building permit TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518) 761-8201
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Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: RC-0348-2019
Tax Map No: 295.10-2-12
Permission is hereby granted to: PGRDM, LLC
For property located at: 5 Shallow Creek RD
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
Owner Name: Phillip Russell Single Family-New $1251000.00
Owner Address: 0 Shallow Creek Total Value $1251000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Barry Patton
Plans&Specifications
Single Family Dwelling w/gas FP 1567 s.f.
Garage 470 s.f.
$ 1,445.10 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, June 10, 2020
(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 Queensbury; Tuesday, June 11, 2019
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement