2008-496 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. P20080496 Date Issued: Wednesday, January 28, 2009
This is to certify that work requested to be done as shown by Permit Number P20080496
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 occupie+DAENCE H. MULLER
Demolition
By Oder 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,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code nforeement
Planning Board or Zoning Board of Appeals.
�®
TOWN OF QUEENSBURY
Et 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20080496 Application Number. A20080496
Tax Map No: 523400-309-009-0002-001-000-0000
Permission is hereby granted to: HOMESTEAD VILLAGE L P
FLORENCE H. MULLER
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
2008-496
94 ALPINE AVE - DEMOLITION OF MOBILE HOME - FLORENCE MULLER
$20.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,September 17,2009
(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 Tom,,a4,Queensbyfr,qBuil
Wednesday, September 17, 2008
SIGNED BY �' for the Town of Queensbury.Director o de orcement
�. .. .................... .. / ..... ......... ,..f� .>t. ^ ..
e - — j OFFICE USE ON ''ly ,
l - y
� TAX M N PERMIT NO._ r FEE P � �
AP
Permission is hereby granted he above d Applicant to demolish the building(sx '
Zi
described herein as set f in th p ion efow. ;
' Director of Buildin es to ;
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: Am1rS Qyorn19 OWNER: V2rz-tirc'� �1/I�CCF/L
ADDRESS:___ rh �* Scs i ADDRESS: A6 M'An cSU�i
PHONE NOS. PHONE:
PERSON RESPONSIBLE FOR WORK: J. Q P,,qm n PHONE:
LOCATION OF DEMOLITION:_ !? A I pI ne AVHF 4i ye nsb;0 r/_
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? Sc." P
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES NO x
✓ 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: RESIDENCEX GARAGE BUSINESS
STORAGE BLDG. OTHER
✓ Size of structure: IV X
✓ Number of stories:
✓ Foundation type: FULL CELLAR CRAWL SPACE ,,// SLAB tj6
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED_,ge
✓ Structures(s): WILL BE REPLACED-j ,/6 WILL NOT BE REPLACED lL
UTILITIES INFORMAT(ON:
✓ Indicate utilities for this structure: GAS tiro ELECTRIC n6 PROPANE kJ 4
PUBLIC WATER,vil) ONSITE WELL-WATER PUMP n(tS PUBLIC SEWER ti h
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO
Have all utilities been disconnected: YES 0- NO IWEBSITE
QUESALL 761.8256 OR EMAIL
a�ueensb��ur_y,netVISIT OU FOR MORE INFORMATION
S IGNATURE OF APPLICANT ueensbury.n t
Town of Queenshui ty• Corrlmunity Development Office - 742 Bay Road, QueensburJ, NY 12804
Queensbury Building & Code Enforcement - Reside4tialnal pection
Office No. (518)761-8256 Arrive: U apart: am/pmDate Inspection request received: Inspector's Initials
NAME: 1C� PER #:
LOCATION: i DA
TYPE OF STRUCTURE:
Comments•
Y s o WA
4' Building Number Address visible from road Y,
'
Chimney Height/"B°Vent/Direct Vent Location
Fresh Air Intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof Complete/Exterior Finish Complete fff III
Platform at all exterior doors
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 I regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safetv 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 s .ft.vents
Bathroom Fans,if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss,draft stopping finished basement 1,000 s .ft.
Emergency ress below grade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to furnace area
Fumace/Hot Water Heater operabo
Low water shut-off boiler �p
Relief Valves installed/Heat Trap/Water Temp110
Enclosed Stairs Sheetrock Underside minimum'A"Gypsum m
Basement stairs closed rise>4 inches
Garage Floor Pitched U
Garage fireproofing/%hour fire door/door closer
Duct work Sealed properly
Gas Logs in Sealed or Glass Enclosure
Final Electrical _
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Bonding
As Buift Se is System/Sewer Dept. Inspection Sticker
Site Plan /Variance required
Flood Plain Certification,if required
Oka to issue C I C or C 10 Temporary/Permanent
L:\Building&Codes Forms\Building&Codes\lnspection Forms\Residential Final Inspection Form revised_100405.doc;Revised
January 7,2008; Revised 6/26108
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