8808 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8808
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Walter Dombek
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OWNER of property located at Lot 15 Stephanie Lane (St. No. 29) Street,Road or Ave. rt
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in the Town of Queensbury,To Construct or place a One—Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and C7
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is P. 0. Box 649 x'
Lake George, New York
2. CONTRACTOR or BUI LDER'S Name
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Ron Baker o
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3. CONTRACTOR or BUILDER'S Address cn
P. 0. Box 1204 En
22 5th St. r
South Glens Falls, N. Y. PO
4. ARCHITECT'S Name
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M
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Plesse indicate by X)
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(}d Wood Frame ( ) Masonry ( )Steel ( ) o
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7. PLANS and Specifications
58'x28 ' per specifications and application
No. submitted including sewage system and two-car
attached garage.
B. Proposed Use 0
One-Family Dwelling M
Paid
$150. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 1 19 85 14
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.) :C
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Dated at the Town of Queensbury thisllth Day of October 1984 N
a� ,�SIGNED BY ate_ for the Town of Queensbury
Building and Zoning Inspecto