2000-150 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 0 Building Permit No. 2000150
TAX MAP NO. 6 . -1-10
Permission is hereby granted to MASCHEWSKI , KEVIN
Owner of property located at 3 ASSEMBLY PT. RD.
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 fled and
approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
PO BOX 181
LAKE GEORGE, NY 12845
Contractor or Builder's Name:
MASCHEWSKI , KEVIN
Contractor or Builder's Address:
Electrical Inspection Agency:
Type of Construction:
DEMOLITION
Plans and Specifications:
DEMOLITION OF RESIDENCE AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
DEMOLITION OF RESIDENCE
$ 20 PERMIT FEE PAID—THIS PERMIT EXPIRES Ap r i 1 4 2002
(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 Queensbury this 4 Day of Apr i 1 2 0 0 0
SIGNED BY t� '� for the Town of Queensbury
Code Enforcement Officer
742 i3ay Road
Q :c nsbur7. N.Y. 12804-9725
A71,:r ttion for DEMOLITION PERMIT
Permit No. _ ;(1Y`-L.0
Instructions for completng the application Date: - --„.)cx_ 0)
Fee Paid: -
1. All applicable spaces are:o 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. Ai
c. location of all utilities. r,P i000
3. Fee r-uhmit:ed per current tc schedule.
Owner of property: )=v�t.1 ��`a kt•
Property Location: A -t-=,E-mf3l`{ ,
Mailing Address: O. Tax Map No. Section (.1d , Block I ,Lot fa
L.6.-1)1Et=�, �
Person responsible for work: V ENI t L 1.4 .\.1/4 I Telephone No. e-PQ› le,%a&
Mailing Address: 1JA-1-1 �!''� �Cj E.
Where will demolition ;n_tee ial be disposed of? EX t"1-t 1-3.�� �.►.i�7 \t t r l ;
Is there any asbestos within building to be demolished? Yes / No Lr
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 d'. d-a are to be removed:
Previous use of building (circle o e): residence garage storage business other
Have all utilities been disconnected? gas , electric VV.'',
ge, propane , water
Size of building(s):
1. 2S' ft. by gGft. Location on property £ t-ry C'F
2. ft. by ft. Location on property
3. Number of stories: ` L
4. Foundation type (circle one): 11 cellar crawl space slab
Foundation will REMAIN BE REMOVED
5. Another structure WILL ✓ WILL NOT , replace this building.
NOTES: -.XtA.'t �� �p 1✓«ttiI
Signature of Applicant:
r. owner's agent,architect, contractor