Application YRAM 1 D
r Services, LLC
Pyramid Network Services, LLC
6615 Towpath Road
East Syracuse, NY 13057
VIA FedEx Delivery
August 24, 2021
Town of Queensburc
Building Department L+- -
742 Bay Road
Queensbury, NY 12804
Reference: SPRINT Removals
90 Gumev Lane
Dear Building Department(Kate Deck);
Please see the attached Demolition Permit Application as requested for the removals of the existing
SPRINT-Nextel equipment at the above referenced Telecommunications facility along with a check in the
amount of $165.00, also included are required Certificates of Insurance and (2) two copies of the
Removal Drawings for the unused equipment located at the facility.
Please contact me at your earliest convenience at(518) 857-1755 or selsbreerpyramidns.com should you
have any questions or require any additional information.
Thanking you in advance for your time with this matter.
Sincerely-
G
Steven Elsbree
Director Construction
Pyramid Network Services
Office Use Only
OL DEMOLITION APPLICATION Permit#: — tD`Ii,-a5-20ZI
Permit Fee:$ )IQ.S
Town of O_uecnsburr
Invoice#: Z
742 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.gueensbury.net Flood Zone? Y eviewed
Demolition Location: 9-0'Gurney Lane Tax Map ID 4:
**AN ASBESTOS REPORT IS REQUIRED WITH ALL
DEMOLITION APPLICATION SUBMISSIONS**
DEMOLITION INFORMATION:
1. Where will demolition material be disposed? Electronics & Raw materials to be recycled
Demo waste to be disposed of land fill .
2. Type of structure to be demolished:
a. Residence_ d. Storage Building
b. Garage e. Other: Telecom Equip. & concrete pad
c. Business
3. What type of utilities are connected to the structure:
a. Gas f.Well-Water Pump
b. Fuel Oil g. Public Sewer t "i4'
c. Propane_ h. Other °"'"
d. Electric X i. None_ -
e. Public Water
4. Have ALL utilities (water,electric, etc.) been disconnected? Yes No
ADDITIONAL INFORMATION:
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.
3. Workers' Comp insurance information is required to be submitted with this application.
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.
I have read and agree to the above:
PRINT NAME: Steven Elssbbreee
SIGNATURE: ✓ DATE:
Demolition Application Revised December 2020
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Pyramid Network Services, LLC
Mailing Address, C/S/Z: 6615 Towpath Road, East Syracuse, NY 13057
Cell Phone: 5( 18 ) 857-1755 Land Line: �)
Email:—selsbree@pyramidns .com
• Primary Owner(s):
Name(s): Town of Queensbury
Mailing Address, C/S/Z: 742 Bay Road, Queensbury, NY 12804
Cell Phone: _( ) Land Line: _( 518 ) 761-8256
Email: KateD@queensbury.net
❑ Check if all work will be performed by property owner only
• Contractor: (List all additional contractors on the back of this form)
Contact Name(s): Pyramid Network Services, LLC
Contractor Trade: Telecommunications Contractor
Mailing Address, C/S/Z: 6615 Towpath Road, East Syracuse, NY 13057
Cell Phone: _( 518 ) 857-1755 Land Line: _( )
Email: selsbree@pyramidns .com
**Workers' Comp documentation must be submitted with this application**
Contact Person for any questions regarding this project: Anthony Ciarico
Cell Phone: 3( 15 ) 952-1406 Land Line: �)
Email: aciarico@pyramidns .com
Demolition Application Revised December 2020