2012-426 elak, TOWN OF QUEENSBURY
F4T*1742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120426 Date Issued: Monday, September 10, 2012
This is to certify that work requested to be done as shown by Permit Number P20120426
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
TOWN OF QUEENSBURY
Issuanceof this Certificate of Compliance DOES NOT relieve the ,
A--
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.
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TOWN OF QUEENSBURY
` 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120426 Application Number: A20120426
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
BP 2012-426
Demolition of Mobile Home - 118 Adirondack Street
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, August 30, 2013
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu efore the e iration date.)
Dated at the Tow of Q e b 41 Tfitlr.•�;�ay,August 30,2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
OFFICE USE ONLY
TAX MAP NO. �/�
PERMIT NO, �(�1r}-`L�c6. FEE PAID
Permission is hereby granted to the above named Applicant to demolish the building(s)
described herein as set forth in the Application below.
Director of Building&Codes Date
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.
APPLICANT/BUILDER: ? i3e.r qL )ct r 0 - OWNER: 1 ,'4-k`1 rA AI\ADDRESS: aa) / Vzcne ADDRESS: I0
• - •410:ft
PHONE NOS. .5y5"--30,3- nZ I( PHONE: 57c,5--- ZZ -5f`y( I?
.7 /
PERSON RESPONSIBLE FOR WORK: rIQ,2 4 Lei i•eylr t _PHONE: SSj!S-3( S2,
LOCATION OF DEMOLITION: 1. 18 1 \ t k 54
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? �(1^ S-�-Q� S(rI`
ASBESTOS INFORMATION: �"� v
✓ Is there any asbestos within the building to be demolished? YES l 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
✓ Size of structure: // X 7 STORAGE BLDG. OTHER
✓ Number of stories: /
✓ Foundation type: FULL CELLAR CRAWL SPACE 7 SLAB
✓ Foundation: WILL BE REPLACED - WILL NOT BE REPLACED --
✓ Structures(s): WILL BE REPLACED 1 / WILL NOT BE REPLACED_____
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC V PROPANE
PUBLIC WATER 1/ ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO 1/
Have all utilities been disconnected: YES INO
QUESTIONS? CALL 761.8256 OR EMAIL
r"-----2jjcodes(a queenspurv,net
z�iL�. � VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensburY.not
SIGNA URE OF APPLICANT
aTown of Queensbury• Community Development Office • 742 Bay Road, Queensbury, NY 12804
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Queensbury Building & Code Enforcement - Residential Final Inspection
Office No. (518)761-8256 Arrive: am/pm Depart: 3 \c:'7am/pm
Date Inspection request received: ' 34)I 2.0 I Y Inspector's Initials:
NAME: •40-(AitY // PERMIT#: 261�^ ")`
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LOCATION: l t�J1-v .i d�;-s2/ DATE: c f 3�� /
TYPE OF STRUCTURE: 1.L��v
Comments:
Yes No NIA
4" Building Number Address visible from road
Chimney Height/"B"Vent/Direct Vent Location Li
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 18 inches
Roof Complete/Exterior Finish Complete
Platform at all exterior doors7146kn
Handrail 4 or more risers
Guards at stairs,decks, patios more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guard at deck, porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Bracing/Handicapped Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-off exposed/regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety glazing/Window in stairwells safety glazing
Interior Smoke Detectors/Carbon Monoxide Detectors
Every level: Every Bedroom:
Outside every bedroom area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access, 1 sq.ft.-150 sq.ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation to floor 1 Sticker on Panel
Duct work sealed properly/Blower Door Test Certification
Floor truss,draft stopping finished basement 1,000 sq.ft.
Emergency egress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Furnace/Hot Water Heater operating
Low water shut-off boiler **��
Relief Valve(s)installed I Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum Gypsum
Basement stairs closed rise>4 inches
Garage Floor Pitched
Garage fireproofing/' hour fire door/door closer
Gas Logs in Sealed or Glass Enclosure
Final Electrical; Energy Saving Light Bulbs 50%
Final Survey Plot Plan
Arc Fault Breaker Habitable Spaces/Tamper Proof Receptacles
Flex Gas Pipe Bonding
As Built Septic System/Sewer Dept. Inspection Sticker
Site Plan /Variance required /
\(
Flood Plain Certification,if required 1
Okay to issue C/C or C/0[Temporary/Permanent]
L:\Building&Codes Forms\Building&Codesllnspection Forms\Residential Final Inspection Form_revised_100405.doc;Revised
January 7,2008; Revised 6/26/08; Revised 12/22/10,Revised 04/13/11
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• Homestead MH Park BP 2012-426
�I r Lot 118 Adirondack Park
/// Demolition Demolition of Mobile Home
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NI/ ,/ TOWN OF QUEENSBURY
BUILDING & CODES EPT. /
Reviewed = . :
Date: _40 - \ --- Y
,: L.
TOWN OF QUEENSBURYE
BUILD NO DEPARTMENT r3 2
Based on our lirrted examination,compliance a�
with our comments shall not be construed �s Z2
i indicating the phns _.nd specifications are n
full compliance with the Building Codes of
j Naw York State. , ` I t, • .73/ . '
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