2014-564 elaki TOWN OF QUEENSBURY
w742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20140564 Date Issued: Monday, March 28, 2016
This is to certify that work requested to be done as shown by Permit Number P20140564
has been completed.
Tax Map Number: 523400-300-016-0001-009-001-0000
Location: 232 FULLER Rd
Owner: THOMAS & HEATHER LAPHAM
Applicant: TIOMAS & HEATHER LAPHAM
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 ( e*40 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.
1
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140564 Application Number: A20140564
Tax Map No: 523400-300-016-0001-009-001-0000
Permission is hereby granted to: THOMAS & HEATHER LAPHAM
For property located at: 232 FULLER 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: THOMAS & HEATHER LAPHAM Demolition
232 FULLER Rd Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2014-564
DEMO of 1 1/2 story house
(following the construction of new home BP 2014-531)
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday,November 06,2015
(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 Queensbury; Thursday, November 06, 2014
SIGNED BY 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 1\69V 06 2014 1 'C1-.5-6 4/
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads 1 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 t 1. 1- 05- �-o ) Demolition Location 6)3d\ Fk I I er1�v
Tax Map ID Soo ' I _ I 1
Applicant .1-\ I in 9) COrisiru. Cu Owner ) d'1 o(i\&_5 H e d I p k a.m
Address 51 C O 43'- k oc.� Address f �i (('R koaci
Adson Kik N•) 1`23 � OlkeerisbItir H y ►QFo1
Phone � ) ) 76H--C3.37-
D -C .3 - Phone (5i0 93a -330S.
Contact Person for Building&Code Compliance: 1 N'\ R I IQ 1-e c k T SQ, Day Phone:as I ` d 70 4/
1. Person Responsible for work: I 0 m ' ` I re k 1 J g
2. Where will demolition material be disposed?
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
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:_residence —garage _business _storage bldg. _Other
b) Size of structure: x
c) Number of stories: '.0y)
d) Foundation Type: ' full cellar crawl space _slab
e) Foundation: will be replaced will not be replaced / n d; 9P re,7 1' Jo C 4.4;
f) Structure(s): twill be replaced will not be replaced
5. Utilities Information
a) I dic a utilities for this structure:
GE ecl tric (-----Propane
\/Public Water On-Site Well Water Pump Public Sewer
b) Have you notified the Town Water Dept.for public water and sewer disconnect? Yes _No no ye-- -- SP r;'► 1-' ezoi
c) Have all utilities been disconnected? _Yes No n o+ y F f — � r c 20 I c
6. Signatures:
Print Name:
Signature: C I✓�ciLl
Date: I1 05
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: 30-2').2-0-A\..c.
Name: Lc \' k. Y] Inspected on: 7C I
Location: 2J ZA\.� v Q ri C2-0a4 Arrive: _ a.m./p.m.
Permit No.: 201`-c-D0-L\ Inspector's Initials:
Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed /Documentation -
Property Cleaned Up and Graded 0
Okay to Issue Certificate of Complianc- ,
./1
Demolition Inspection_11 2012