1999-019 BUILDING PERMIT
!0 1 TOWN OF QUEENSBURY
VALUE
$ No. 99019
TAX MAP NO. 53.-1-4 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HARRIS, KEITH
OWNER of property located at MUD POND RD. Street.Road or Ave.
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 Town of Queensbury Building and Zoning Ordinance.
1. OWNERS Address is
219 PICKEL HILL RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
HARRIS, KEITH
3. CONTRACTOR or BUILDERS Address
4. ARCHITECTS Name
5. ARCHITECTS Address -
6. TYPE of Construction—(Please indicate by X)
DEMOLITION
1 )Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
DEMOLITION. OF SINGLE FAMILY DWELLING AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
DEMOLITION OF SINGLE FAMILY DWELLING
20 February 1 2001
$ 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
town of Queensbury before the expiration date.)
1 February 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
ui ding and Z n ng Inspector
TOWN OF QUEENSBURY
�_. 742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT `
Permit No. qctp _ �" 0) 1
Instructions for completing the application ® Date: I -` �.o�.t1
1. All applicable spaces are to be completed. ; . - . I
2. Two plot plans are to be submitted, drawn to scale, showing:
a. lot boundaries, with dimensions and adjacent roads and streets. JA N 2 6
�99�
b. all existing structures, indicating which are to be removed.
c. location of all utilities. TOWN OF QUEENSSURY
3. Fee submitted per current fee schedule. BUILDING AND BURY
Owner of property: /.11 //41 f Property Location: f' Li ,1J
Mailing Address: 2-i% f9iiir/e ///// A4// Tax Map No. Section .3 , Block / , Lot Y'
61J(5,Gi5/3NA, /11 V./2-S'eV
Person responsible for work: red/ Telephone No. -717.77
Mailing Address: c1,,�.•-
Where will demolition material be disposed of? 5'®7T 71/4,-/es"} ''c
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 desc i bed above are to be removed:
Previous use of building (circle one): residence garage storage business other
Have all utilities been disconnected? gas .GCS , electric .f5 , propane ,-/t°f , water 7e5
Size of building(s):
1. a'l ft. by 7(.) ft. Location on property
2. ft. by ft. Location on property '
3. Number of stories: l
4. Foundation type(circle one): full cellar crawl space slab
Foundation will REMAIN BE REMOVED
5. Another structure WILL WILL NOT , replace this building.
NOTES: i�M/t 610,1,,L
Signature of Applicant
r, owner's agent,architect, contractor
GENERAL INSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building&Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive/rnv am/pm Depart am/pm
Inspector's Initials OA
NAME: tee t 44 > PERMIT# - I
LOCATION: mix, let DATE : 3
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers 1
Monolithic Pour Form
Reinforcement in Place
The contractor is responsible for jj yy��
providing protection from freezing CG,�s GJ •
for 48 hours following the placement
of the concre .
Materials for this urpose on site
Foundation/Wall
Reinforcement in P1
Foundation/Dampproo
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents ' Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior. R-
Foundation Walls Exterior R-
Floors R-
Walls R=
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1,2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping
GENERAL INSPECTION REPORT
Town of Queensbury
Dept. of Community Development Date inspection request received:
Building& Code Enforcement
742 Bay Road
Queensbury,NY 12804 Arrive y j/3o am/pm Depart am/pm
Inspector's Initials -c,- /k
NAME: V--e%ill )-c r), S PERMIT#
LOCATION: DATE : 3 5 "
TYPE OF STRUCTURE:
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form _ �, ,2/3 �, ��n�
Reinforcement in Place ru r�
The contractor is responsible for providing protection from - mg Eve ke` sh Y-
/�� // pevd `
for 48 hours following the • acement p%cedi IA. Ce% h, G^,
of the con te.
Materials for purpose o site C;r�4
Foundation/Wall uL
Reinforcement in Place
Foundation/Dampproo. i g
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents n Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Wails Interior R-
Foundation Walls Exterior R-
Floors R-
Walls / R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2. 3, 4 hour
Firestopping
GENERAL INSPECTION REPORT
Town of Queensbury
Dept.of Community Development Date inspection request received:
Building& Code Enforcement
742 :>ay Road
Queensbury,NY 12804 Arrive pl'`f(am/pm Depart am/pm
Inspector's iti
NAME: � /7.; PERMIT#
LOCATION: 4d I P, , DATE : 3
TYPE OF STRUCTURE: cm d
RECHECK
N/A YES NO COMMENTS
Footings/Piers
Monolithic Pour Form �
Reinforcement in Place �JfG e� no S�f�
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purpose on site
Foundation/Wallpour
Reinforcement in Place
Foundation/Dampproofing
Backfill Approval
Plumbing Under Slab
Plumbing Vent/Vents in Place
Rough Plumbing
Heating Rough-In
Insulation
Foundation Walls Interior R-
Foundation Walls Exterior R-
Floors R-
Walls R-
Ceiling R-
Duct work or piping in
unheated spaces R-
Proper Vent, Attic Vent
Framing
Jack Studs/Headers
Bracing/Bridging
Joist Hangers
Jack Posts/Main Beam
Air Infiltration Barrier
Fire Separation 1, 2, 3, hour
Penetration Sealed
Fire Wall 2, 3, 4 hour
Firestopping