1975- Res. 178BUILDING PERMIT
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
No.
PERMISSION is hereby granted to_g~'~fard lE Rs-~ti,n
OWNER of property located at ~t ~~stsn ~et~ ~ Street, Road or Ave.
in the Town of Queensbury, To Construct or place a ~~~ 1
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
Rs Ds ~i '
GIBS Fa11~~ N+lhr Yank
2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction - (Please indicate by X)
1 Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications
No. Z~~ ~ 1"'~ ~BT~'~ C "t X 2.'2•
F(~ t~7 ~~M~Y.~~4R tI.rY' - l~tl~i -?RaA~I~F~I$i.~
8. Proposed Use
$ .,~.,,... PERMIT FEE PAID -THIS PERMIT EXPIRES ~~~ 19~_
(lf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this Day of 19
~' -~3~
SIGNED BY ~ '~° ~ ~'j'' ~ +~#{ ~~~ r ~ '~ ~~ ~~~~ for the Town of Queensbury
Building and Zoning Inspector --~
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