2014-171 TOWN OF QUEENSBURY
FON 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20140171 Application Number: A20140171
Tax Map No: 523400-296-019-0001-011-000-0000
Permission is hereby granted to: GARY W SAMPSON
For property located at: 30 COUNTRY CLUB 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 Value
Owner Address: GARY W SAMPSON Garage Detached $8,000.00
PETRONELLE M.E. SAMPSON Total Value
30 COUNTRY CLUB Rd $8,000.00
QUEENSBURY NY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
2014-171
Garage Detached 458 sq. ft Area Var. 50-2014 Approved for second garage on parcel.
$72.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 05,2015
(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 Quee bury /rue. . yi : st 05,2014
SIGNED BY r' for the Town of Queensbury.
Director of Building&Code Enforcement