2012-364 - ,A. TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120364-39099 Date Issued: Tuesday,November 1, 2016
This is to certify that work requested to be done as shown by Permit Number P20120364-39099
has been completed.
Tax Map Number: 265.-I-71
Location: 4 PICKLE HILL RD
Owner: Patrick O'Rourke
Applicant: Patrick O'Rourke
This structure may be occupied as a: Demolition
Removal of Mobile Home and demolition of barn 14'x 20' By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan, V '
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.
Aek4 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120364 Application Number: A20120364
Tax Map No: 523400-265-000-0001-071-000-0000
Permission is hereby granted to: PATRICK O'ROURKE cn
For property located at: 4 PICKLE HILL Rdey)
1\
in the Town of Queensbury,to construct or place V
�3'
at the above location in accordance with application together with plot plans X: oth ormation hereto filed
and approved and in compliance with the NYS Uniform Building Codes and th\Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: PATRICK O'ROURKE Demolition
4 PICKLE HILL Rd Total Value
LAKE GEORGE,NY 12845
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2012-364 Renewal fee pd 10/16/2013
Demolition of Barn 14'x 20'
Mobile Home to be removed
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 01,2014
(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 Tow of Qu sbu f W• , '. • ugust 01,2012
SIGNED BY \ for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
• ����` 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120364 Application Number: A20120364
Tax Map No: 523400-265-000-0001-071-000-0000
Permission is hereby granted to: PATRICK O'ROURKE
For property located at: 4 PICKLE HILL 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: PATRICK O'ROURKE Demolition
4 PICKLE HILL Rd Total Value
LAKE GEORGE,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2012-364
Demolition of Barn 14'x 20'
Mobile Home to be removed
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, August 01, 2013
(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 • + • nsbury , We es:ay,August 01, 2012
' r 1 for the Town of Queensbury.
SIGNED BY ...i .. Q ury.
Director of Building&Code Enforcement
I -� OFFICE USE ONLY 9' \'. _ t_ , �T
TAX MAP NO. la'r—`?1 PERMIT NO. ha 3 to FEE PAID mac) ) - s , -�--- •---- •,
Permission is hereby ',
gr e e abov am App' .nt demolish the building(s)
described herein as se orth in pl' io elow / i JUL 3 Q 2012
1 _ ,
Director of Building&Codes \ Date TOVUP!T'T U&ENSBuRY
BUILDING.PA CODES !
J
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. y
�i� f V-r�C + L
APPLICANT/BUILDER: C.✓ �a��I--- OWNER:
ADDRESS: --/ Ri k-1.,_- 1-//// eJ ADDRESS:
PHONE NOS. 2 ,,/,_..-- 7 67 PHONE:
PERSON RESPONSIBLE FOR WORK: i «1 0 0Ce- Le_ PHONE:
LOCATION OF DEMOLITION: L/ /9(' le-/u H in (7
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? 4/2-,--5"?` /E ./ci.-T 4 i'I i t
ASBESTOS INFORMATION:
✓ 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.
STRUCTURE INFORMATION:
✓ Indicate which structure(s) will be demolished: RESIDENCE GARAGE BUSINESS
STORAGE BLDG. X OTHER
V
Size of structure:/ 4/ X e 0
✓ Number of stories:
.s----‘ /0 *4,k %71,y,)/..e u i/l h c_ move,/
✓ Foundation type: FULL CELLAR ,1( CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED WILL NOT BE REPLACED y
✓ Structures(s): WILL BE REPLACED WILL NOT BE REPLACED K
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC < PROPANE
PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO_
Have all utilities been disconnected: YES NO
QUESTIONS? CALL 7614256 OR EMAIL
i
codes(a queensbury.net
VISIT OUR WEBSITE FOR MORE INFORMATION
/
f A ' / / www.queensbury.net
IGNATU-E a APPLICANT
Q0 Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
,ern of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received:
Name: -net i< Z) ADO"(f(e Inspected on: j ZIGfr
Location: ' -f i'j`C.i),) E `.it Rd Arrive: //' a.m./p.m.
Permit No.: j —3 b'4-) Inspector's Initials: Ni
Comments and/or diagram
Y N N/A q--7(Pir
Gas Shut-off
Water Shut-off
.
Electric Disconnected
Asbestos Removed / Documentation �-
Property Cleaned Up and Graded reifI L Anoar?
Okay to Issue Certificate of Compliance
Demolition Inspection_11 2012
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: 4 0' am/pm Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:
NAME: I"Ct* D b U f K 8- PERMIT NO.: / -36, Y
LOCATION: Lf 31(‘ ,o i 0 1( INSPECT ON:
s
rn f �`�I 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 l�
Demolition Inspection Report 11 27 12
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SWIS : 523400
Print Key : 265 . -1-71
Comment : Photo