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2004-407
TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040407 Application Number: A20040407 Tax Map No: 523400-308-0.12-0002-011-000-0000 Permission is hereby granted to: FRANK STMS For property located at: 63 MINNESOTA Ave i i 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: RONALD &RUTH ROBINSON Demolition 51 MINNESOTA Ave Total Value QUEENSBURY, NY 12804 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-407 FRANK SE\4S DEMOLITION OF 12' X 16 STORAGE BUILDING $20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, June 08, 2005 (lf 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 T o ueen T e ay, June 08, 2004 ; SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Permit NTo. OZI-qc)? Application for Demolition Permit Fee PaicD� Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 Notes: Instructions/Requirements for a permit: Fill in all applicable spaces and submit two(2)plot plans,drawn to scale,showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures on the property and indicate which are to be demolished. Indicate on the plot plan the location of all utilities. J<. ... A' 6hner ::,-. r .. a.;= . :.' P,ersa�t,Res';onsble,for Work . ;•. . Name c, ti S iMS t;� Address z A h m iNti,s(9 3 .A A✓e 3� Il I un;es4+ir J PhoSte ��ax Pho�ne� ` 2. Location of demolition: L) R M�_ 3. Tax Map No. 4. Where will demolition material be disposed of? TO 6 t E If LS.5 5. Asbestos Information A copy ofAsbestos Removal Report must be filed with our office before demolition begins. a. Is there any asbestos within the building to be demolished? ❑ Yes No If YES, our office needs the following information: b. Name of firm removing asbestos: C. License number of firm: d. Indicate location where asbestos material will be disposed 6. Structure Information a. Indicate which structure(s)will be demolished: []Residence; ❑garage; storage building; ❑business; Mother b. Size of structure: t ft.by 1 l, ft. C. Number of stories d. Foundation type: []full cellar; ❑crawl space; Kslab e. Foundation: ❑will be removed; ©will not be removed f. Structure(s): ❑will be replaced; ©C will not be replaced 7. Utilities Information Indicate utilities for this structure: ❑gas ❑electric ❑propane ❑onsite well-water pump ❑public water ❑public sewer Have you notified the Town Water Dept. for public water and public sewer disonnect? ❑Yes ❑No Have all utilities been disconnected? ❑Yes ❑No Signature of Applicant: X'L"'J ,ice Date: