8294 BUILDING PERMIT
TOWN OF QUEENSBURY
No. A 2 9 4 _
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Derek Clark
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OWNER of property located at Lot 157 Peggy Ann Road
Street,Road or Ave. n
Section 4 Lane nes u viszon },
in the Town of Queensbury,To Construct or place a One Family 1r Dwelling
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at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
2. CONTRACTOR or BUILDERS Name
Gary Baker Construction o
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3. CONTRACTOR or BUILDER'S Address „0 v
Warrensburg, New York 12885 a, ro
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4. ARCHITECT'S NamenC
Epic Designs/Edward J. Eppich
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5. ARCHITECT'S Address
P. O. Box 996 of
Glens Falls, New York
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6. TYPE of Construction—(Pleas indicate by X)
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)Wood Frame 1 !Masonry 1 ►Steel ( 1
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7. PLANS and Specifications O
2614"x5918" per plot plan, specifications and
No. application submitted including two-car attached
garage and sewage system.
8. Proposed Use
One-Family Dwelling 0
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$5. 00 C/O Paid
15. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES July 1 1984 •
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llf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 2R4-h Day of December 1983 ID.,
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SIGNED BY �•
� �B for the Town of Queensbury tq
Building and Zoning Inspector �►+