2011-512 TOWN OF QUEENSBURY
742 BayRoad,Queensbury,NY 12804-5902 (518) 761-8201
Q rY,
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20110512 Date Issued: Wednesday, February 20, 2013
This is to certify that work requested to be done as shown by Permit Number P20110512
has been completed.
Tax Map Number: 523400-295-015-0001-029-000-0000
Location: 29 OWEN Ave
Owner: CRAIG & JILL EMBLIDGE
Applicant: CRAIG & JILL EMBLIDGE
This structure may be occupied as a:
Demolition
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the � 1F/
property owner of the responsibility for compliance with Site Plan, ;
Variance, or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
100
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20110512 Application Number: A20110512
Tax Map No: 523400-295-015-0001-029-000-0000
Permission is hereby granted to: CRAIG&JILL EMBLIDGE
For property located at 29 OWEN Ave
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: CRAIG&JILL EMBLIDGE
29 OWEN Ave Demolition
QUEENSBURY,N.Y. 12804 Total Value
Contractor or Builder's Name/Address Electrical Inspection Agency
ANTHONY CATONE
NY 12804-0000
Plans&Specifications
BP 2011-512 Demolition of existing workshop/shed due to storm damage from Hurricaine Irene yr.
2011
$30.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Sunday,October 14,2012
(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 eens ; Vida ,October-14,2011
SIGNED BY o! for the Town of Queensbury.
Director of Building&Code Enforcement
/ /1. \_..9 OFFICE USE ONLY; ;
TAX MAP NO. S-t ,3 ' ( PERMIT N0. , 3��'�, FEE PAID
Permission is hereby granted to the above named Applicant to demolish the building(s) s
described herein as set forth in the Application below.
Director of Building&Codes Date t ,y 5
APPLICATION FOR DEMOLITION PERMIT:
Fill in 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. / , L -
APPLICANT/BUILDER: ( OWNER: j_\\ a-- rs4\��JSe
ADDRESS: y ADDRESS: .2`71
PHONE NOS. 3(o/ - C54 3`t PHONE:
PERSON RESPONSIBLE FOR WORK: \NevsyN_/ PHONE:
LOCATION OF DEMOLITION: ct 1 k-c - Qcr t,.y v\ o Ss ��ct o- v� fc
WHERE WILL DEMOLITION MATERIAL BE DISPOSED? tv.f3\-r — e r-L ,r�S
ASBESTOS INFORMATION:
✓ Is there any asbestos within the building to be demolished? YES NO (/
✓ If YES, our office needs the following information:
o Name of firm removing the asbestos:
o License number of firm:
o Indicate where the asbestos material will be disposed:
NOTE:A copy of Asbestos Removal Report must be filed with our office before demolition begins.
STRUCTURE INFORMATION:
✓ Indicate which structure(s)will be demolished: RESIDENCE GARAGE I BUSINESS
STORAGE BLDG. OTHER
✓ Size of structure: /Z X -1-1_
✓ Number of stories: /
✓ Foundation type: FULL CELLAR "CRAWL SPACE SLAB
✓ Foundation: WILL BE REPLACED 1/ ILL NOT BE REPLACED
✓ Structures(s): WILL BE REPLACED ✓WILL NOT BE REPLACED
UTILITIES INFORMATION:
✓ Indicate utilities for this structure: GAS ELECTRIC 7 PROPANE
PUBLIC WATER ONSITE WELL-WATER PUMP PUBLIC SEWER
Have you notified the Town Water Dept. for public water and public sewer disconnect? YES NO Lz
Demolition Inspection Report
Office No. (518) 761-8256 Date Inspection re• - - - e.:
Queensbury Building &Code Enforcement Arrive: r` ,! ., 9-71*-,art: am/pm
742 Bay Rd., Queensbury, NY 12804 Inspector's Initials�0. r
NAME: �I , A ', PER .:
LOCATION: 40 i J G INSPECT ON: 7 - 16-
Comments
6Comments and/or diagram
Y N N/A
Gas Shut-off
Water Shut-off
Electric Disconnected
Asbestos Removed/ Documentation
Property Leaned Up and Graded
Okay to Issue Certificate of Compliance
Demolition Inspection Report 11 27 12
L g N
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PLOT PLAN
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\.. , a Show all existing and proposed structures. Indicate the setbacks of all structures and buildings from all property lines.
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Town of Queensbury * Community Development Office * 742 Bay Road, Queensbury NY 12804