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2000-610 TOWN OF QUEENSBURY QL 742 Bay Road Queensbury, NY 1 2 804-5 90 2 (518) 761 -8201 Community Development - Building & Codes (518) 761 -8256 BUILDING PERMIT Permit Number: P20000610 Application Number; A20000610 Tax Map No: 523400- 1 11-000-0001 -006-000-0000 Permission is hereby granted to: GEORGE ROZAKIS Owner of property located at: 404 DIX Ave in the Town of Queensbury, to construct or place a Demolition 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 Cedes and the Queensbury Zoning Ordinance, Owner Address: GEORGE ROZAKIS 404 DIX Ave QUEENSBURY, NY 12804 Contractor or Builder's Name 1 Address Electrical Inspection Agency Type of Construction: Demolition Value : S Plans & Specifications DEMOLITION OF RESIDENCE DUE TO FIRE DAMAGE AS PER APPLICATION $20.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday, August 16, 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 the Town f Que sbu , ed e d ust 16, 2000 SIGNED BY for the Town of Queensbury. Director of Building & Code Enforcement TOWN OF QUEENSBURY 742 Bay Road Queensbury, N.Y. 12804-9725 Application for DEMOLITION PERMIT Permit No R C1QD- 6 I O Instructions for completing the application Date: 0 /6 O o Fee Paid: X90 O b 1. All applicable spaces are to be completed. 2. Two plot plans are to be submitted, drawn to scale, showing: a. lot boundaries, with dimensions and adjacent roads and streets. b. all existing structures, indicating which are to be removed. C. location of all utilities. 3. Fee submitted per current fee schedule. rhvner of property: ti -CZW 6^^e•= f~ O�-�� rj Property Location., _ _ © � f/ � `�- A Mailing .Address: • _ % Jt`� ,+' " 'J "Fax Map No. Section � ��, Block �, Lot - Person responsible for work: e ! Teleptme No. Mailing Address: Where will demolition material be disposed of? is there any asbestos within building to be demolished? Yes I No If YES, name of firm removing asbestos from structure, license number, and where asbestos will be disposed of: NAME OF FIRM UCENSE NUMBER LACAMON WI—MAE ASBESTOS WILL BE DISPOSED * A COPY OF ASBESTOS REMOVAL REPORT MUST BE FILED VMM THIS DEPARTMENT BEFORE DEMOL.MON BEGINS. The following buildings) located on property described above are to be removed: Previous use of building (circle residenceD garage storage business other Have all utilities been disconnected? gas , electric !'` , propane water Size of building(s): I . t. by ft. Location on property 2. ft. by ft. Location on property 3. Number of stories: 4. Foundation type (circle one) ! cellar crawl space slab Foundation will REMAIN BE REMOVED S. Another structure WILL WILL NOT , replace this building. NOTES: Signature of Applicant: ow"cr, owncr'a agent, arahit..:ct, contractor TOWN OF QUEENSBURY NT BUILDING S CODE ENFORCEMENT �.. 742 BAY ROAD QUEENSSURY NY 12604 (518) 761-8256 ARRIVE : DEPART : IN P !FINAL INSPECTION REP NG (!hotel, mot apt, Complex) DATE INSPECTION REQUEST RECEIVED : ! F r NAME LOCATION DATE PERMIT TYPE OF STRUCTURE FOOTINGS BACKFILL� FRAMING LUMBING� INSULATION f)► TES NO CFIIMNEYI " 8 " VENT/}I.EIGHT -- PLUMBING VENT/FIXTURES ROOFING XTERIO FINIS HEATINGJHOT WATER ,�� ELIEF VALVES I F OORB FOUND I.NS CATION INTERIOR STAIRS / kAILINGS STOCKROOM ENC OS RE _ F=IRElDEMISE WALLS PENETRATION FIRE DAMPERS CEILING FIRE STOPPING I FIRE DOORS/CLOSERS EXIT DOOR S ARDWARE EXIT STAIRS /RAILS � PLATFORM ELEVATOR --• HAND C P D ACCESS IfANDICAPPED BATHS HANDICAPPED PARKING FINAL LE TRIO L SITE PLAN V RI CE E - FINAL SURVEY PLOT PLAN IF RE `ti s �s __ -- -- --- _ s __ - 1�I1 Aug (3 2000