2000-438 �Q� MR P BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
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Building Permit No.
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Permission is hereby granted to
Owner of property located at
in the Town of Queensbury,to construct or place a
at the above location in accordance to 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.
Owroddre
Contractor or Builder's Name:
Contractor or Builder's Address:
Electrical Inspection Agency:
Type of Construction: LEMOU-7 1:04
Plans and Specifications: A L1EA,%J'jN)Qj- pLiNDA-rZt,� AS PEP, iWWC, �RLM�
Proposed Use:
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(if 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.)
e—
Dated at the Town of Queensb this — ay Of
SIGNED BY for the Town of Queensbury
Code Enforcement Officer
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N .Y. 12804-9725
Application for DEMOLITION PERMIT
Permit r No. _ 2
Instructions for completingl the application Date. o
Fee Paid: c _r
I . All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale, showing:
e'
a, lot boundaries, with dimensions and adjacent roads and. streets. f� t ' " r
b. all existing structures, indicating which are to be removed.
e. location of all utilities. JUN 2 1 2000
3. Fee submitted per current fee schue Ale. .
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Owner of property: AIP Property i-acafie:at:
Mailing Address: /V/ w/j /o Tax Map No. section yo_._,,_, Bieck Loot 17
Person responsible for Work c / Z 'K �fIJ &UA✓CXJf Telephone No.
Mailing Address- Qi `� M IYTs I L�7
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Where will demolition material be disposed of? '
Is there any asbestos within building to be demolished? Yes 1 No �
If YES, name of firm removing asbestos from structure, license number, and where asbestos will he disposed of:
NAME OF FIRM LICENSE NUMBER
LOCATION WHERE ASBESTOS W1LL BE DISPOSED
* A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED WITH THIS DEPARTMENT BEFORE DEMOLITION BEGINS,
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 utilities been disconnected? gas electric propane wate
Size of building(s):
I . 5 ft. by 3:3 ft. Location on property AfW 2n OU:^/ Cam,_
2. ft. by ft. Location on property .... T-
3. Number of stories: 11
4. Foundation typo full Cella crawl space slaty
F'txtndation wi13 =G'U _ BEREMOVED
5. Another structur WrLL WILL NOT replace this building.
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Signature of Applicant: I S tft'►4' '��►
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