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DEMO-0520-2022 Office Use Only 71, DEMOLITION APPLICATION W Permit#16y'n- otao- 2©22 Permit Fee: $ 1 195 Torn of Queensbury Invoice#: 742 Bay Road,Queensbury,NY 12804 � P:518-761-8256 www.gueensbury.net Flood Zone? Y CTl /Reviewed By. 14 Highview Road, Lake Demolition Location: George, NY 12845 Tax Map ID #: '239.15.1.15 **AN ASBESTOS REPORT IS REQUIRED WITH ALL DEMOLITION APPLICATION SUBMISSIONS** DEMOLITION INFORMATION: 1. Where will demolition material be disposed? Hiram Hollow Land Fill 2. Type of structure to be demolished: a. Residence_ d. Storage Building b. Garage e. Other: Deck c. Business D E C l5 2 a V E 3. What type of utilities are connected to the structure: LS a. Gas f. Well-Water Pump AUG 18 2022 b. Fuel Oil g. Public Sewer c. Propane h. Other TOWN OF QUEENSBURY d. Electric i. None BUILDING&CODES e. Public Water 4. Have ALL utilities (water, electric, etc.) been disconnected? Yes X No ADDITIONAL INFORMATION: 1. Two inspections are required: an inspection to determine that utilities are disconnected, and a final inspection after the structure is removed and the site is cleaned up and graded. 2. Twenty-four (24) hour notification is required for inspections. 3. Workers' Comp insurance information is required to be submitted with this application. Declaration: I acknowledge that no structure(s)will be removed from the parcel until the demolition application has been reviewed and approved by the Town of Queensbury Building&Code Enforcement and Zoning Departments and a permit has been issued. I have read and agree to the above:( / PRINT NAME: 2 ve8 V SIGNATURE: DATE: ( �' Demolition Application Revised June 2022 CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL • Applicant: Name(s): Redbud Development, Inc. Mailing Address, C/S/Z: 2 Commerce Park Drive, Wilton, NY 12831 Cell Phone: 518.321.8169 Land Line: 518.691.0428 Email: geff@redbuddevelopment.com • Primary Owner(s): Name(s): Alice & Jack Lynch Mailing Address, C/S/Z: 14 Highview Road, Lake George, NY 12845 Cell Phone: 617.999.4684 Land Line: N/A Email: aflynch5421 @gmail.com Check if all work will be performed by property owner only • Contractor: (List all additional contractors on the back of this form) Contact Name(s): Contractor Trade: Mailing Address, C/S/Z: Cell Phone: Land Line: Email: **Workers' Comp documentation must be submitted with this application** Contact Person for any questions regarding this project: Geff Redick Cell Phone: 518.321.8169 Land Line: 518.691.0428 Email: geff@redbuddevelopment.com Demolition Application Revised June 2022 8 41 III if I11 T '04 4.1 'L ' 1, T T If1 1 . i, I, , -,,— A, 14, 41 IV, if if if 11 41 � if it 4�— ------ �t 4 it 4 it I if t if It it 41f 141 if r it if I it At If 1 1 J, i I AIIII 41 4 14' 4,11 it 4 1 it 4,- if it f t 41 4 41 if (NI m I it it 41 1 1 At If ip ' 4. ghka- 4_7 LJJ LU z z m LLI LLI Ld M 0 0 LLI < WI/ Ld V) z — _j rA I/ cr w 0 C) z D Z 0 w m w w m 0 C) LL C, ") R =3 Co 0 (-- Q LL, co oq4j3 oop t6­5� zx c -x- Ljj < Lij I� 00 azr 0 z C' E LLJ > _j < > z _j LJ r-) >0 w r_Y i­- W z 00 LL ui LL , (L,-, L, j C) cr C) 0 , " L"j 0 2 0 0 :2--Zz Ott3< Lw� 21) CL L<L) Q_- 0 cr- ly CL � >_ ui L� LLJ:r D Li C.) 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