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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150058 Application Number: A20150058
Tax Map No: 523400-289-011-0001-033-000-0000
Permission is hereby granted to: RONALD & CYNTHIA MACKOWIAK
For property located at: 9 GLEN HALL Dr
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: RONALD & CYNTHIA MACKOWIJ
14 STONEWALL Dr Demolition
WAPPINGERS FALLS,NY 12590-01 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2015-058
Demolition Only
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,June 19, 2016
(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 To o ueens . le 19, 2015
SIGNED BY ' \ for the Town of Queensbury.
Director of Building&Code Enforcement
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F CEOWEn
Town of Queensbury Building ��i —elf. s• only
DEMOLITION PERMIT APPLE 0 ' ION
`'zAK 2 0 2015 Re, d
NO WORK MAY COMMENCE UNTIL PER',,i a r.M .,,3 NS 3 I it N.'.: 15-b
Fill in applicable spaces and submit two (2) plot plans, drawn cE3494ASDRIRO •NM]ES
boundaries with dimensions and adjacent roads/streets.-Shovrafl'extstirtg`Stti'Odtdres --Permit --:
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities..S p -r2- 7-/-2 .iyG,p 4/��40/`l�&.2
j 2 5 7G a..,6/--.3.-./ .024 ` ...r.)4,-..,4-,s Cj' a11 -�G� ?) l'
Date Demolition Location
1 Tax Map ID _S-2...:3 c-10•-Zi-Gil-cc/_6,33
Applicant 4 /%q Ge_614/,4-/e-- Owner / =4u 1 'II`,4 f - ;.4m___
Address I ‘-A'/''!'?.71�r'-v Address /1/.
..-5-24•4,x-141--0 211,,,v'&
Qvc yrs.J...--r-s2 , /17' /2e6 y jil/tp9,01✓V4-6/1rs /:T 1*S ,i, '
1 l �5f6
Phone aG.?- 5^C -572 . ("') Phone cCVS-25-g -el-7V
5�14
Contact Person for Building&Code Compliance: " Oes; _i-•.✓..4-.� Day Phone: .'3-!'G i- 7
1. Person Responsible for work: -5X-42.-wese� ,•9G. s �.,s'/ e , //rt.,-A Z./b. u 4
2. Where will demolition material be disposed? C V? 'Dv,,.../..
3. Asbestos Information: The Asbestos Removal Report must be filed with our Asa before demolition begins.
a) Is there any asbestos within the building to be demolished _Yes J No
b) If Yes,our office need the following information:
• Name of firm removing the asbestos:
• License number of firm:
• Indicate where the asbestos material will be disposed:
4. Structure Information
a) Indicate the structure(s)to be demolished: -✓residence _garage _business _storage bldg. _Other
b) Size of structure: 34t5 x e.., ,2 eg.,...-4� .N.er.,... f/. .::,/vu/.cG 4 PSG/ytey„35;,2
c) Number of stories: Z C�� /-`+-.-P 1 ‘2__fir_Sim a`'`yS Q' C
d) Foundation Type: full cellar e/ crawl space stab cv�i�,/wsrs , C+",Z. (`-" t-, )
e) Foundation: :/will be replaced will not be replaced
f) Structure(s): will be replaced will not be replaced
5. Utilities Information
a) Indicate utilities for this structure:
Gas ✓Electric 11.".k1le...-Cr64--1) v Propane
Public Water L/On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes v No 'Y`
c) Have all utilities been disconnected? Yes No p,�,f-✓ b 94,<,_/ r:-,- -,4..--
6. Signatures:
Print Name: ¢4--1 • G=ee.j''v(A-
Signature: , ...,—.....1 - fir // 4 Date: 3/7-� //S
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Town of Queensbury Building &Code Enforcement
Office No. (518)761-8256
Demolition Inspection Report
Inspection request received: 8 F1 12<Alo l
Name: Mack'9'V4`O -> Inspected on: i 1 lSt.
