BOTH-000281-2016 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: BOTH-000281-2016 Date Issued: Monday, May 23, 2016
This is to certify that work requested to be done as shown by Permit Number BOTH-000281-2016
has been completed.
Tax Map Number: 308.19-1-36
Location: 24 OGDEN RD
Owner: LORRAINE WINTER-BOULE
Applicant: LORRAINE WINTER-BOULE
This structure may be occupied as a: Demo only of shed
Permit renewed through July 2, 2017 By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the /J
property owner of the responsibility for compliance with Site Plan, �d
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 12804-5904 (518)761-8201
QL Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000281-2016 y5P EQ-\A- 2'-
Tax Map No: 308.19-1-36
Permission is hereby granted to: LORRAINE WINTER-BOULE REVISED
For property located at: 24 OGDEN 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
ape of Construction
Owner Name: LORRAINE WINTER-BOULE Demolition $0.00
Owner Address: 24 Ogden RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
RENEWED
Plans&Specifications
Demo only of shed
$ 0.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Sunday,July 2,2017
(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 o uee ury; n �JWed d 2, 2014
SIGNED BY: G_�?k�'/ � 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.:
Fill in applicable spaces and submit two (2) plot plans, drawn to scale, showing lot
boundaries with dimensions and adjacent roads/streets. Show all existing structures Permit Fee: ,3b
on the property and indicate which are to be demolished. Indicate on the plot plan the
location of all utilities.
Date 2 ®— Demolition Location
Tax Map ID 3 O I — — (P
Applicant )- 6w'b'erL�e
Address �' Address
q /
Phone 1g,
1 g7/ tY6S Phone
Contact Person for Building&Code Compliance: Day
Day Phone:
1. Person Responsible for work: ��( r o�p r'
2. Where will demolition material be disposed? /
3. Asbestos Information: The Asbestos Removal Report must be filed with our offi efore 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 _businessstorage bldg. _Other
b) Size of structure: x
c) Number of stories: _I
d) Foundation Type: full cellar _crawl space slab
e) Foundation: will be replaced _ ill not be replaced
f) Structure(s): will be replaced will not be replaced
5. Utilities Information
a) Indicate utilities for this structure:
_Gas —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? _Yes No
c) Have all utilities been disconnected? _Yes _No
6. Signatures:
Print Name:
Signature:
Date: `�y
Town of Queensbury Building&Codes Demolition Permit 518-761-8256
Demolition Inspection Report
Office No. (518) 761-8256 Date Ins cti st received: r7 3
Queensbury Building &Code Enforcement Arrive: am Depart: am/
742 Bay Rd., Queensbury, NY/ 12804 Inspector's Init
NAME: 9 o%t ` e_ , /PERMIT NO.: aol�47
LOCATION: a9 INSPECT ON:
Comments and/or diagram
Y N N/A
Gas Shut-off /
Water Shut-off /YGGP�1 E'
Electric Disconnected ✓
Asbestos Removed/ Documentation
Property Cleaned Up and Graded
Okay to Issue Certificate of Compliance
CK�
7712 Demolition Inspection Reportit q
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