2013-438 •
TOWN OF QUEENSBURY
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-
742 Bay Road,Qucensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130438 Date Issued: Friday, June 06, 2014
This is to certify that work requested to be done as shown by Permit Number P20130438
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
property owner of the responsibility for compliance with Site Plan, sv
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.
064 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130438 Application Number: A20130438
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 -438 50 WINDSONG DR.
DEMOLITION of mobile home
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 18,2014
(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 To of ensb , a iy/s 1.., , September 18,2013
SIGNED BY V I for the Town of Queensbury.
Director of Building&Code Enforcement
OFFIC
E
TAX MAP NO. 3 ,�� -+ PERMITNOE ONL/ " i3 g FEE PAID �� / G'✓�L��
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 21_113
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: IC(V1rSkc i1/( 1 ' c,�c, OWNER: 4 ?/ ,/-�i�!,f�
ADDRESS: ,)(2,(i LUZc v ,1 C V ADDRESS: ;'°,S /7 C4ec/�vA, '�Y
PHONE NOS.,SSS ,5 — 51_1/ pHoNE: 22.6 -6 " /�/'/Z,
PERSON RESPONSIBLE FOR WORK: P.!(55/ K%ZA,c)/tM PHONE: 56S 303-�S,( (
LOCATION OF DEMOLITION: 5r1 0)1 icAo n Or
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? DUPil
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 X GARAGE BUSINESS
STORAGE BLDG. )C OTHER
✓ Size of structure: /4,/ X 4 6
✓ Number of stories: /
✓ Foundation type: FULL CELLAR CRAWL SPACE SLAB )C
✓ Foundation: WILL BE REPLACED X WILL NOT BE REPLACED
✓ Structures(s): WILL BE REPLACED X WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC )X PROPANE
PUBLIC WATER X ONSITE WELL-WATER PUMP PUBLIC SEWER
/v//a
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO Y••
Have all utilities been disconnected: YES X NO
QUESTIONS? CALL 761-8256 OR EMAIL
1-2,-L\ codes(a�queensburv.net
�� � VISIT OUR WEBSITE FOR MORE INFORMATION
www.queensbury.not
SIGNA URE OF APPLICANT
a'',. Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins•ection r-' fe ..
Queensbury Building &Code Enforcement Arrive: U �Ti'!= art: G- 0 amin •
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s:
NAME: PERMIT}O.: / 3- 3
LOCATION: 5L' ( )to AP) 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
Okay to Issue Certificate of Compliance 1
\///
Demolition Inspection Report_11 27 12
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