2013-459 -41 OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130459 Date Issued: Friday, March 18, 2016
This is to certify that work requested to be done as shown by Permit Number P20130459
has been completed.
Tax Map Number: 523400-239-012-0002-066-000-0000
Location: 25 BRAYTON Ln
Owner: COLLEEN M HALSE
Applicant: COLLEEN M HALSE
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 `� / / �J /lit
property owner of the responsibility for compliance with Site Plan, Ly
�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: P20130459 Application Number. A20130459
Tax Map No: 523400-239-012-0002-066-000-0000
Permission is hereby granted to: COLLEEN M HALSE
For property located at: 25 BRAYTON Ln
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: COLLEEN M HALSE Demolition
25 BRAYTON Ln Total Value
LAKE GEORGE NY 12845-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
JOSEPH ROULIER
PO BOX 301
CLEVERDALE.NY 12820-0000
Plans &Specifications
2013459
DEMO - shed to be removed
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, October 02, 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(t( ue •sbury We t i •s�•y, October 02,2013
SIGNFT)BY - t for the Town of Queensbury.
Director of Building&Co.e Enfo ement
Town of Queensbury Building & Codes Office Use Only ,,/ -r II 1 1
DEMOLITION PERMIT APPLICATION Received: 27J'y'?( L I
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit No.: i 3-'J 51i
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot 1� /� �
boundaries with dimensions and adjacent roads I streets. Show all existing structures Permit Fee: / ":
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. I )
Date 4!,}-7/ad l 3 Demolition Location .5 13 ay+on 0Lan a
/
Tax Map ID �/Y/, ( _a'/_��f / n, I
Applicant Cil-te ) -HAI e Owner (pilfer)
' l- - C.-1
Address Address ..2 fS B trot fon Lap.C
Like 64rceikid /0)110
Li
Phone Phone
Contact Person for Building&Code Compliance: )o-2 Rd lit 6I Day Phone:
1. Person Responsible for work: `I D-E ?n Lc_(c e r % /
2. Where will demolition material be disposed? ser. cis. ,,,,�., ire ,;C 54q/ .5aeale
3. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begins: r
a) Is there any asbestos within the building to be demolished _Yes X Noll'
w
b) If Yes,our office need the following information: ao
• Name of firm removing the asbestos: I0
• 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 _businesstorage bit:. _Other
b) Size of structure: 01x /4' S r►
c) Number of stories: / Af
/
d) Foundation Type: O full cellar O crawl space 0 slab y �-V `f 7 jU t 3
e) Foundation: will be replaced will not be replaced I "
f) Structure(s): will be replaced X will not be replaced
5. Utilities Information
a) Indicate utilities for this structure: w/ A
Gas ectric 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 r744
c) Have all utilities been disconnected? Yes No y/q
6. Signatures:
Print Name: • a e..4.,.
Jr 1
Signature: c_______—.. --- Date: 0:V1*--
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Town ofpueensbury Building & Code Enforcement <�„�-,''�,
Office No. (518) 761-8256 'V
Demolition Inspection Report
Inspection request received:"" \� T 1 4Name: st Aet:u Inspected on: 11 `
Location: 7S Ti J( Arrive: ; ' a.m./p.m.
Permit No.: 2iil� - �I Inspector's Initials: 1L7
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation "----
Property
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliar e i
Demolition Inspection_11 20 12
TOWN OF QUEENSBURY
## 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
Inspections per Permit
Permit# P20130459
Inspection Date Inspection Type
Approved/Denied Comments
Permit Type Person Responsible
09/27/2013 Miscellaneous Demolition STAFF
Misc 2013-459
permit app reed&entered
10/02/2013 Miscellaneous Demolition CRAIG BROWN Staff
Approved 2013-459
zoning approved
10/02/2013 Miscellaneous Demolition STAFF
Misc 2013-459
permit issued
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SWIS : 523400
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Print Key: 239 . 12-2-66
Comment : Photo ! �
PEML EUS.L- �t
I HAVE PERSONALL €ASURED THE DISTANCE
FROM THE PROPERTY LINES TO THE
PROPOSE�RU URE(S)ORS��S}�
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SIGNATURE 1r
TOWN OF QUEENSBURY
BUILDING & CODES PT. TOWN OF QUEENSBURY
BUILDING DEPARTMENT
Reviewed Y Based on our limited examination,compliance
u.,!-,h our comments shall not be construed as
Date: indicating the plans and specifications are in
full compliance with the Building Codes of
New York State.
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SWIS : 523400
Print Key : 239 . 12-2-66
Comment: