2011-456 "OW TOWN OF QUEENSBURY
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�� 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110456 Date Issued: Wednesday, February 20, 2013
This is to certify that work requested to be done as shown by Permit Number P20110456
has been completed.
Tax Map Number: 523400-289-006-0001-032-000-0000
Location: 32 NACY Rd
Owner: JAMES & LILLIAN CONWAY
Applicant: JAMES & LILLIAN CONWAY
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the r"-- ,,,„„P 4
property owner of the responsibility for compliance with Site Plan,
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
lhaki TOWN OF QUEENSBURY
cow 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20110456 Application Number: A20110456
Tax Map No: 523400-289-006-0001-032-000-0000
Permission is hereby granted to: JAMES & LILLIAN CONWAY
For property located at: 32 NACY Rd
in the Town of Queensbury,to construct or place
at the above location in accordance with 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. Type of Construction Value
Owner Address: JAMES &LILLIAN CONWAY Demolition
32 NACY Rd Total Value
LAKE GEORGE, NY 12845-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2011-456
demolition of residence
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Saturday, September 22, 2012
(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.)
Dated at the Town of Qtxeensbury� o Thur da , September 22, 2011
SIGNED BY ,t. ✓ s' � for the Town of Queensbury.
Director of Building&CWe Enfo
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cp._ 9 !p—f-3� OFFICE USE ONLY 1 I 1
TAX MAP NO. PERMIT NO. FEE AID 4 ' re
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Permission is hereby granted to the above named Applicant to demolish the . • .61:/,, � i
described herein as set forth in the Application below.
Director of Building&Codes Date i
i 66-' 0 2 2011
................................................ TCCiCti4 3EE7QS6 r
BUILDING & CODES
APPLICATION FOR DEMOLITION PERMIT:
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads / streets. Show all existing structures
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. (oQyAPPLICANT/BUILDER: 4w�7)6"/J5'j: JAI OWNERs 4 LU/AJ
ADDRESS: 7 IVVO16 ' i- LAKF4eckeztE.. ADDRESS: 32 JAY Quargiu5ertiogy
PHONE NOS.6$3 - 3185- PHONE:
PERSON RESPONSIBLE FOR WORK (40V D PHONE:
LOCATION OF DEMOLITION:31__'Y 'Q,1) . QUF. FU Y o,V - (gee*
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? y e v / /t)(1
ASBESTOS INFORMATION: /1 i 6k5 Svitucv eci; 4Z Caind rdSrs/frivic= demo,44.o
✓ Is there any asbestos within the building to be demolished? YES NO X
✓ If YES, our office needs the following information:
o Name of firm removing the asbestos:
o License number of firm:
o Indicate where the asbestos material will be disposed:
NOTE: A copy of Asbestos Removal Report must be filed with our office before demolition begins (,;a--'
STRUCTURE INFORMATION: j��01
✓ Indicate which structure(s) will be demolished: RESIDENCE/GARAGE BUSINESS
STORAGE BLDG. OTHER >!
V Size of structure: 25 X .'f(. /3305Pt 4ZSF
V Number of stories: / ' ur k°l bos ,..�+t �v
w
QL
✓ Foundation type: FULL CELLAR V CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED /
✓ Structures(s): WILL BE REPLACED WILL NOT BE REPLACED v
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC x PROPANE
PUBLIC WATER ONSITE WELL-WATER PUMP X PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO ��
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins•ection r-:,east r e' ed:
Queensbury Building &Code Enforcement Arrive: /. I/ depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initi. . /
1
NAME: i'1 w 6� PERMIT 0 . //-1 S
LOCATION: _3 D. !u P Poi
C►i INSPE+' t : 11,7
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition Inspection Report 11 27 12
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