2014-145 TOWN OF QUEENSBURY
gay742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140145 Date Issued: Friday, February 26, 2016
This is to certify that work requested to be done as shown by Permit Number P20140145
has been completed.
Tax Map Number: 523400-303-020-0001-026-000-0000
Location: 2 PHILLIPS Ave
Owner: WALTER PROUTY
Applicant: WALTER PROUTY
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 / ) 4 J" �l
property owner of the responsibility for compliance with Site Plan, `fJ�''`�
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
a .
ON742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140145 Application Number: A20140145
Tax Map No: 523400-303-020-0001-026-000-0000
R.
Permission is hereby granted to: WALTER PROUTY
For property located at: 2 PHILLIPS Ave
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: WALTER PROUTY
PO BOX 252 Demolition
HUDSON FALLS NY 12839-0000 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2014-145
DEMO mobile home
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Tuesday,April 28, 2015
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town f Que sbu //MIA '.a / 1 . 4 28,2014
4
SIGNED BY 1- \ for the Town of Queensbury.
Director of Building&Code Enforcement
• Town of Queensbury Building & Codes of.: On g 2014
DEMOLITION PERMIT APPLICATION
Rt....-.peed)\ OR 2 I
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED Pe ' No99 , 9F QBE oDE9 /9 3—
Fll in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot L—- b
L1D
boundaries with dimensions and adjacent roads I streets. Show all existing structures Permit Fee:
on the property and indicate which are to be demolished. Indicate on the plot plan the 6•X�
location of all utilities.
Date v23-J2Pt 0.2 0/7 Demolition Location o2 Ph.I -4 ve,
Tax Map ID 3,a a - I'026
Applicant W AGTER le. P2o d t try Owner (,J4/-7(C K P2 a el 17
Address PD. Lox �S2 Address Pro, 606 ..252_
Needsoh F4163,4J /021157 gmolson F,1-1Ls /75 /&Y39
Phone S/.7- 79 . 7O&' . Phone .5752- 7% rcx -
Contact Person for Building&Code Compliance: 7.ant% // eo 4/ 7y Day Phone: 79.4-9,64,
1. Person Responsible for work (5J4-LT f/ecg /
2. Where will demolition material be disposed? �//Z./� 14/0//n4 - run o P Atofrr/g u
3. Asbestos Information: The Asbestos Removal Report must be filed with our office before demolition begins.
a) Is there any asbestos within the bulling to be demolished Yes t No
b) If Yes,our office need the following information:
• Name of firm removing the asbestos:
• License number of firm:
• Indicate where the asbestos material will be disposed:
4. Structure Information
a) Indicate the structure(s)to be demolished:Yresidence X garage _business _storage bldg. _Other
b) Size of structure: /a x SD 0,2a ya LI 99 9—
c) Number of stories: (
d) Foundation Type: _full cellar 7$ crawl space _slab
e) Foundation: _will be replaced )C will not be replaced
f) Structure(s): _will be replaced it will not be replaced
5. Utilities Information
a) Indicate utilities for this structure:
Gas 7' Electric Propane
Public Water On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? X Yes No
c) Have all utilities been disconnected? AC Yes No
6. Signatures:
Print Name: 1Q21}1.- BTF22 K tRait T—)1
Signature: . k( tv-4 Date:v2s ,,,.),�0/y
Town of Queensbury Building&Codes Demolition Permit v 518-761-8256
pc\ crN cast GK
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins on request received:
Queensbury Building &Code Enforcement Arrive: l lJ am/prkDepart: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: J t
NAME: I C�v U� PERMIT NO.: / 4 7 Jp
tJ
LOCATION: P IN; 1),‘' INSPECT ON: l/ Si— /y
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Cleaned Up and Graded / V
Okay to Issue Certificate of Compliance
Demolition Inspection Report_11 27 12