Location: Cl�f-4 �WA Arrive: Y .m. .m
Permit No.: t `d` Inspector's Initials:
Comments and/or diagr
Y N N/A
Gas Shut-off 6e� V-k1
Water Shut-off 2p v� - �Z— --YcS-0&
Electric Disconnected a ssoc�c
Asbestos Removed/Documentation 4
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition Inspection_112012
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i; •- ;: B„ - TOWN OF RUEENSBURY Mackowiak, Ronald BP 2015-058
/ BUILDING DEPARTMENT 9 Glen Hall Drive
/! %� with 0 comments shall''.rriot be construedpIlanas- Demo Only
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DETAILED SITE PLAN MAK 2 U 2015
SCALE 227834' SHMP.,•=0
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SITE SOILS DATA 10 o s 10 zo 70WN OF RUEENSBURY
TEST PITS r BUILDING & CODES TAX MAP #'s 289.11-1-33,
TP -1 - 5/19/14 BY L HUTOWINS P.E (1N 99WT)AI + \ 289.11-1-59.122
09SERVARM OF BANK CUT NEAR SYSTEM ": TQI4I'E y , _ ALTERADON OF THIS DOCUMENT EXCEPT BY A LICENSED
WOODS DUFF WASTEWATER SYSTEM DESIGN I HAVE PEFw'.- " 2 P O E595YA ENGINEER IS A WOLAnav OF NYS MUCATION LAW.
A O -m• TOPSOIL COMLM k BOULDERSI_1 ?TY I I jr S TO I PIE ?
i 10-72' MEDIUM BROWN CRAYELLY FINE SAND - GOBBLES R NUR BEDROOM RESIDENCE FROM THF li
BOULDERS WATER SAWNG Fl%NRES (1.6 GPF MAK RUSH.`U RE(S) OR SjGN(o) p 11,, § _ � a}
ry~ / MOM THROUGHOUT DE GPM MAX FAUCETS) s
DESIGN PLOW - 110 CPOA3EDROON / /�i ! / 'F d
NO EMOFNCE Of SEASONAL HIGH GROUNDWATER TABLE /`(� //� J Z`/
SYSI DESIGN FLOW - 440 GPD 9/ �I (I' 11/ 1 ISSLIM FOR SEPnC PERMIT 5/z1/,4
SEPTIC TANK - USE 1,250 GALLON PRECAST CONCRETE TANK - 0 PRELIMINARY 5/20/14
IGP2: TEST PIT DATA TAKEN FROM 'IPNS 3" TI 'DETAIL SHEET GRINDER PUMPING STARON - EIONE UH071 GRINDER PUMP ASSEMBLY rV "
PREPARN FOR SHERWDCO ACRES CONSTRUCTION CORPOPAnON• BY EFPLUFNT PUMPING STAMN - 4.0 CYLINDRICAL PUMP 57AMNDafe
,.. HUTCMNS ENGINEEMNG. UATEO IA61M LEACH FIELD - 22" IWDE OPEN -BOTTOM GRAVEIIESS CHAMBERS SEPTIC REPLACEMENT PLAN
U-3 - LOT C - 1/30/07 BY T. HUTCHINS. P.E MGMSSEO BC' DESIGN PENCOLAVM RALE = 1-5 MINAN'
DAN RYAN, P.E - TOWN OF GUEENSBURY ENGINEER APPUCARON RATE = 1.2 G-PO/SF IJIEPaPEU EOL
FOREST UT0-4'
COVERAGE ABSORPPON AREA REWIRED = J67 SF Ronald &/Cynthia Mackowiak
' 0-4• TOPSOIL STANDARD 2• WE TRENCH LENGTH REOUWN = ,64 LF MAP REFERENCE: Dig Safely. 9G!m H.9V , Glen lake
4-42" MVPNMT BROW GRAVELLY SAND, PEW BOULDERS 25% RETXPCVM IN LENGni USING 22• WIDE CHAMBERS - 13S,f 'MAP OF A SIARVEY MAGE Nft New(%York TO. ¢neensburW ft. mMmW NY
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42-39' GRAY COARSE SAND, BOULDERS USE 5 TRENCHES AT 26' LONG = 140 1E RONALD B. @ CYNTHIA F. p Wwm.P.wr,wmm
MOM TO 65" POTABLE WATER SUPPLY IS OAl-SITE Wfll. MACKOIWAK" GAIN 0912912013; ocd.n.. Rub a..w,.. pNyle AM O1eduk ClH sml%' NOTED Data 1 4
MAINTAIN NAY MIN. SEPARARON TO AB RWIPRON PI REWSEU 12/12/2014 BY VAN DUSTIN W P11°i1 D"""�' 169 HOMlond RCCd
NO SEASONAL MCH GROUNDWATER ENOENCE 0.4. .n
LOCATION MAP NO MO NNG MAINTAIN 50• MIN SEPARAnCN TO S GC TANK AND SEES LANG SUR EYORS S O evubu K NY 12804
WE]NSBURY. NEW YORK. 900'982.7982 29762 -01 -SS
N15' y..ep...pAea. (516) 145-0307 PHma
Hutchins Engineering 516 745 -awe Foa