8167 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8167
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Daniel DeChck
OWNER of property located at Lot 3 Tina Lane Street,Road or Ave, d
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in the Town of Queensbury,To Construct or place a One—Family pwea .1 ing M'
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Tow of Queensbury Building and Zoning Ordinance. Cy
1. OWNER'S Address is
22 Nor hway Lane �•
Glens alls, New York x
2. CONTRACTOR or BUI LDER'S Name
same
3. CONTRACTOR or BUILDER'S Address
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same w
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4. ARCHITECT'S Name '
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5. ARCHITECT'S Address M
6. TYPE of Construction—(Please indicate by X)
IK)Wood Frarne ( )Masonry !I, ( )Steel ( 1
7. PLANS and Specifications
26'x30� per plat, plan, specifications and
No. application submitted including sewage system. o
8. Proposed Use
One-Family Dwelling
$5. 00 C/O Paid
$91. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 1 19 84
(If a longer period is required'an appiicaY n for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.) W
Dated at the Town of Queensbury this 14, Day
/ooff October_ 19 83
SIGNED BY 4 tq' for the Town of Queensbury
Suit ing and Zoning Inspector
C/O Paid
CERTIFICATE OF OC .JPA CY x
OWN OF ENSBURY �, x
WARREN COUPtTY, NEW YORK
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This is to certify that work req ,ested to be done as shown by Permit No. 8167
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has been completed.
This structure may be occupied as a _- One—Family. Dwelling
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Location Lot 3 Tina Lane
Owner Daniel De hick ##
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By Order Town Board
TOWN OF QUR$NSBURY
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