2015-091 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
CL Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150091 Date Issued: Wednesday, November 02, 2016
This is to certify that work requested to be done as shown by Permit Number P20150091
has been completed.
Tax Map Number: 523400-315-005-0001-003-002-0000
Location: 57 WEST MT. Rd
Owner: ELIZABETH MORGAN
Applicant: ELIZABETH MORGAN
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, �d
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
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150091 Application Number: A20150091
Tax Map No: 523400-315-005-0001-003-002-0000
Permission is hereby granted to: ELIZABETH MORGAN
For property located at: 57 WEST MT. 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: ELIZABETH MORGAN Demolition
57 WEST MT. Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
BP 2015-091
Demolition of inground swimming pool -remove from tax - assessment records
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday, April 17,2016
(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 ;4 ; 't , i 1117,2015
SIGNED BY ! for the Town of Queensbury.
Director of Building&Code Enforcement
0 .-
Town of Queensbury Building & Cods>, EC [l dfficalsniy
DEMOLITION PERMIT APPLICATI N Re id
l��'R 15 ��i5� : Li)
NO WORK MAY COMMENCE UNTIL PERMI IS SUED Permit No.: 0��'0��
Fill in applicable spaces and submit two (2) plot plans, drawn to 4scale, showing lot '7ENSBURY
boundaries with dimensions and adjacent roads/streets. Show all existing structures Permit Fee: Y1Yo
on the property and indicate which are to be demolished. Indicate on ffie plot plan the
location of all utilities. jj((
Date 1031/) Demolition Location
Tax Map ID W-:). "D -'
� ` +2 ( � t,�
Applicant \(0 "--,-- 4 I I __Gl ' .�t(} C (/ Owner j 1 `cl',)T�,� i in ..11
Address J (.4QS ' �n tj.V1"tom 11 •�1�ikddress SA 111?
Q U o/ _
Phone 77 I (} ._c)(D J 7 —� Phone
Contact Person for Building&Code Compliance: ;z,,,K,\ \So t1 w1 e1 Day Phone:
I 1. Person Responsible for work: J 0$0 41 jai`\Aer
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 X 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:_residence _garage _business _storage bldg. _Other
b) Size of structure: x A1C' -71r-�r�uv-rc SIN kmmkYmc 1 01
c) Number of stories: V v
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 Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes _No
c) Have all utilities been disconnected? Yes No
6. Signatures: 1/ i
Print Name:
ieIrfillb."VA r• ►_'.
Sig ; ure: W. lMITM Date: y7s/45
4111
Town of Queensbury: sing&Codes Demolition Permit 518-761-8256
Town of Queensbury Building &Code Enforcement
Office No. (518)761-8256
Demolition Inspection Report
Inspection request received: zil2Z1]alio `
Name: Y Inspected on:
Location: VVIV yoyw-)b�An Arrive: a.m.l p.m.
Permit No.: �rz>- i7I Inspector's Initials:
tvo al ' , u 1vc�t-_l
Comments and/or diagram
Y N NIA
Gas Shut-off
Water Shut-off fi i� c�l�rG
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition 120 2012 `�
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I Elizabeth Morgan BP 2015-091, '
( b� o� \ 57 West Mountain Road
, Demolition - Inground Swimming Pool
,0I ,n�`�� , Remove from tax-assessment records
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TOWN OF QUEENSBURY
BUILDING & CSS` S 'EP
TOWN OF QUEENSBURY Reviewed B item\
BUILDING DEPARTMENT Date:
Based on our limited examination,compliancegir
with our comments shalt not be construed as
indicating the plans and specifications are in
full compliance with the Building Codes of
New York State.
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