2013-017 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130017 Date Issued: Monday, February 04, 2013
This is to certify that work requested to be done as shown by Permit Number P20130017
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
Issuance of this Certificate of Compliance DOES NOT relieve the ( 0.1
�_
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&Cod Enforc mcnt
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130017 Application Number: A20130017
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
Plans&Specifications
2013-017
Demolition at 57 Windsong Drive
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,January 15,2014
(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 of'Que sbu tTu• • t 2y/ anuary 15,2013
SIGNED BY - - for the Town of Queensbury.
Director of Building&Code Enforcement
3 rf� Q-1)-1'� ) OFFICE USE ONLY h � fr�-�
TAX MAP NO. , I r( PERMIT NO. Z o I JFEE PAIDPermission is hereby granted to the above named Applicant to demolish the building(s)
described herein as set forth in the Application below. 01:
'JAN i : 2013
�j
Director of Building&Codes Date J
•
•
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.
APPLICANT/BUILDER:�''-)C f ;i ' Q OWNER: HOoles
ADDRESS: 159-1 4-kirc,ncioc ,J� ) ADDRESS: ( �uz2r 1p
1�:�• aSly,by/d Szc�
PHONE NOS. 'T -303-Sa I I PHONE: SSSS_-303 -S.17 ► 1
PERSON RESPONSIBLE FOR WORK: p�g( PHONE: S 5-303 //
LOCATION OF DEMOLITION: S7 (,J,nd\ r, �,1� �'� �o�S� k'y )ac�
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? IJ C) pS -e f 0Lned bc1 Irese/ll,, Glhi.sk
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES
NO ,C.
✓ 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
x 7() STORAGE BLDG. X OTHER
✓ Size of structure: P-I
✓ Number of stories: 1
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED
✓ Structures(s): WILL BE REPLACED x WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC }c 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
Have all utilities been disconnected: YES )< NO
QUESTIONS? CALL 761-8256 OR EMAIL
codes(a queenspurv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
SIGNAT RE OF APPLICANT www.queensbury.n0t
EiTown of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
s u a
Queensbury Building & Code Enforcement — Manufactured / Modular Final Inspection
Office No. (518) 761-8256 Arrive: am/pm Depart:,') ' am/pm
Date Inspection request received: Inspector's Initials: ti'�=t�
NAME: PERMIT#:
LOCATION: Lir) L-(_;•(\ -s' DATE:
Manufactured Home //-M v
Modular Home
Footings_ Foundation Backfill_ Framing
Comments:
Yes No N/A
Foundation support, pier spacing, 1 1 1 z;
Per manufacturer
Anchoring per manufacturer 2'from ends
Water line shut off
Sewer line support @ 4 feet
Heating Crossover[doublewide}off grd.
Dryer vented outside
Skirting ventilated 1 sq.ft.per 1,500 sq.ft.
Hot water relief valve piping outside
Deck,porches,steps, railing
Fumace/hot water operating 1\-k°
\\\ l
Garage Fire proofing
Fire Door/Door closers
Plumbing Fixture/3"Vent through roof[Modular]
Foundation insulation[if applicable]
Smoke/Carbon Monoxide Detectors/Interconnected
Final Electrical
Variance required
Data Plate okay
Manufactured HUD seal okay
Warranty Seal after January 1,2006
Installers Warranty Seal
18"x 24"access or 22"x 30"attic access
Vapor retarder under home 6 mil poly or other
911 Street number
Okay to issue C/C or C/O[Temp./Perm.]
Model# Serial#
Manufacturer
Date of Manufacturer
L:1Pam Whiting120101Building Codes Forms\ManufacturedModular Final Inspection_03 04 10.doc