2013-282 TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518)761-8201
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Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130282 Date Issued: Friday, June 28, 2013
This is to certify that work requested to be done as shown by Permit Number P20130282
has been completed.
Tax Map Number: 523400-266-001-0001-006-000-0000
Location: 167 PICKLE HILL Rd
Owner: BARBARA B. HOWE TRUST
Applicant: BARBARA B. HOWE TRUST
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
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.
TOWN OF QUEENSBURY
"04-1
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130282 Application Number: A20130282
Tax Map No: 523400-266-001-0001-006-000-0000
Permission is hereby granted to: BARBARA B. HOWE TRUST
For property located at: 167 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: BARBARA B. HOWE TRUST Demolition
BARBARA B. HOWE, TRUSTEE Total Value
167 PICKLE HILL Rd
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
RICK MCGUIRE
NY 12804-0000
Plans& Specifications
2013-282
DEMOLITION of green garage at southeast corner of property
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,June 27,2014
(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 Town of Que sbu T s i ne 27,2013
oiVASIGNED BY V for the Town of Queensbury.
Director of Building&Code Enforcement
Town of Queensbury Building & Codes Office Use Only
DEMOLITION PERMIT APPLICATION -'Received:
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Permit No.: I 3 —c
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot 36
boundaries with dimensions and adjacent roads /streets. Show all existing structures Permit Fee:
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities. ,/
Date (g-, — 2.`{- 13 Demolition Location /G' 7 Pick/6.. /,//
76}-644, 7,,,-a 7, A.f yr 1 //G i. p�e p z.r.'f
Tax Map ID ,n��'�' - / 6hi�1aq cm go:/-01.e__
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Applicant RRGRk'ij //ewe. Owner ,5c e_
Address 167 A C,k1e g II Cc'ci Address
9oee,n, did.y Ny 12R,
Phone 7 i z-. 336)2 Phone
Contact Person for Building&Code Compliance:--31 c-a 4 .t-w o wt._ Phone: 7 4,,I - (c--24K
s4ererccri Jc.
1. Person Responsible for work: RS Lk /n J r{0/'14-
2. Where will demolition material be disposed? /o/7
3. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begins.
a) Is there any asbestos within the building to be demolished Yes _No laps
b) If Yes,our office need the following information: V
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• Name of firm removing the asbestos:
• License number of firm:
• Indicate where the asbestos material will be disposed:
a.4. Structure Information
a) Indicate the structure(s)to be demolished:_residence /garage _business _storage bldg. _Other `S
b) Size of structure: x
c) Number of stories: I rt 41
d) Foundation Type: full cellar crawl space slab D
e) Foundation: will be replaced t/ will not be replacedocie 4 ."
f) Structure(s): will be replaced // will not be replaced T
5. Utilities Information
a) Indicate utilities for this structure: 3.ait‘
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Gas V' Electric Propane 44,,,le ?'1
,,p�`
Public Water - On-Site Well Water Pump Public Sewer aiN
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b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes No �
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c) Have all utilities been disconnected? Yes No (-1434 C t-1-cZt; x (-I -4-3i 3� qP t
c-)I c k I F-1 LA c ()13
6. Signatures: (� I �
Print Name: eARbIRPi X10L
Signature: 4 A.. '%z , ?, w-Z_/ Date: /z u //.3
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Demolition Inspection Report
Office No. (518) 761-8256 Date Insp ctio request received:
Queensbury Building &Code Enforcement Arrive: 5L`/ am/�p /, Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: (; /�
NAME: gai-b+1-o toe, PERMIT NO.: 3!
LOCATION: ji p �—f R C �4'I P J-44 i i f"^'�9, INSPECT ON: 11 I3
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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