1999-630 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 0 Building Permit No. 99630
TAX MAP NO. 120 . -1-31
CLUTE, LARRY
Permission is hereby granted to
Owner of property located at 111 HOWARD ST.
in the Town of Queensbury,to construct or place a DEMOLITION OF RESIDENCE
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.
Owner's Address:
13 DAWN RD.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
CLUTE, LARRY.
Contractor or Builder's Address:
•
Electrical Inspection Agency:
Type of Construction:
DEMOLITION
•
Plans and Specifications:
DEMOLITION OF RESIDENCE BY FIRE DEPARTMENT AS PER APPLICATION
' Proposed Use:
DEMOLITION OF RESIDENCE .
20 - October 1 2001 • _
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.)
1 October 1999
Dated at the Town of Queensbury this Day of
SIGNED for the Town of Queensbury
• Code Enforcement Officer
,itErgt-IVED
TOWN OF QUEENSBURY
742 Bay Road SEP 2 8 1999,
Queensbury, N.Y. 12804-9725 TOVV v OF e"?r1`•ENSEI.iRY
Application for DEMOLITION PERMIT BUILDING ,N1' 00
6
Permit No.
Instructions for completing the application Date: —
Fee Paid: - t V
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale, showing:
a. lot boundaries, with dimensions and adjacent roads and streets.
b. all existing structures, indicating which are to be removed.
c. location of all utilities.
3. Fee submitted per current fee schedule.
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Owner of property: [��Q- C Property Location: i—cs-rzJ (!
Mailing Address: ( A f Tax Map No. section t .O, Block I ,Lot 1g
Person responsible for work: e_ Telephone No.
•
Mailing Address: _
Where will demolition material be disposed of? c 7,-N/ jr(), '
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 described above are to be removed:
Previous uise of building (circle one) residence garage storage business other
Have all utilities been disconnected? gas , electric , propane , water
Size of building(s):
1. t/ ft. by :3D ft. Location on property
2. ft. by ft. Location on property
3. Number of stories: 1
4. Foundation type(circle one): full cellar crawl s a slab
Foundation will REMAIN OVED
5. Mother structure WILL WILL NOT > replace this building.
NOTES:
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Signature of Applicant:
owner. owner agent,architect, contractor
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