2013-362 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
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CERTIFICATE OF COMPLIANCE
Permit Number: P20130362 Date Issued: Monday, September 23, 2013
This is to certify that work requested to be done as shown by Permit Number P20130362
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:
Demolitiop
•2/ 13-1I63t n ei By Order of Town Board
(TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the _ 4/tit--
//
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
` � 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
.777 _ Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130362 Application Number: A20130362
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 a Electrical Inspection Agency
Plans&Specifications
2013-362 71 Alpine Ave.
DEMOLITION
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 06,2014
(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 f Quee sbury ��Tu s ay/August 06,2013
SIGNED BY - /- for the Town of Queensbury-.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
DEMOLITION PERMIT APPLICATION Received:
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit No.: I3' 3 Cc
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot � Q
boundaries with dimensions and adjacent roads I streets. Show all existing structures Permit Fee: .�C_ ° i i C�/
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. AUG 0 5 2013 V "
Date 0 8 / 051/ 3 Demolition Location 1-\ceakelThtr\) J1irE_
Tax Map IDv _ . _
Applicant KC)/A/ /1- Al 09 Q-A/7 Owner 51-s4Z-C
Address 7 I -fi r,/.2 4-c.fe Address
�Jearn,ve-y /C y
Phone - ? g 36 / d a y K Phone
Contact Person for Building&Code Compliance: Day Phone: .59"'2 C
1. Person Responsible for work: KW. #4 9 IQ(I 9 Q;J -7-
2.
2. Where will demolition material be disposed?
3. Asbestos Information: The Asbestos Removal Report must.be filed with our office before demolition begins.
a) Is there any asbestos within the building to be demolished _Yes 1,--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:([esidence _garage _business —storage bldg. _Other
b) Size of structure: /6 x 7 /
c) Number of stories: 1
d) Foundation Type: full cellar crawl space 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 Electric /Propane
✓ Public Water On-Site Well Water Pump Public Sew
b) Have you notified the Town Water Dept.for public water and sewer disconnect? _No
c) Have all utilities been disconnected? J Yes No
6. Signatures: V
Print Name: K'et/I Al 9 A. v 9 .,,v!-
/Signature: —A, ----� Date: 0 F` 6 S b
Town of Queensbury Building&Codes Demolition Permit 518-7611256
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S ?fYTws
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am/pm Depart: 1 -Y _am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: 1 �
NAME: HOm-c�p' p r d PERMIT NO.: / —3
LOCATION: / P'1 4C31 r)P INSPECT ON: - W9
Comments and/or diagram
Y _ N N/A
Gas Shut-off 17'
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded /,/ /O
Okay to Issue Certificate of Compliance
Demolition Inspection Report 11 27 12
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins.-ction .`{ ed:
Queensbury Building &.Code Enforcement Arrive: 0 . /p nl •-part: "-7p�
742 Bay Rd., Queensbury, NY 12804 , Inspector's Initi. _IJ _
NAME: G'c (v1 A) 4 c, PERMIT 0. (!-
LOCATION: 7/ Al n;;4,. 0.4'urf- INSPE • : -! 3
Comments and/or diagram
Y / N N/A (_V 1e\ JC`\�
Gas Shut-off `//
Water Shut-off30 I-61341U
Electric Disconnected
Asbestos Removed/ Documentation VVV EC)
S70
Property Cleaned Up and Graded v
Ql—
Okay to Issue Certificate of Compliance
Demolition Inspection Report 11 27 12
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