RC-0127-2021 �. Office Use Only
HOME INSPECTION Permit#: QC •��Z.�' 4
APPLICATION Permit Fee:$ 110'
Town of Quccnsbury z,
Invoice:#:
742 Bay Road, Queensbury, NY 12804
P: 518-761-8256 www.aueensburV.net
CONTACT INFORMATION:
• Applicant:
Name(s): City of Glens Falls - Office of Community Development
Mailing Address, C/S/Z: _42 Ridge Street,,Second Floor, Glens Falls, NY 12801
Cell Phone: 5( 18 ) 390-0944 Land Line: ( 518 ) 761-3833
Email: i.thatcher@ctmale.com -on behalf of the City of Glens Falls
• Agent:
A_gent:
Name Scott Warden - Howard Hanna Contact Scott for access to the house
Mailing Address, C/S/Z: N/A
Cell Phone: 5( 18 )_598-9387 _ Land Line: � )
Email: scottwarden@howardhanna.com
• Proposed Owner(s):
Name(s): Edwin Waters, Jr.
Mailing Address, C/S/Z: 99 Warren Street,Apt 2, Glens Falls, NY
Cell Phone: _( 518 )232-1921 Land Line:
Email: edw268880@gmaii.com
MAR 19 2021
• Property Location: TOWN OF QUEENSBURY
BUILDING&CODES
Street Address: 51 Michigan Avenue
Tax ID: 308.12-2-40
Contact Person for any questions regarding this project: See above for City of Glens Falls
Cell Phone: _(518 ) 390-0944 Land Line: _( )
Email: j.thatcher@ctmale.com -on behalf of the City of Glens Falls
Home Inspection Application March 2021