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2004-952 TOWN OF QUEENSBURY 742 Bay Road,_Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20040952 Application Number: A20040952 Tax Map No: 523400-309-011-0002-022-000-0000 Permission is hereby granted to: MONICA RICKF,TSON For property located at: 16 LUZERNE Rd 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: MONICA RICKETSON Demolition 8876�STATE ROUTE 40 Total Value FORT ANN,'NY 12827-9671 Contractor or Builder's Name /Address Electrical Inspection Agency Plans&Specifications 2004-952 DEMOLITION OF SINGLE FAMILY DWELLING $20.00 PERMIT FEE PAID-THIS,PERMIT EXPIRES: Saturday, December 10, 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 Queensbury; Friday, December 10, 2004 SIGNED BY 4 for the Town of Queensbury. uil g nforcement Pernut Q0 1114 Fee Paid V !Application for Demolition PWhLit Building&Codes Office-Town of Queensbury 742 Bay Road Quy Y (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. �3 �9 :A licant ... Qrwner M.�.. _ _ �. ._ P�r4Res onsAble for,Work T Name. rL,7(5/V G 15- r�ddre�� PhoYae 7T—( i Fa5,,. 2. Location of demolition: 1 (o L_U7-e�c fv 3. Tax Map No; `� � I ( —J R_ � 4. Where will demolition material be disposed of? �/�S 5. Asbestos Information A copy of Asbestos Reinoval.Report must be filed with our office before demolition begins. �+f a. Is there any asbestos within the building to be demolished? ❑ Yes i No , 0, r� If YES, our office needs the following information: b. Name of firm removing asbestos: C. License number of firm: d. Indicate location where asbestos material will be disposed 6. Structure Information a. Indic which structure(s)will be demolished: esidence; ❑garage; ❑storage building; ❑business; ❑other b. Size of structure: ft.by ft. � C. Number of stories d. Foundation type: []full cellar; crawl space; ❑slab e. Foundation: ❑will be removed; ❑will not be removed ill be f. Structure(s): replaced; ❑will not be replaced -�`- - ,/1%,uf 7. Utilities Information Indicate utilities;eis th ructure:lectric ❑propane ❑onsite well-water pump Lter ❑public sewer Have you notified the Town Water Dept. for public water and public sewer disonnect? ZYes [ONo Have all utilities been disconnected? ❑Yes ❑No Signature of Applicant: �� Date: 7 � PP - Queensbury Building & Code Enforcement - Residential Final Inspection Office No. (518)761-8256 Arrive: ��.2! am/pm , Depart: am/pm Date Inspecti-an request received: Inspector's Initials: 20 - , ,�L NAME: PERMIT#: LOCATION: DATE: TYPE OF STRUCT Comments Y N N/A Chimney Ht./"B"Vent/Direct Vent Location Fresh Air Intake 3 inch Plumb Vent through roof minimum 6" Roof Complete/Exterior Finish Complete (�✓Iv\ Guard 30 in.or more @ stairs,decks,patios Guard at stairwell at 34 in. or more Guard at deck,porches 36 in. or more Exterior Finish Complete Interior/Exterior Railings 34 in.to 38 in. Platform at all exterior doors Interior Handrails stairs 2 or more risers Enclosed Stairs Sheetrock Underside minimum '/z" Gypsum Grade away from foundation 6 in.with 10 ft. Handrail Termination at Newell Post or Wall 6 inch clearance to sill plate Gas Valve shut-off exposed/regulator 18"above grade Gas Furnace shut-off within 30 ft.or within line of site Oil Furnace shut-off at entrance to furnace area Furnace/Hot Water Heater operating Low water shut-off boiler Relief Valves installed/Heat Trap/Water Temp 110 Interior privacy/trim/doors/main entrance 36 in. Bathroom/Kitchen watertight Safety glazing/Window in stairwells safety glazing Interior Smoke Detectors: Every level: / Every Bedroom: Outside every bedroom area: Inter Connected: / Battery backup: Carbon Monoxide Detector Bathroom Fans, if no window Plumbing fixtures Foundation insulation Floor truss,draft stopping finished basement 1,000 sf Emergency Emelgency egress below rade Basement stairs closed rise>4 inches Garage Floor Pitched Garage fireproofing/'/e hour fire door/door closer Duct work Sealed properly Gas Logs in Sealed or Glass Enclosure Attic access 30 in.x 22 in.x 30 in.(ht.)In accessible area Crawl'S aces 18"x 24"access, 1 s . ft,150 s . ft.vents `) BuildingNo./Address visible from road r� u Gil rs �;�teClk Final Electrical Site Plan /Variance required Final Survey Plot Plan �{e-- As Built Septic System/Sewer Dept.Inspection Sticker Flood Plain Certification, if required �4j // f� 474����^�� Okay to issue C/C or C/O Temporary/Permanent �,o J L:\PamW\Building&CodesUnsvection Forms\Res. Final Insp. form 2.docLast printed 2/12/04