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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150304 Application Number: A20150304
Tax Map No: 523400-308-019-0001-020-000-0000
Permission is hereby granted to: CLUTE ENTERPRISES
For property located at: 32 DIVISION 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: PAUL&MICHELLE BAILEY
216D JOHN BURKE APTS Demolition
QUEENSBURY NY 12804-1981 Total varve
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
BP 2015-304
Removal of existing Mobile Home off-site. No demolition work onsite.
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 14,2016
(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 theT ween ty 4a ,.July 14,2015
SIGNED BY ,Yf for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit #: ZolS; _ ---
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit Fee
Provide 2 plot plans drawn to scale, showing lot boundaries with dimensions and adjacent roads /streets. Show all existing structures
on property and Indicate which are to be demolished. Indicate the location of all utilities p �
�kal.D I�r�crnti
Date 211214--o-l-S__-- 6 J 1 f}er �l�t on Location i�emoyt L,W ��Jt e Ec
18. I -! � o , - f�
Tax Map ID -�G__----�=_ T0411r•< �;: �UEI_h,SUIJY
8UILDING ;
-.-mss_
APPLICANT ����r��z'-� _�. -��- OWNER
Address _iE1 �J� Address ---------------�--_---------
--- ----------------------------
Phone ------ ------- Phone ----------------- ---------
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: � r� _________ Phone:
- J
L Person Responsible for Work
2. Where will demolition material be disposed f ,( 74
3. All buildings to be demolished require an Asbestos Survey
4. Anbuildinq substantially dams ed by fire must obtain an Asbestos R va l D a M-ht of Labar
5. Asbestos Information: The Asbestos Removal Report must be filed ithur o e or demofftion begin
a) Is there any asbestos in the building to be demolished Ye _ s" I
b) If Yes,our office needs the following information Yes[
es No
Name of firm removing the asbestos
License number of firm
Indicate where the asbestos material will be disposed
b. Structure Information
a) Indicate the structure(s)to be demolished _ _ Residence ___ Garage ___ Business
-tj bc- r-e kinci"C41— __- Storage Bldg. ___ Other
b) Size of Structure ytv¢ 0"" �;l le-
c) Number of Storles j0-,1 S a Ff F,f
d) Foundation Type
e) Foundation
f) Structure(s)
7. Utilities Information
1
a) Indicate utilities for this structure --_ Gas _ Electric ___ Propane __Y Public Water -_ Public ewer
On-site well water pump , V
a) Have you notified the Town Water Department for public water and sewer disconnect? _X-__ Yes
b) Have all utilities been disc onn e _ Yes ____ No
8. Signature x,
Print Name: Date�- ---- - - - ----------------- --- ---------
Signature; ----- --------------------- Date -- ___ Pror
t�
i�
Town of Queensbury Building& Codes- Demolition Permit - December 2014
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received: )?15
Name: cLh. eve SZS Inspected on: 1
Location: �y\SjrVIn +��- Arrive: a.m.l P.M.
Permit No.: S' 3C Inspector's Initials:
Comments and/or diagram
Y N NIA
Gas Shutoff
Water Shut-off
Electric Disconnected
Asbestos Removed f Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition Inspection-11 20 12
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