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BUILDING DEPARTMENT Town of AuroraNillage of East Aurora 575 Oakwood Avenue, East Aurora, NY 14052 Phone: (716)652-7591 APPLICATION FOR DEMOLITION/SUBSTANTIAL MODIFICATION Property Owner Name: fr ic k.. eCLsSo<.J Phone #: 7 / &> 5" q1J.. - 6 ~ 0 Property Address: qO SY ·F l t\ \i\r\-c' f -<--- S SBL # = - - - - - - - - - ~ - - - - . . - - - - - - - Zoning District=-----~-=--c--=------ Applicant (if not the Owner): N Phone#: 7 I b 7:5"9 Oso 8 1. Brief description of the demolition: - ~ - ~ - ~ - - , , - j - - C , \ . _ ·_ftA-_~._.a._._ _ _ _ _ _ _ _ _ _ _ _ __ 0 2. Size of demolition (feet): Jc width l ~ length _a_ Height DJOl9otal sq. ft. or~ Entire Building/Structure 3. Demolition Threshold (Village only): D 30% (>2,501) D 40% (1,201- 2,500) D 50% (<1,200) 4. Disconnection of services: D Water D Sewer D Electric D Gas ~ NIA 5. Asbestos Survey: D Yes D N/A - Age of Structure: _ _ _ __ 6. Water use needed for dust control: D Yes D N/A 7. General permit NYS DOT (state) or ECPW (county street/road: D Yes D N/A 8. Name of Contractor: ' tJC ~ w+~<- t.U'[e,l,rRepresentative: Ncttk,,vt Z/w\LJ,i.t( Address of Contractor: g lf q l - le> l e_ • Cot d .t V'-. tJ Y f l/ o ·5 ~ Phone#: J t l :2 !i8 o~ oS Email: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 9. Name of Asbestos Contractor: _,,___._ _ _ _ _ _ _ _ _ _ _ _Representative: _ _ _ _ _ _ _ __ Address of Contractor: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Phone#: _ _ _ _ _ _ _ _ _ _ _ _ E m a i l : - - - - - - - - - - - - - - - - - - - - - , - - - - 10. Contractor's General Liability, Workers' Compensation, and Disability Insurance Certificates with the Town of Aurora & Village of East Aurora as Certificate holder: i1'8lYes D N/A IMPORTANT • Site Plan or Survey showing lot and buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of the layout of the property must be submitted with this application. Indicate the distance to the nearest building on the adjoining lot. • A written report from a licensed exterminator regarding extermination must be submitted with the application, if applicable. • Written verification that all utilities (i.e., gas, electric, water, and sewer) have been properly shut off and disconnected must be submitted with the application. • No work may commence until an asbestos survey is completed and filed with the commissioner of the NYS Dept of Labor in accordance with the Industrial Code 56 and the rules and regulations of the Dept of Labor (submit a copy to this Dept) • Debris, including any in-ground storage tanks, must be systematically removed from the site and not allowed to pile up or cause any obstruction. • Demolition shall be carried out during daylight hours only on normal workdays. • No explosives can be used in connection with the demolition of buildings or structures unless a special permit is first obtained by the Village Board of Trustees (village). • All cellars and basements of demolished buildings or structures shall be filled in and made safe. The surface of the infill shall be level with the surrounding premises. APPLICATION IS HEREBY MADE to the Code Enforcement Officer for the issuance of a Building Permit pursuant to the NEW YORK UNIFORM FIRE PREVENTION AND BUILDING CODE for the construction of buildings, additions, and alterations, as herein described. The applicant agrees to comply with all applicable codes, laws, and regulations. The undersigned hereby certifies that all of the information contained in this application is correct and true. Owner Name: erl~Lh ~a 5So<.J Email: '60th . RC\.S5oG....~@ ) ~ ..,, Co~ (Applicant or Corp/LLC must complete the affidavit on the next page to sign as the owner's agent.) , Owner Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _ _ __