96-645 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 96645
TAX MAP NO. 8. -5-17 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LA RAIA, JOSEPH & RITA
OWNER of property located at 219 ASSEMBLY POINT Street, Road or Ave.
in the Town of Queensbury,To Construct or place a DEMOLITION OF RESIDENCE
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
219 ASSEMBLY POINT RD
2. CONTRACTOR or BUI LDER'S Name
CET CONSTRUCTION
3. CONTRACTOR or BUILDER'S Address
3453 LAKE SHORE DRIVE
LAKE GEORGE. NY 12845
4. ARCHITECT'S Tme
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
DEMOLITION
( )Wood Frame ( )Masonry ( )Steel ( )
7. PLANS and Specifications
DEMOLITION OF RESIDENCE AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
DEMOLITION OF RESIDENCE
$ 20 PERMIT FEE PAID —THIS PERMIT EXPIRES October 21 19 98
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 21 Day of October 19 96
SIGNED BY AJIP—S+4 for the Town of Queensbury
Building and Zoning lnspecWc
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT
Permit/No.
Instructions for completing the application Date: /0
Fee Paid:,,41(') , ���'✓
1. All applicable spaces are to be completed.
2. Two plot plans are to be submitted, drawn to scale, showing:
a. lot boundaries, with dimensions and adjacent roads and streets.
b. all existing structures, indicating which are to be removed.
C. location of all utilities.
3. Fee submitted per current fee schedule.`
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Owner of property: a,1k1W f am 4g6,0/.y Property Location:
Mailing Address: 4 avf Z*KF— &Vf>_ Tax Map No. section � , Block ,Lot
Person responsible for work: �A�.M,nvGrl®(d Telephone No. a^2-30
Mailing Address: 6 - t; -
zwrele e Vim. o4,�6' '
Where will demolition material be disposed oV
Is there any asbestos within building to be demolished? Yes / No 1°
If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of:
NAME OF FIRM LICENSE NUMBER
LOCATION WHERE ASBESTOS WILL BE DISPOSED
A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED WITH THIS DEPARTMENT BEFORE DEMOLITION BEGINS.
The following building(s) located on property described above are to be removed:
Previous use of building (circle one) residence - garage storage business other
Have all utilities been disconnected? gas electric , propane , water
Size of building(s):
1. ft. by '�T ft. Location on property C k&y1F 1r 1
2. ft. by ft. Location on property
3. Number of stories: I
4. Foundation type(circle one): full cellar crawl space slab 'I1 2S
Foundation will REMAIN BE REMOVED ►�
5. Another structure WILL 1/ WILL NOT , replace this building.
NOTES:
Signature of Applicant:
owner. ner's a t chitcct, contractor
IGri, Z"
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