2013-388 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130388 Date Issued: Friday, February 14, 2014
This is to certify that work requested to be done as shown by Permit Number P20130388
has been completed.
Tax Map Number: 523400-296-014-0001-007-000-0000
Location: 78 MONTRAY Rd
Owner: GRAYSON PROPERTIES LLC
Applicant: GRAYSON PROPERTIES LLC
This structure may be occupied JUL,'- a:-, AITER
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,
Variance, or other issues and conditions as a result of approvals by the
Director of Building& Code nforcement
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: P20130388 Application Number: A20130388
Tax Map No: 523400-296-014-0001-007-000-0000
Permission is hereby granted to: JOE ZENNAITER
GRAYSON PROPERTIES LLC
For property located at: 78 MON I RAY 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: GRAYSON PROPERTIES LLC Demolition
1004 CHESTNUT St Total Value
MECHANICVILLE,NY 12118
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2013-388 lot 20
DEMOLITION mobile home
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday, August 19,2014
(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 nsbu f M i ati,August 19,2013
SIGNED BY 41 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.: / 3 -3 S S1
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads I streets. Show all existing structures Permit Fee: �j(} p 0
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities.
Date ^./ — / .3 Demolition Location C/ ✓`
Tax Map ID 0/76 -- l7 -- / (
Applicant J -eogotV.ht�%-c v`' Owner x 6
n /
Address -< J, hC J`-I -� Address /�� / �L 9 i
%c-c4 --7/1//7" Cf --C/-149, .1/G v(.�J / l o? fir
Phone 5/ 4/9S- 4/// Phone
Contact Person for Building&Code Compliance: J°/:5 Day Phone: 1195 e//>
1. Person Responsible for work: ✓�� 7 r. A/Ai-61_ GI
2. Where will demolition material be disposed? v4 ]`i 0 3/ d/,
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: /y x C)
c) Number of stories:
d) Foundation Type: full cellar k 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 k Propane
Public Water Tc On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? k Yes _No
c) Have all utilities been disconnected? Yes No
6. Signatures:
Print Name: fl 0
Signature:
715-6,--647.-e--b-t---1 r �� �� � Date: —/ /
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection re els e'- ve•.
Queensbury Building &Code Enforcement Arrive: ^-O am • D-.art: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia s: /
NAME: ;'1 / c"Iz°r PERM NO `-
f/ 6
LOCATION: `) nlr INSPECTION: 2 --- 11-1 -1 ti
ti
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
Demolition Inspection Report 11 27 12
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