2006-090 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060090 Application Number: A20060090
Tax Map No: 523400-308-014-0001-052-000-0000
Permission is hereby granted to: ANGEL LEWIS
Nor property located at: 183 PITCHER Rd
in the'Down 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 NY S Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ARC COMMUNITIES 14, LLC
900 Demolition
PO BOX 790830 Total Value
SAN ANTONIO, TX 78279-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2006-090
DEMOLITON OF 14' X 70' MOBILE HOME
$20.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Tuesday, March 20, 2007
(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 7Quee ury /1 o day, March 20, 2006
ti[C;NGll BYfor the Town of Queensbury.
Director of Building&Co Enforcement
Vwlut No.n
Application for Demolition Permit `',Y,� Paid
Building& Codes Office—Town of Queensbury 742 Bay Road Queensburpf,NY 12804 s::
(518)761-8256 Notes:,
Instructions/Requirements for a permit:
Fill in all applicable spaces and submit two(2)plot plans,drawn to scale,showing lot boundaries with dimensions and adjacent roads J streets.
Show all existing structures on the property and indicate which are to be demolished. Indicate on the plot plan the location of all utilities.
1.
— 0 POrso pWitsible for
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Fax
2. Location of demolition: E) 3. Tax Map No. A ��
4. Where will demolition material be disposed or. C-C,L4�r Sn
-
5. Asbestos Information ��_w
A copy of Asbestos Removal Report Must be filed with our office before demolition begins.
a. Is there any asbestos within the building to be demolished? 0 Yes RT'No
If YES, our office needs the following information;
b. Name of firm removing asbestos:
C. License number of firm:
d. Indicate location where asbestos material will be disposed
6. Structure Information
a. [Residence;
cate which structure(s)will be demolished:
F-Igarage; F-Istorage building; E]business; Mother
b. Size of structure: __J_J_ft.by lo ft.
C. Number of stories I
d. Foundation type: ❑full cellar; Elcrawl space; ❑slab
e. Foundation: ❑will be removed; ❑will not be removed
f. Structure(s): ❑will be replaced; F-1will not be replaced
7. Utilities Information
Indicate utilities for this structure:
Dgas electric Elpropane Flonsite well-water pump
4®public water Fjpublic sewer
Have you notified the Town Water Dept. f public water and public sewer disonnect? f_jYes EjfTo
P ' 917
Have all utilities been disconnected? L24f'es F_]No
Signature of Applicant: 7
Date: ��_'
FINAL INSPECTION REPORT
MOBILE / MODULAR
Town of Queensbury
Building & Code Enforcement
742 Bay Road
Queensbury, NY 12804 �P)IvL-
(518) 761-8256
ARRIVE:q,16 DEPART: INSP:
DATE INSPECTION REQUEST RECEIVED:
NAME4�1` k(
LOCATION: 7!� ( 'C `� � "` ,{°r 6e
DATE: C ' PERMIT rvCSU('51
MOBILE HOME MODULAR HOME
FOOTINGS _ FOUNDATION _ BACKFILL_ FRAMING_
N/A YES NO
1. foundation support, pier spacing
per manuf. ........................
—2. anchoring per manuf. ............... _
3. water line shut off ...................
4. sewer line support a 4 feet .......
5. heating crossover (dblewide) off grd. — — —
6. dryer vented outside ......................
7. skirting ventilated .................... —_
8. hot water relief valve piping outside — — —
9. deck, porches, steps, railing ........
10. furnace/hot water operating ........
11. garage fire proofing .................. — — —
12. door closers ........................... — — —
13. plumbing fixture ...................... —_
14. foundation insulation (if appl.)...... — — —
15. smoke detectors .......................
16. final electrical ........................ — — —
17. variance required ..................... — — —
18. data plate okay ....................... —_
19. mobile HUD seal okay ..............
Model # Serial#
Manufacturer
Date of Manufacturer
OKAY TO ISSUE YES NO
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