2000-045 TOWN OF QUEENSBURY.
742 Bay Road
Queensbuty, N.Y. 12804-9725
Application for DEMOLITION PEPMrr
Permit No.
Instructions for completing the application
1. All applicable spaces are to be completed. FEB 1 5 Fee Paid:
2000
2. Two plot plans are to be submitted, drawn to scale,"'Shq'y0Pg:
a. lot boundaries, with dimensions and adjacent roads and's
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JILL'41 "i ',, L OF
b. all existing structures, indicating which are to pre c. location of all utilities.
3. Fee submitted per current fee schedule.
S13-4alce r;2 tieo
Owner of pro] Y. a
Per2 Property Location: ,UeeA3_S b 90
Mailing Address: 571 Tax Map No. Section D�), Block
—,Lot
Z
Person responsible for work: �v- Telephone No.Ctd-
Mailing Address:
Where will demolition material be disposed of? �;67'_e (:::�
Is there any asbestos within budding to be demolished? Yes— I No
If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of:
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 I- , propane water
Size of building(s):
1. ft. by ft. Location on property
2. ft. by ft. Location on property
3. Number of stories:
4. Foundation type(circle one): full cellar crawl space slab
Foundation will REMAIN BE REMOVED
5. Another structure WILL Z-- WILL NOT replace this budding-
NOTES:
Signature of Applicant:
owner,ow is agent,architect, contractor
BV-I-L-DING PERMIT
Town of Queensbury, 742 Bay Load, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 2000045
TAX MAP NO. 130 . -3-29 30') r..
Permission is hereby granted to BURKE, BRUCE & JOYCE
U
Owner of property located at 2 ALLEN LANE
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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
P.O. BOX 512
GLENS FALLS, NY 12801
Contractor or Builder's Name:
Contractor or Builder's Address:'
Electrical Inspection Agency:
Type of Construction:
DEMOLITION
Plans and Specifications:
DEMOLITION OF RESIDENCE _
TO BE DEMOLISHED BY WEST GLENS FALLS FIRE DEPARTMENT
Proposed Use:
DEMOLITION OF RESIDENCE
$ 20 PEIi:M[T FEE PAID-THIS PEIt1VlIT EXPIRES February 17 2002
(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 To of Queensbury t 's 17. Day of - Februar 2000
SIGNED BY �- far the Town of Queensbury
Code Enforceinent OfficZr
76-19-1 (8/94)-29c
AimNEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATI�N. h4a 1 )tom
4111111111110 APPLICATION .FOR RESTRICTED BURNING PE MIT ��"Lj
EB 1 2000
LOCATION PERMIT NO.,
See form 76-11-3 for filing instructions ands''""'
Cif L.,;-'..-} [,B form 70-00-2 for address of office where application may be filed.
� B~I�f'i�t{�
1. N OF APPLICANT 13. LOCATION OF OPEN FIRE
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2. ADDRESS(5�et) � �� � cam, :"'7 1 �,it.) q �
3 CITY,TOWN,VILLAGE COUNTY STATE ZIP CQDE
a lei W A.z(ee � A) k ? 3 to g
4. PERSON SIGNING APPLICATION 5. DATE
OF APPLICATION 14. TYPE AND MATERIAL TO BE BURNED
1.❑Employee of Applicant 2.KApplicant
6. N
15. METHOD OF STARTING FIRE(See conditions on reverse side)
7. TITLE
8. NAME 9F PERSON SUPERVISING OPEN BURNING 9. TE4E HONE 16. REASONS FOR NECESSITATING BURNING OF MATERIAL
PeAe {-{2215 i.� 't io
�F 'r ee/l7Y�v-a0,r
10. ADDRESS{Street)
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1. CITY, TOWN, VILLAGE COUNTY STATE Flzalp
EXPECTED COMPLETION DATEODEVeeA S 6..{,� .t;Af ke-Q A) � O . AM ROUNT OF TIME REQUIRED FOR RESTR CT D P N BURNING ANIS
12. TYPE OF RESTRICTED BURNING PROPOSED _ ( ec 4-4 .9-1
1.❑Residential on-site 2.❑Land clearing + ?e�T't.1/�,/pC1j
3.❑Agricuhural (Fire town or town in fire district) .S �
4.0 Designated burning area serving a county,city, town'or village 1
5. Designated area for burning of toxic,explosive or 18, EMERGENCY METHOD FOR EXTINGUISHING FIRE(Describe)
d rous materials ] c /, �•
6_L�Otherge(Describe) r- , } Z+'4'�O ' R2 C3.�J` 2ue�j `� �j �2k1 S { �O '� i IQ e-
I AGREE TO ABIDE BY ALL CONDITIONS OF THE PERMIT. (See Reverse Side and Below)
DATE APPLICA lGNATURE TITLE t'L� �COAJ _
` -7' X
AGENCY USE ONLY
19. RECOMMENDED ACTION 20. DATE 21. SIGNATURE
1.E]Approved 2.0131sapproved X
PERMIT FOR RESTRICTED BURNING
(issued pursuant to 6 NYCRR 191, 215 and-the Environmental Conservation Law)
23. DATE ISSUED 1 24. BURNING DATES PERMITTED 25. SIGNATURE OF APPROVAL 26. TITLE
X
THE FOLLOWING CONDITIONS APPLY IN ADDITION TO THOSE SPECIFIED ON THE REVERSE SIDE:
FEB 1 5 2600
TOWN
UILI4y.
REVIEWED D Y
DATE -. :
TOWN 4E QUEENSBURY BUILU NG DEPARTMENT
Based on our limited examination, Cry
compliance with our comments shall
not be construed as indtaWg the
Plans and specifications are in full
compliance with ilia code.
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