2014-367 a
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
will
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140367 Date Issued: Tuesday, October 14, 2014
This is to certify that work requested to be done as shown by Permit Number P20140367
has been completed.
Tax Map Number: 523400-226-016-0001-006-000-0000
Location: 17 DUNCAN Cv
Owner: T. ARTHUR & LISA PERRY
Applicant: T. ARTHUR& LISA PERRY
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 f Building C.T'ay merit
Planning Board or Zoning Board of Appeals.
jj111� TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NP 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140367 Application Number: A20140367
Tax Map No: 523400-226-016-0001-006-000-0000
Permission is hereby granted to: T. ARTHUR& LISA PERRY
For property located at: 17 DUNCAN CV
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: T. ARTHUR& LISA PERRY
13 OREGON Trl Demolition
WATERFORD,NY 12188-0000 Total Value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2014-367
Demolition of 2-story, 30'x 30'home
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,August 21,2015
(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 of Q7 sbu 4 Ti s“ • •gust 21, 2014
SIGNED BY i for the Town of Queensbury.
Director of Building&Code Enforcement
I �_- 777177-7-1n.
Town of Queensbury Building & Codes triniu,3 Tse only ti'U
DEMOLITION PERMIT APPLICATION er,eiro 1 4 -2814
NO WORK MAY COMMENCE UNTIL PERMIT IS ISSUED PerrnitNo.: Ail-3619
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot TOWN OF QUE�1.36-Er" ..Y
boundaries with dimensions and adjacent roads J streets. Show all existing structures_ Peri 8 CODES
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities.
Date 91/4/14 -7 Demolition Location / / d k,v / ,C/o,rr
Tax Map ID �`�.n�2Zte. /6' "7— 4 t/esetlak, i/ / )4,..ary
Applicant jig) Mii-bei ffr 49- Ziemer 44 Pe ler,
Address PD. Box Z¢I Address tolt/J�r1
O flal !/?'i/
feta tL /Air 046 iter ivgg
Phone 6S(- as-71 Phone 542-- e539
Contact Person for Building&Code Compliance: lat /1? 1l�etdr7S Day Phone:
79/-2110
1. Person Responsible for work: ,QINS i ,..
2. Where will demolition material be disposed? ari gin lC//Yl��/ SA 01.---
3.
—.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 J 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 demolis ed:_residence _garage _business _storage bldg. _Other
b) Size of structure: �O'x '
c) Number of stories: 7---
d)
jamd) Foundation Type: _full cellar K crawl space _slab
a) Foundation: _will be replaced will not be replaced
f) Structure(s): _will be replaced will not be replaced
5. Utilities Information
a) Indicate utilities for this structure: ,
Gas X Electric Propane
Public Water K On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes No
c) Have all utilities been disconnected? _k_Yes No
6. Signatures: /f� J�
Print Name: fif/- (/
A (f J y,
Signature: i .ria, / - 4 Date: 014
7
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Town of Queensbury Building & Code Enforcement
Office No. (518) 761-8256
Demolition Inspection Report
Inspection request received: ff^�
Name: r t15 Inspected on: (0/ W \ l
Location: / 7 D u n o p,€) (2o3 . Arrive: ('��c9� a.m./p.m.
Permit No.: / 41 3 Ioo,7 ' Inspector's Initials: C
GR �
, ``��^ Comments and/or diagram
Y ,r N/A
Gas Shut-off /
V
Water Shut-off V
Electric Disconnected
Asbestos Removed /Documentation ✓
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliantql0
Demolition Inspection_11 2012