98-558 TOWN OF QUEENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT ^S_ss
Permit No. �}
Instructions for completing the application Date:
1. All applicable spaces are to be completed. 1!"--
2. Two plot plans are to be submitted, drawn to scale, showing:
a. lot boundaries, with dimensions and adjacent roads and streets. S E? 09 6 98
b. all existing structures, indicating which are to be removed.
c. location of all utilities. %,.
3. Fee submitted per current fee schedule. t.,.� �LU>'1i= dL: _� -
Owner of property: ieg oxv Property Location: ��lcy
Mailing Address: 2�/L,E� �,���� Tax Map No. Section /6 , Block / .Lot /9
Person responsible for work: (V y� / 2 Telephone No. 1- 3 QD7
Mailing Address: 28/tv..) jam,»
�71 toyi s4v/-6/WS`2.817.4
Where will demolition material be disposed of? A4,.1/1t,J ZONd4L
Is there any asbestos within building to be demolished? Yes / No V
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:
C38v�.�
Previous use of building (circle one) residence garage storage business other
Have all utilities been disconnected?8 gas , electric , propane , water
Size of building(s):
3 82. ($d y 3z fY .soorx/
1. 4!d ft. by 2' ft. Location on property Aez/71ve4,7 Co,2.4xz t.
2. ey ft. by /6 ft. Location on property Soz.oz•u' .-n rtr
3. Number of stories: 41L/
4. Foundation type(circle one): (ll!el? �r slab
Foundation will REMAIN BE REMOVED )X
5. Another structure WILL WILL NOT X , replace this building.
NOTES: 17:4K.zV, i
Signature of Applicant:
owner, owner's agent,architec, contractor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT `
531 BAY ROAD
fib QUEENSBURY NY 12804
(518)745-4447
4011110.
ARRIVE: DEPART: INSP: L
FINAL INSPECTION REPO*,
-01112 lEY+�Er
DATE INSPECTION REQUEST RECEIVED:
NAME M A VA0 13\(
LOCATION V EEIFLEE. p OA(7)
DATE Z 5"-Q I9, PERMIT # EifiJ
TYPE OF STRUCTURE UCT-1r OF CAMQ_J
FOOTINGS BACKFILL_ FRAMING_ PLUMBING_
INSULATION
N/A YES NO
CHIMNEY/"B" VENT/HEIGHT
PLUMBING VENT/FIXTURES
ROOFING
EXTERIOR FINISH
HEATING/HOT WATER
RELIEF VALVES \
FLOORS
FOUNDATION INSULATIO
INTERIOR STAIRS/RAILINGS
STOCKROOM ENCLOSURE
FIRE/DEMISE WALLS PENET• ,TION
FIRE DAMPERS
CEILING FIRE STOPPING
FIRE DOORS/CLOSERS
EXIT DOOR HARDWARE
EXIT STAIRS/RAILS
PLATFORM/ELEVATOR
HANDICAPPED ACCESS
HANDICAPPED BATHS
HANDICAPPED PARKING
FINAL ELECTRICAL
SITE PLAN/VARIANCE REO.
FINAL SURVEY PLOT PLAN, IFIF REQ
OK TO ICE"^ / -
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