2004-747 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20040747 Application Number: A20040747
Tax Map No: 523400-308-006-0001-070-000-0000
Permission is hereby granted to: ANDREW K BARBARA DARNi,F,Y JR
For property located at: WARREN Ln
in die 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: ANDREW DARNLEY JR
10 WARREN Ln Demolition
Total Value
QUEENSBURY, NY 12804-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2004-747
DEMOLITION OF SFD
$20.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, September 30, 2005
(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 of sbury; Thursday, September 30, 2004
SIGNED BY r for the Town of Queensbury.
Director of Building&Co of ment
Perrnit N c —? 7
1�pplication for Demolition Permit Fee Paid
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 scale,showing lot boundaries with dimensions and adjacent roads/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.
� 1. .S he s i
'�WTt�r ,. perSol7.RES. ORS1blCfOr, OT1f. +.,.
d e f
=_Address
W3
k
r
2. Location of demolition: ��-�-+`Q-it 3.��aX Map No.
4. Where will demolition material be disposed or
5. Asbestos Information
A copy of Asbestos Refnoval Report must be filed with our office before demolition begins.
a. Is there any asbestos within the building to be demolished? ❑ Yes �(J]No
If YES, our office needs the following information:
b. Name of firm removing asbestos:
G. License number of firm:
d. Indicate location where asbestos material will be disposed
6. Structure Information
a. Indicate which structure(s)will be demolished:
DlGidence; ❑garage; ❑storage building; ❑business; ❑other
b. Size of structure: z S ft.by 'Z S— ft.
C. Number of stories /
d. Foundation type: ❑fill liar; crawl space; ❑slab
e. Foundation: will be removed; ❑will not be removed
f. Structure(s): ❑will be replaced; ❑will not be replaced
7. Utilities Information
Indicate utilities for this structure:
❑gas ❑electric ❑propane0-on-site well-water pump
❑public water ❑ ublic sewer
Have you notifie the Town Water Dept. f r public water and public sewer disonnect? ❑Yes []No
Have all utilities een isconne ted? es ❑No
Signature of Applican . Date: 2 g _
xeW'ULJd;°Id
-3WOS 011ON
ECC VED
"I h ve seen or observe ,or bel' ve I saw evidence of, 5EP 2 O
all je is such as hou es, well ,trees,fences,etc., 2004
sho n n thi docum t. I'a represent that I have T NN OF QUEENSBt1Ry'
per n Ily me iured he d' ances set forth on the diagram" JIWING AND CODE
1 ATW DATE
WWL 011a3s ■00£
No71ve o00L
1
XO9
,ram, Nounetasia
W.;R k I A
h
AVAVnasN33nb
ROM
.OS-C MUM U M o f
�
'NP�3'lN2iV01�QNV
3NVIN NUVM �, ��