2000-409 BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 0 Building Permit No. 2000409
TAX MAP NO. 73.-1-21
Permission is hereby granted to TRA—TOM DEVELOPMENT, INC
Owner of property located at FOX FARM ROAD
in the Town of Queensbury,to construct or place a DEMOLITION OF RESIDENCE AND GARAGE
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:
36 FIELD STONE DRIVE
GANSEVOORT-, NY 12831- _
Contractor or Builder's Name:
GALUSHA.-CONSTRUCTION
Contractor or Builder's Address?
Electrical Inspection Agency:
Type of Construction:
DEMOL TIONgki
Plans and Specifications:
L 5,-,�PER,APPLICAT:IQN;;j:
Proposed Use:
DEMOLITION OF-- RES-IDENCE,;-.'
2.01
it'll-
PERMIT FEE PAID—TfHS PERNIIT'tj�P5�S'
(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.)
,t-
k jrwi 2z a
s �A'D Dated at the Town of Qaeensbur�.tbii! ay of
SIGNED BY j for the Town of Queensbury
Code Enforcement Officer
TOWN OF QULENSBURY
742 Bay Road
Queensbury, N.Y. 12804-9725
Application for DEMOLITION PERMIT
Permit N . �1
Instructions for completing the application Date: &11
Fee Paid:
1. All applicable spaces are to be completed. Ell
�p
2. Two plot plans are to be submitted, drawn to scale, �g: ,
a. lot boundaries, with dimensions and adjacent roa stee# „
b. all existing structures, indicating which a�A0e removed. Q
c. location of all utilities.
3. Fee submitted per current fee schedule. t�� Jti y
Owner of property: �024A — (0,-"L Q� C c� k Property Location; V E3 k �l1 c7a
Mailing Address: 36 R,5(d 9 Delty'C Tax Map No. Seetionu_, Block
Person responsible for work: Telephone No.
Mailing Address:
01
Where will demolition material be disposed oV _ M 6 f kO C-A)0 L(LO Ct--04 w
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 arage storage business other
Have all utilities been disconnected? gas , electric , propane , water
Size of building((s°)):
1. '�S ft. by 2`; ft. Location on property
2. 10 ft. by 6$ ft. Location on property
3. Number of stories: le
4. Foundation type (circle one): full cellar crawl space slab
Foundation will REMAIN BE REMOVED
5. Another structure WILL WILL NOT , replace this building.
NOTES:
Signature of Applican-
wner,owner's agent,architect, contractor
FOX FARM ROAD --
S 65'10'45" E"Z
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STATE of NEW YORK
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