96-565 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY 96565
TAX MAP NO. 13. -1-25 No.
WARREN COUNTY, NEW YORK
AMIRSALEH, MAHYAR & FRAN
PERMISSION is hereby granted to
CLEVERDALE RD.
OWNER of property located at 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
P. O. BOX 220
ALPINE , NJ 07620
2. CONTRACTOR or BUILDER'S Name
HOWLAND, DEAN JR
3. CONTRACTOR or BUILDER'S Address
28 HUNTER LANE
QUEENSBURY, NY 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
DEMOLITION
( )Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
DEMC►39ITION OF RESIDENCE AS PER APPLICATION
8. Proposed Use
DEMOLITION OF RESIDENCE
$ 20 PERMIT FEE PAID —THIS PERMIT EXPIRES September 1719 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 17 Day of September 19 96
SIGNED BY for the Town of Queensbury
Building and Zoni spector
TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
•
Application for DEMOLITION PERMIT �
Permit No. � (-C
Instructions for completing the application Date: —
Fee Paid:
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.
•a\flb. all existing structures, indicating which are to be removed. 7 ,.,. r
c. location of all utilities. r `' '
3. Fee submitted per current fee schedule. SEP 11 1996
d, oPY
Owner of property: AJ,f,Q /&,jit, 0�.�;ism % Property Location: `�j 4'
Mailing Address: }P. .Ro 22c) Tax Map No. Section i Bt! r ,ter
Person responsible for work: /247,3 its LrRjrf Ii Telephone No. '/93-6(017
Mailing Address: Z F //),,,5' G.f ee
Where will demolition material be disposed of?
Is there any asbestos within building to be demolished? Yes / No X.
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 X. , propane , water
Size of building(s):
1. hr, ft. by %. ft. Location on property /1Ja&i‘ .rsf ,��
2. ft. by ft. Location on property
3. Number of stories: 2
4. Foundation type (circle one): full cellar awl s ac slab
Foundation will REMAIN REMOVED
5. Another structure WILL WILL NO , replace this building.
NOTES:
Signature of Applicant: �.yLrf y� 2 e /
owner owner's a an 'a ch( itec�� 1, onlractor
111W
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
A1 742 BAY ROAD
QUEENSBURY NY 12804
( (518) 761-8256
ARRIVE: DEPART: Ij1 INSP: d4
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INSPECTION REQUEST RECEIVED:
NAME A�\,l(!2�' L.6- /•
LOCATION /CLG-lfe-�� �'((dO�C,C�'
DATE E/ 5/ 98 P MIT H , r 365--
TYPE OF STRUCTURE 41// d
FOOTINGS FOUNDATION _ BACKFILL FRAMING
ROUGH PLUMBING _ SEPTIC INSULA ION
FINAL ELECTRICAL WOOUSTOVE OR FI EPLACE
NIA YES NO
CHIMNEY HEIGHT/B VENT/HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/• :ILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY\DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGH
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES / •
FOUNDATION INSULd/ION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRI AL
SITE PLAN/VARIANCE REO. �—
FINAL SURVEY/PLOT.PL
OK TO ISSUE/C 0 0 C C' ,�
'��/� TOWN OF QUEENSBURY fl&
. �i.,Y.( BUILDING & CODE ENFORCEMENT
wM4 Y 742 BAY ROAD
``� ,, `� QUEENSBURY NY 12804
(' (518) 761-8256
ARRIVE: r;(2 DEPART: INSP: (4- _
FINAL INSPECTION REPORT - RESIDENTIAL
DATE INS 7CTION REQUEST RECEIVED: --' _-
NAME VC-\\ �,L.-PN 10 CN V
LOCATION
DATE N 1 `" _ PERW H 6
TYPE OF STRUCTURE () UKlSi s)CfVL(g
FOOTINGS FOUNDATION BACKFILL _ FRAMING
ROUGH PLUMBING SEPTIC __ INSULATION
FINAL ELECTRICA WOODSTOVE OR FIREPLACE
N/A ' YES NO
CHIMNEY HEIGHT B VE HEIGHT
PLUMBING VENT
ROOFING
EXTERIOR FINISH
DECK/PORCH/STEPS/RAILINGS
RELIEF VALVES
FURNACE/HOT WATER OPERATING
INTERIOR TRIM/PRIVACY DOORS
FINISH FLOORS:
BATH/KITCHEN WATERTIGHT
OTHER FLOORS SWEEPABLE
OTHER FLOORS CARPETED
STAIR CLEARANCE/RAILINGS
SMOKE DETECTORS
BATHROOM FANS
PLUMBING FIXTURES
FOUNDATION INSULATION
GARAGE FIRE PROOFING
DOOR CLOSERS
FINAL ELECTRICAL
SITE PLAN/VARIANCE REQ.
FINAL SURVEY PLOT PLAN / _
OK TO ISSUE C/O OR•C
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�F�6 etrfiY AP REFERENCES
4I ) -cO 14°1'.Gof lands of Mary Esth
Dtd. 9/21/1981-by Coulter.
J .I •Man of Rinlev' s Point