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DEMO-0157-2018 TO ITN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: DEMO-0157-2018 Date Issued: Thursday, October 4, 2018 This is to certify that work requested to be done as shown by Permit Number DEMO-0157-2018 has been completed. Tax Map Number: 289.10-1-36 Location: 15 GENISTA LN Owner: David Judkins, Dawn Judkins Applicant: Dawn Judkins This structure may be occupied as a: Demolition of single family dwelling Asbestos report received By Order of Town Board Silt fence to be installed prior to demolition and remain in place until all disturbe( TOWN OF QUEENSBURY are stabilized 4 12 18 cb Issuance of this Certificate of Compliance DOES NOT relieve the (" 4,4041k- 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 Enforcement Planning Board or Zoning Board of Appeals. -17 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: DEMO-0157-2018 Tax Map No: 289.10-1-36 Permission is hereby granted to: Sherwood Acres Construction Corp. For property located at: 15 GENISTA 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 Tvpe of Construction Owner Name: David Judkins Demolition-Residential $0.00 Owner Address: 286 Butler Pond RD Total Value $0.00 Queensbury,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency Sherwood Acres Construction Corp. PO Box 908 Minerva,NY 12851 Plans&Specifications Demolition of single family dwelling Asbestos report received Silt fence to be installed prior to demolition and remain in place until all disturbed areas are stabilized 4_12_18 cb $ 150.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday,April 12,2019 (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 o sbury; 4 Th i 12,2018 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement p Office Use Onniv�� pa — Permit#: 's� Y"t(� G� ,SDEMOLI,_ Na4PPAT,ION _ APR Permit Fee:$ TWn of Queensbury Q 9 2��$ Invoice:#: 0Z � 742 Bay Road, Queensbury, NY 12804 TOWN O 6UEENSBElRY P:518-761-8256 www.aueensburv.net ,_„� Bl!!I DING&CODES Demolition Location: / e'4 I 4c— Tax Map ID **AN ASBESTOS REPORT IS REQUIRED WITH ALL .DEMOLITION APPLICATION SUBMISSIONS** CONTACT INFORMATION: • Applicant: Name(s): ,Pct A/, Mailing Address, C/S/Z: Z3 P /6,L- P 6�,W Azw Cell Phone: ( r1fl) ?- Land Line: ( T-/.k' ) -V— 7-21-2; Email: CIO jt4dk /h a f/, /0 • PrimarvOwner(s): br) Name(s): �C A-m --- Qt) (jj)011 'b�i a i el 4 �.,('�11)(n J LtCiS Mailing Address, C/S/Z: Cell Phone: ( ) Land Line: ( ) Email: chyj LI& o6 1 q-59 & q rna l m • Contractor: `J Business Name: D�)fP ''\AI nbr) ;del-r-S Cb-ml b- , CN D Cd 1f` Contact Name(s): —6&' 'Pe'ri" , Mailing Address, C/S/Z: O Ub po . b q&O /L'')nP-,f(,-1A-1v1 I.;6'b7f Cell Phone: qIq ) r�, �1 - �D Land Line: (51�S Email: (�Cf het^ g L.9 Ira 1'M011 z 0 UYY') Contact Person for Building & Code Compliance: b&6ek Nxbef- kb-r4rucior) 661moi��' Cell Phone: (q,4 ) fp2F- gZb2 Land Line: ( 519 ) Email: kcL-rke-e, KL. ►lb+ ry)rA-,i ° C&rr Demolition Application Revised June 2017 i DEMOLITION INFORMATION: 1. Where will demolition material be disposed? ',6 A e.,vu l V 2. Type of structure to be demolished: a. Residence b. Garage c. Business d. Storage Building 3. What type of utilities are connected to the structure: a. Gas b. Fuel Oil c. Propane d. Electric X_ e. Public Water f. Well-Water Pump g. Public Sewer h. Other i. None ,2 4. .Have ALL utilities been disconnected? Yes No x yYltL� -yak Q77Ta"7)'It,i')'�' 5�u� ADDITIONAL]N FORMATION: 1. Two inspections may be required: an inspection to determine that utilities are disconnected, if necessary, and a final inspection, after the structure is removed and the site is cleaned up and graded. 2. Twenty-four(24) hour notification•.is required for inspections. Declaration:I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. have read and agree to the above: PRINT NAME Pt' V "Cl J !/ZlsG1<-_/k J OaLO(l ka..�fy)s SIGNATURE: �Q�Arl�l I ' �' DATE: Demolition Application Revised June 2017 442 1 CO QUI co o cam, w 0 — _:.. : '* oa w�'' �Q oi QGI 444... O MD HE R.E OCAT.ED RECOASTR MTED 3 --_ 1/2"IPF •,, .001 A,J °� CIRs ✓Y '��:, �cF IV�i F PLOT PLAN I HAVE P RSONALLY MEASURED THE DISTANCE 'es € i.C�NI HE PROPERTY LINES TO THE I-,;-\Gi ED STRUCTURE(S)OR SIGN(S) SIGNAT E DATE ��` moo° ' . <;a� 1P o A.l 0 CI RS •i MEST,GRAM :E'E R EC'NS`T3433CTf D 1/2" IPF 4 aujw° - E i 46 _. area ' / 4,,688± said ft��"�? A P _ - f r t 29, 4. .. . I/2"IPF _ y x � I O`Off Line f. 435 I RAVJ r. o` 1 _ PARKING ARC � � < EXIST G PARKING 431 ` BE RECONSTI 7.7 EX 2•ST'CC7iRY ROE 'PORE DEMMMED& REM'WEdt,RiE3W BDW y hed SCo e 'TO"BE r<0fism, CTED L� COP'�f i ATUNE.L KE.5.ET BA:CIt i :Larscl�� aNNI #12 Shen L. 3.Laeia G. iq key - 727tt-44 e CrRs � ,Lands/Vic 0 f / liam A. &Bonnie W Thomas $00�2` 1 fy / Fro � 89.10;-1 35 $o Silt fen(e to be installed as �" r 415� a a EXIST CES iP0CL Installs on must be completR o Inspected �:aE: r �, RCL4t to inning demolition. Ad mer's Qlof me _ , w � , l'(�Zjo �r ' M AdJoinerS wilds, Please ontact this OfflCe to ►drr�le D 1 9 4 s �F aso: 'H� C9i_ Wood Dwe Frame lion( n inspecti' n of the site to a �. �u �\1 �rr9 / » TOWN OF QJEEN$BURY BUILDING DEPA ENT - L NG M Wood Deck q/ Based on our limited exami ation,compliance Clear By 4,6 with our comments st aii n be construed as / tI wood indicating the plans ens spe fixations are in/ CIRs ' CrRs Deck full compliance with the Building Coge,. New York State. Deck _.: z .• ;:ram wood.�eck i Wood ®o J�F Wood peck uu _.._.. I 0 3D D 7 } © Axle Found p � Water Source t F 'OWN OF QUE 289.10-1-36 DEMO-0157-2018 50,5'± Al BUILDING & Along Shoreline Reviewed B or Judkins, Dawn & David Glen Lake Date: 15 Genista Lane Demolition only of SFD ��`� '� - � � � SCALE: 1`20' (GRAPHIC SCALE