97-071 BUILDING PERMIT
TOWN OF QUEENSBURY No. 97071
VALUE $ 0
TAX MAP NO. 13. —2-42 WARREN COUNTY, NEW YORK
( (aO •\r1 \
PERMISSION is hereby granted to CHECKLA, BRUCE & JOY
OWNER of property located at LACKEY ROAD Street, Road or Ave.
in the Town of Oueensbury,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 Town of Queensbury Building and Zoning Ordinance.
1. OWNERS Address is
60 SMITH HILL RD.
AIRMONT,NY 10952
2. CONTRACTOR or BUILDER'S Name
DAVIS, DENNIS
3. CONTRACTOR or BUILDERS Address
7 ALGONQUIN DRIVE
QUEENSBURY, NY 12804
4. ARCHITECT'S Name `
5..ARCHITECT'S Address
6.'TYPE of Construction—(Please indicate by X)
DEMOLITION
( )Wood Frame ( -1 Masonry ( )Steel ( 1
7. PLANS and Specifications,
DEfOLITION OF RESIDENCE AS PER APPLICATION
8. Proposed Use
DEMOLITION OF RESIDENCE
March 24 _ 99
$ 20 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.)
March 97
Dated at the Town of Queensbury..this ' ' 26ay of - 19
SIGNED BY /_,,, � for the Town of Queensbury
Building and'Zoning Inspector
TOWN OF QUEENSBURY
742 Bay Road .
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT (� r r]
Permit No. DO / IJ
Instructions for completing the application Date: 3-'/3-q-7
Fee Paid: 2p, 00
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale, showing: �� `t
a. lot boundaries, with dimensions and adjacent roads and streets. !'`T1 v,,•.`,:::i '' '-.`=-�--
b. all existing structures, indicating which are to be removed.
c. location of all utilities. MAR 1.3 1997
3. Fee submitted per current fee schedule.
C a C�a\� Ci r_ :�.;< <, �;C cko,
Owner of property: Property Location: a� !�.
y J
Mailing Address: an 3l� � \\i\\ Tax Ma No. Section l)) , Block 'L ,Lot
iN\onscaS �r\\r MC-AA Y,, \OCk&L
Person responsible for work: ----Y/( (\k ',c.)M i`S., Telephone No. 'k) -A 4A Q
Mailing Address: 1 ,` (� `)�(1 D �Y.
C- _ iv-,you . ,
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Where will demolition material be disposed of? Mc. Lc u gc\\ c " _ 1,k\d:K \1.\
Is there any asbestos within building to be demolished? Yes / No y
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 use of building (circle one): residence ) garage storage business other
,Ac6Have all utilities been disconnected? gas , electric , propane , water
Size of building(s):
1. 26' ft. by : ft. Location on property r dv\�
2. i� ft. by ft. Location on property ((L(1.C
3. Number of stories: p' 2.
4. Foundation type (circle one): full cellar pace) slab •
Foundation will REMAIN BE REMOVED .X
5. Another structure WILL y WILL NOT , replace this building.
NOTES:
Signature of Applicant. kb
owner. owner's agen architec. contractor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY ROAD
QUEENSBURY NY 12804 AA?
(518)745-4447
ARRIVE: DEPART: INSP:
FINAL INSPECTION REPO
Ir
DATE INSPECTION REQUEST RECEIVED:
NAME CAA GC�1 1
LOCATION L-AC\AE P1C)c D
DATE Z L PERMIT # 9-7-1:57'
TYPE OF STRUCTURE Dam() RE 1
FOOTINGS BACKFILL FRAMING PLUMBING_
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT FIXTURES\
ROOFING \�
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES
FLOORS
FOUNDATION INS LATION
INTERIOR STA S/RAILINGS
STOCKROOM ENCLOSURE
FIRE/DEMISE WALLS PENETRATION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE
EXIT STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO.
FINAL SURVEY PLOT PLAN, IF REQ
OK TO
(ç'6A-Y "\e: L(4-2-48) 761-8256
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 BAY RD., QUEENSBURY NY 12804 -4
INSPECTOR'S REPORT: ARR//./DEPART INT
REQUEST F I/SSPECT ON ECEIVED:e)
3
NAME
LOCATION ci Gl
DATE PERM 6 /
TYPE OF STRUCTURE: lQ 1\ 0
RECHECK APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FO
REINFORCEMENT IN ACE
THE CONTRACTOR IS RESPONSIBLE FOR
PROVIDING PROTE TION FROM FREEZING
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE. _
MATERIALS FOR THIS PURPOSE ON SITE
k'OUNDATION/WALLPOUR
REINFORCEMENT IN PLACE i L
FOUNDATION/DAMPPROOFING -
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE _
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR INFILTRATION BARRIER •
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 •
-
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