2003-712 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
IOW
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20030712 Application Number: A20030712
Tax Map No: 523400-226-015-0001-036-000-0000
Permission is hereby granted to: METTVTF,R. ANTHONY& JAMIE
For property located at: 22 BAY Pky
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: STEPHEN&HELEN MARTIN
Demolition
LARAINE METIVIER Total Value
1 SHERWOOD Dr
QUEENSBURY, NY 12804
Contractor or Builder's Name /Address Electrical Inspection Agency
MCGITIRE_ RICK
NY 12804-0000
Plans&Specifications
2003-712
DEMOLITION OF SINGLE FAMILY DWELLING AS PER APPLICATION
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday, September 02, 2004
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of•ueensbury before the expiration date.)
Dated afi the T , ; of l e b ;
day, September 02, 2003
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Permit No.
D3-74
Application for Demolition Permit Fee Pa "
Building&Codes Office—Town of Queensbury 742 Bay Road Queensbury,NY 12804 ,
(518)761-8256 Notes:
Instructions/Requirements for a permit:
Fill in all applicable spaces and submit two(2)plot plans,drawn to cale,showing lot boundaries with dimensions and adjacent roads/streets.
Show all existing structures on the property and indicate which are
,to
e demolished. Indicate on the. lot plan the location of all utilities.
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2. Location of demolition: 'r' --'� 3. Tax Map No. c=. • '- /S — 3 co
4. Where will demolition material be disposed of? 6 / A"
t
5. AsbestosiInformation
.y
A copy of Asbestos Removal Report must be filed with our office before demolition begins. ;C i
a. Is there any asbestos within the building to be demolished? ❑ Yes ►i y .- N SL '
If YES, our office needs the following information: f
b. ` Name of firm removing asbestos: Y\--76'"""
c. License number of firm:
d. Indicate location where apbqstos materi 1 w it be disposed i- •
- . � 4'4 4e tt or na BJ€ �(Uk? moos G•c ost' d
6. Structure Information \, doh,,0 or ad�dlit4tC Qrj0r 0 C()mi icclivi -of
+ i
a. ndic• - which structure(s)will be demolished: WO it
esidence; ['garage; ['storage building; ❑business; Pother
b. :ize of structure: '-4-D ft.by v ft. 4
c. Number of stories I Y.,t- � eld. Foundation type: ❑full cellar; ❑crawl space; ['slab ? . Sr m e p, I lr t
e. Foundation: Elwinbe removed; ❑will not be removed i_R `L u r 1 1,,�__
f. Structure(s): pli;i?1 be replaced; ❑will not be replaced l"`' w.eVeell ---"'
7. Utilities InformationF,,.“,.j.„A,„ ,ci ce Lit,
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Indicate utilities for this structure:
gas e ectric ❑propane ❑onsite well-water pump -
❑public water public sewer
Have you notified the Town Water Dept. for public water and public sewer disonnect? ❑Yes ❑No /A-1//k"
Have all utilities been disconnected? ❑Yes ❑No
Signature of Applicant:-'-/-- t ,,�-- ' /may< -�.�_-, Date: ' ' -f7