2015-301 -4Iak TOWN OF QUEENSBURY
cow742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20150304 Date Issued: Tuesday, July 14, 2015
This is to certify that work requested to be done as shown by Permit Number P20150304
has been completed.
Tax Map Number: 523400-308-019-0001-020-000-0000
Location: 32 DIVISION Rd
Owner: PAUL & MICHELLE BAILEY
Applicant: CLUTE ENTERPRISES
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 ( J
property owner of the responsibility for compliance with Site Plan, �d
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.
TOWN OF QUEENSBURY
41.11h
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
FIVM
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20150304 Application Number: A20150304
Tax Map No: 523400-308-019-0001-020-000-0000
Permission is hereby granted to: CLUTE ENTERPRISES
For property located at: 32 DIVISION 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: PAUL& MICHELLE BAILEY Demolition
216D JOHN BURKE APTS Total Value
QUEENSBURY NY 12804-1981
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
BP 2015-304
Removal of existing Mobile Home off-site. No demolition work onsite.
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,July 14,2016
(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 T n o ueen ry 4' :r i a ,July 14,2015
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
i
Town of Queensbury Building & Codes Office Use Only
Received
DEMOLITION PERMIT APPLICATION Permit #: Z-0i —
Permit Fee 'i 3a°6
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED
Provide 2 plot plans drawn to scale, showing lot boundaries with dimensions and adjacent roads/streets. Show all existing structures
on property and indicate which are to be demolished. Indicate the location of all utilities
Divi�jte ed--
Date -11 i o1 I S fii U 4` Demolition Location rerv�ur��a`�rin e --L..Di c(C
Tax Map ID 3C . lq--/ -a..,0 TOWN OF QUEENSBI.LRY
BUILn!Mr- p r•rirr _
APPLICANT _C., ' OWNER —ILS C-�ri'extd) -Q3l
Address _ ,j, ✓lele 2-,e- Address
_ 11z° s 1176. _
Phone - Phone
CONTACT PERSON FOR BUILDING & CODES C-it-i-e Phone:
1. Person Responsible for Work
2. Where will demolition material be disposed? IlLe_ 71. r.46.-1, X tttl,..",,,,
3. All buildings to be demolished require an Asbestos Survey
4. Any building substantially damaged by fire must obtain an Asbestos :val mi' ,• . .. - D ..a me t of Labor
5. Asbestos Information: The Asbestos Removal Report must be filed ith ' ur o; e - •r• demolitionbegin
a) Is there any asbestos in the building to be demolished ____ Ye __ , .
b) If Yes,our office needs the following information ____ Yes ____ No
ill%Name of firm removing the asbestos ,. .
,
License number of firmler 14) '
11111
Indicate where the asbestos material will be disposed
6. Structure Information '
a) Indicate the structure(s)to be demolished _Residence ___ Garage ___ Business
11.) ✓eyv,0 6'd— ___ Storage Bldg. ___ Other
b) Size of Structure ,4. o vwd' L. ) -
c) Number of Stories !0-1(Sa Ft- .A J(V ycJ `
f+
d) Foundation Type
e) Foundation ',' 411";V - i ' -9"
f) Structure(s) -
7. Utilities Information
a) Indicate utilities for this structure ___ Gas ___ Electric ___ Propane _'Y_ Public Water __ Public ewer
___ On-site well water pump
a) Have you notified the Town Water Department for public water and sewer disconnect? ____ Yes •
b) Have all utilities been disconn- te.. _ ! Yes ____No
IF
8. Signature
Print Name: )"/.
ame: _tr _ Date _
_t_
Signature: -- O Date
_A 4-
Town of Queensbury Building & Codes - Demolition Permit - December 20141(1.9& 6/
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received: \ 0�t5
Name: (AUS 'p4 s Inspected on: 111A
11A) 20,J5
Location: 32 h\v\S«m - Arrive: a.m./p.m.
Permit No.: 15- 3G Inspector's Initials:
Comments and/or diagram
Y N N/A
Gas Shut-off 1.
Water Shut-off
Electric Disconnected
Asbestos Removed / Documentation
Property Cleaned Up and Graded V
Okay to Issue Certificate of Compliance
Demolition Inspection_11 20 12