94-672 .TOWN OF QUEENSBURY
APPLICATION FOR DEMOLITION PERMIT_
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DATE: I 1C9- FEE PAID: r
INSTRUCTIONS FOR COMPLETING THIS APPLICATION N011199��
1: All applicable spaces are to. be completed. h Townot
Queensbul, ,
2. Two plot plans are to be submitted, drawn to scale, Fhow—:%t. A U
a. Lot boundaries, with dimensions and adjacent roa and streets"'
b. All existing structures, indicating which are to be remov=e ,
c. Location of all utilties.
3. - Fee submitted per current fee schedule.
OWNER OF PROPERTY: ) t LtC1C 1L i..r�l��j�
P.O. ADDRESS: 1/jT,.r 1�o_�A I �rl +��5`t3��,2>- TEL:
PROPERTY LOCATION: wj .� , TAX MAP
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Person Responsible For Work: CC=,- Tel : `7 3--020
Address: �0, 4e t , c r 2:> -4
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WHERE WILL DEMOLITION MATERIAL BE DISPOSED OF.?
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The following building(s) located on property described above are to be removed:
Previous Use of Building (Circle One):
Residence Gara a Storage ' Business Other
Have all utilites been disconnected? Gas --***" Electric lPropane Water !
Size of Building(s):
I. Z2 ft. x . ft. Location on property G,E
2. ft. x ft. Location on property
3. Number of Stories:
4. Foundation Type (Circle One): Full Cellar Crawl Space Gw
Foundation Wi-11 Remain Be Removed
5. Another-Structure Will Will Not ,/, Replace This Building.
Replacement of structure-will require application- for Building Permit.
NOTES:
SIGNATURE OF APPLICANT:
er, 6r gent, Architect ontractor
r
BUILDING PERMIT
TOWN OF QUEENSBURY No
WARREN COUNTY, NEW YORK r
PERMISSION is hereby granted to i 1LL
OWNER of property located at r Street, Road or Ave. o
;y
in the Town of Queensbury,To Construct or place a 1 G1 !f 2 1
at the above location in accordance to applicatiodtgether w th plot plans and other information her to fil and
approved and in compliance with the Town of Queery Building and Zoning Ordinance.
1. OWNER'S Address is r
v
2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) M�
( )Wood Frame ( ) Masonry ( )Steel
7. PLANS and Specific f I e— t!
No. ` u \C) Q,1 E6 C4
8. Proposed Use
$ C=�nr /
PERMIT FEE PAID —THIS PERMIT EXPIRES G 19�
(if a longer period is required an application for an extension must be made to the Build i g and Zoning inspector of the
town of Queensbury before the expiration X
I�,,
Dated at the Town of Queensbury this ~� Day of V �,�� 19 C�
SIGNED BY for the Town of Queensbury `
Building and Zoning I ns6S6tor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(518)745-4447
iVE:: DEPART: �' C�INSP: //`�
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME r-5(,�.,'Ic.� l-
LOCATION
DATE ( APEERRM�IT
TYPE OF STRUCTURE
FOOTINGS FOUNDATION BACKFILL _ FRAMING _
ROUGH PLUMBING SEPTIC INSULATION
FINAL ELECTRICAL WOODSTOVE OR FIREPLACE
N A YES NO
CHIMNEY HEIGHT B VENT HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK PORCH STEPS LING
RELIEF VALVES
FURNACE HOT WATER OPERATING
INTERIOR TRIM PRIVACY DOORS
FINISH FLOORS:
BATH KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN VARIANCE RE .
FINAL SURVEY PLOT PLAN
OK TO ISSUE C/O 01 C C
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