94-671 TOWN OF QUEENSEURY
APPLICATION FOR DEMOLITION PERMIT
Al
DATE: / /- 1G-�j ¢ FEE PAID:
INSTRUCTIONS FOR COMPLETING THIS APPLICATION
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale sha �o�:1004 s;
14Pa. Lot boundaries, with dimensions and adjacent roads wets.
b. . ,All existing structures, indicating which are `' `o b tM0 "ed.
C. Location of all util ties. idg D rV
pt.
Gn ,
3. Fee submitted per current fee schedule.
OWNER OF PROPERTY:
P.O. ADDRESS: 41136e/;o,� TEL:
PROPERTY LOCATION: �p,2. ,.r ,,/ 2 TAX MAP #:
------------------------------------------/0-
-----------------------------------
Person Responsible For Work: GCS 6, /1� , .� Tel :
Address: 20, ;,!G / `p- •� 2> -0 �v �cs
---------------------------------------------------------------------------------
WHERE WILL DEMOLITION MATERIAL BE DISPOSED OF? -o NF-J
--------------------------------------------------------------------------------
The following building(s) located on property described above are to be removed:
Previous Use of Building (Circle One) :
Residence Garage Storage Business Other
Have- all utilites been disconnected? Gas Electric r Propane Water
Size of Building(s) :
1. 3�_ ft. x 2,6 ft. Location on property F26-4 - 0 E
2. ft. x ft. Location on property
3. Number of Stories:
4. Foundation Type (Circle One) : Full Cellar Crawl Space Slab
Foundation Will Remain Be Removed
5. Another 'Structure Will Will Noty/ , Replace This Building.
Replacement of structure will require application for Building Permit.
NOTES:
SIGNATURE OF APPLICANT:
Ow r, 0 e s A nt, Architect, ontractor�
BUILDING PERMIT
TOWN OF QUEENSBURY No. �zl— 7
WARREN COUNTY, NEW YORK
l
PERMISSION is hereby granted to 1 L1C (y, o_�
r
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury,To Construct or place a dVJ lJ`'�y `
at the above location in accordance to application together with plot plans and other information hereto filed and / ' ^
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. (((•••���
1. OWNER'S Address is
>
2. CONTRACTOR or BUILDER'S Name
rr
Le, H-0 r�
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and S�ipti ee'r
o� �/
�S 1 Gib ck-KC) co+(� r--" S ��r_ �'s A
8. Proposed Use U V /
O
$ PERMIT FEE PAID—THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
0,
town of Queensbury before the expiration date
Dated at the Town of Queensbury this Day of 119
' - C
SIGNED BY for the Tow of Queensbury A
Building and Zoning spector 1
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY ROAD
QUEENSBURY NY 12804
(! (518) 761-8256
r
ARRIVE: DEPART: INSP:
Qw-
FINAL INSPECTION REPORT - RESIDENTI/A�L
DATE INSPECTION REQUEST RECEIVED: �\V
NAME ��r 1�� k0 \ 1 Oa-r,\
LOCATION J
DATE�%! _ PE,RgM�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 11EIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
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 08 C/C\