2013-437 u: •
TOWN OF QUEENSBURY
742 Bay Road, ucensbu NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20130437 Date Issued: Friday, October 18, 2013
This is to certify that work requested to be done as shown by Permit Number P20130437
has been completed.
Tax Map Number: 523400-297-013-0001-036-002-0000
Location: 18 KITCHELL Ln
Owner: PATRICIA VONDERLIETH
Applicant: PATRICIA VONDERLIETH
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
"--- t,'ieP
Issuance of this Certificate of Compliance DOES NOT relieve the 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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20130437 Application Number: A20130437
Tax Map No: 523400-297-013-0001-036-002-0000
Permission is hereby granted to: PATRICIA VONDERLIETH
For property located at: 18 KITCHELL Ln
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: PATRICIA VONDERLIETH
18 KITCHELL Ln Demolition
Total Value
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
ONEAL NURSERY AND LANDSCAPING
DAVID ONEAL 518-538-3878
39 TOWNER Rd
LAKE LUZERNE NY 12846-0000
Plans&Specifications
2013-437
DEMOLITION of fire damaged home
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 18,2014
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu efore the exp. tion date.)
Dated at the Town f Qum nn,l�u a VV4 may;September 18, 2013
vvv
SIGNED BYfor 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.: 'J 2011
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot / :: -••</ 3 7
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. P
Date 9���,3 Demolition Location 11 •X-6.4.1(
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Tax Map ID 297. 13 � 36 •y
Applicant 0N.'e v,2s N.eNm,_,Pwner1���; V'.zr rcvso
Address 31 //iv..:/,,,r�., .. /Zc a o Address is lc.E��. - \ t�tJ
1L • 4-t.L✓LZ�Nt N `' (QbI>12..v� I' ../ .
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Phone (:,9(.Cs-)i) - 3S 3v /2 &Y4 Phone
tSr1) (ovs -3')c LF_ U
Contact Person for Building&Code Compliance: C'9 , Day Phone: (S78).C3?-3$7V
1. Person Responsible for work: av : 0 0/..) \
2. Where will demolition material be disposed? i
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 K 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:_Kresidence _garage _business storage bldg. _Other
b) Size of structure: 5 o x
c) Number of stories: 2-
d) Foundation Type: x full cellar ( w' 6,0 crawl space slab
e) Foundation: will be replaced 'A will not be replaced
f) Structure(s): '� will be replaced Oh will not be replaced
5. Utilities Information
a) Indicate utilities for this structure:
Gas j( Electric Propane
Jc Public Water On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes 1., No
c) Have all utilities been disconnected? 'i. Yes No ir �.,�,r�.p ' -to (;Q,,,.�,;�,
6. Signatures:
Print Name: 6.7„:':214.0 c-A.r+A.v
Signature: _ Date: OSA.?
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive: am,/_pr/ Depart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials:(< �
NAME: ti 011 S tx l lh PERMIT NO.: /3-213
LOCATION: l Q Ki-rob INSPECT ON: /t) —/
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation C/
Property Cleaned Up and Graded V�
Okay to Issue Certificate of Compliance if
Demolition Inspection Report 11 27 12
j1
MAP REFERENCES:
MAP OF LANDS OF
ELIZABETH U RENNER
DATED: MAY 13, 1952
�
BY: A. J. LAN'FEAR
MAP OF A SURVEY MADE FOR
SS>S EILENE C. BANNON
DECEMBER 31, 1987
, s�
YE
BSTEVES
I VAN DUS N &
w MAP OF A MOWFICATION
TO AN APPROVED SUBDIVISION
P
r+ GRF RECYCLING
) DATED; SEPTEMBER 20, 2000
ori
LAST REVISED: MAY 3, 2001
LANDS NIF OF BY: VAN DUSEN `& STEVES
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