIBLE FOR WORK: /y1�,QR1,,S CQoIJas PHONE (a1 7?'a-,5?SF
LOCATION OF DEMOLITION: G°Rflg •j -447
WHERE WILL DEMOLITION MATERIAL BE DISPOSED?
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES NO
✓ 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 / GARAGE BUSINESS
STORAGE BLDG. OTHER
✓ Size of structure: I I-/ X 6
✓ Number of stories: J
✓ 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:
✓ Indicate utilities for this structure: GAS / ELECTRIC ✓ PROPANE
PUBLIC WATER V ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO
Have all utilities been disconnected: YES NO \/
QUESTIONS? CALL 761-8256 OR EMAIL
codes(a aueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.net
SIGNATU E OF APPLICANT
��� Town of'Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins•ectIptn re. - -':-iv:•
Queensbury Building &Code Enforcement Arrive: • h' A► P-part: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia . /,. --
NAME:
NAME: 3 t.l ( r.011 re?`)61 PERMIT NP.: / oP(/a4
LOCATION: Z40. rem --F r INSPECT ON) S' I'D— Lt
Comments and/or diagram
Y N N/A p4-1 1 6+`1 a
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance �— Fti3 O
13
Demolition Inspection Report 11 27 12
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The Subtitle
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The Map Title w .E
NM
110.11
USER ASSUMES ALL RISKS AND RESPONSIBILITY FOR DETERMINING WHETHER THIS MAP IS SUFFICIENT FOR
PURPOSES INTENDED.
Printed: Sep 14, 2012