99-655 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 9 9 6 5 5
TAX MAP NO. 7 . -1-23
Permission is hereby granted to MC MI LLEN, ROBERT &
Owner of property located at 147 ASSEMBLY PT. RD.
in the Town of Queensbury,to construct or place a DEMOLITION OF SINGLE FAMILY DWELLING
at the above location in accordance to 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.
Owner's Address:
DOROTHEA 27 MOORWOOD DR.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
NORTH QUEENSBURY FIRE DEPT.
Contractor or Builder's Address:
Electrical Inspection Agency:
Type of Construction:
DEMOLITION
Plans and Specifications:
DEMOLITION OF SINGLE FAMILY DWELLING AS PER APPLICATION
Proposed Use:
DEMOLITION OF SINGLE FAMILY DWELLING
20 October 19 2001
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(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.)
19 October 1999
Dated at the To of Queensbury this Day of
SIGNED for the Town of Queensbury
Code Enforcement Officer
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT 0
Pe o. / ' -�-�
Instructions for completing the application Da f
F ai : %0 51
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale, showing:
a. lot boundaries, with dimensions and adjacent roads and streets.
b. all existing structures, indicating which are to be removed.
c. location of all utilities.
3. Fee submitted per current fee schedule.
Owner of property: f►►G 1 l/evt Liitit- ai K e. Property Location: /41 A SSek+. 4i 1 --i O
Mailing Address: ay as r W mot Tax Map No. Section , Block ,Lot
6Vv , Y. 12111i
Person responsible for work: /)Crtb Qieer1►u. f -e Pell', Telephone No. S / ``( 7
Mailing Address:
Where will demolition material be disposed of? e t s
Is there any asbestos within building to be demolished? Yes / No /
If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of:
NAME OF FIRM LICENSE NUMBER
LOCATION WHERE ASBESTOS WILL BE DISPOSED
* A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED WITH THIS DEPARTMENT BEFORE DEMOLITION BEGINS.
The following building(s) located on property described above are to be removed: I
Previous use of building (circle one): residence garage storage business other
OCT 14 1999
Have all utilities been disconnected? gas 4,0i , electric ✓ , propane/St , water
Size of building(s):
1. l ft. by 2'0± ft. Location on property see. e
2. ft. by ft. r Location on property
3. Number of stories:
4. Foundation type (circle one): full cellar crawl space sla P eo
Foundation will REMAIN BE REMOVED
5. Another structure WILL x WILL NOT , replace this building.
NOTES:
Signature of Applicant: /4/6X
owner. owne , rcha ect, contracto
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