1972- Res. 178i
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October 13. 1972' .` ".
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~~~.~-' Patricia Black
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~i.~3E~~c~t~~ ~ry~~ ya~:c~~~ ~c,~upl.:~~a~~;r~ ~it~ t~~ato~ a.nd ~~4~°a~e r+~s~~ti~~~a~~tc~
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~3$ Sti:1°.~~ '~`a.'i ~i1~ ~~.~~~5:=~,~v: ~'34.7£%~' ~~'d11"l~~~~°G':
'~'t~u :~rEW `~~~<~~~~.<~~~ ~:d~ k~~j~dii'y t~~ Eu:~.~.ciin~ ~:~~pacto~' ~apc~n
~:o.~~j1?.~ti~~i oa 'ft~,"~,x`~: "wr.4.~~a~~.:~.~?'~:i.a~s•a ~~n that tie i'r~~~a~ction ca~x _
i b'1~ s"1~`t~.w FsI1Ss F3G?,a.L a7., a". .~..i t':>3~~:tE~ :,
THIS PERMIT IS NOT TRANSFERABLE ~iEN FINAL APPROVAL AND
~ OCCUPANCY TS GAINED.
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TOWN OF QUEENSBURY
3
G
WARREN COUNTY, NEW YORK
AppIICBfIOl1 IOC TOWN OF QUEENSCURY
22 r'p
A MOBILE HOME OUTSIDE OF A MOBILE HOME D R~~ o~o~ V
F~c p~
~'' ~~~ - 1972
Mail or bring this application to : A.M.
E Building & Zoning Department ,?l8~s+1g11~i,~1~2~3~4~5~6
§ Queensbury Town Office Building
R . D . 1 Bay Road :~,~
~ Glens Falls, New York 12801
This application for a Mobile Home Permit shall be
accompanied by a plot plan drawn reasonably to scale _
showing alI dimensions, the size of the lot, the location
on .the lot of the Mobile Home, the water supply and sewage
system. If the applicant is not. the owner in fee of the
premises, then the application must be accompanied by
the written acknowledged consent of the owner.
t - ~, -,
Name of applicant --
Address) ~J
Location of mobile home premises by street or road, etc.
~~/ i
Give nearest cross street. __
3.
'~ 4. State fully the reasons for this request ~ ~---~,n ~t~-2_
<,~-
Use extra sheets if necess ry
5. Description of mobile home, year, model, make, serial,,
~ and dimensions / Q L~ ~ ~~+ :.~ ~l~o~!~~f 1.~l. .7i /~ ~c~~
,S~~ia~ ~~%`7ya70
/ ~~~~ ~ '
(Applicants signature,)
Address ~~'-'~~.~n ~• ~~
i i ~ ~ ~ ;`
_._. ,
d . ~' l ~'_ fir, :; ~ ,:?" .~.q'7,wc~C~/
Name of owner o land
THIS SIDE FOR TOWN GOVERNMENT USE ONLY
Report of the investigation of Building Inspector and
recom~nendations~.
Approved
Disapproved
x ~ 0th er : -
Recommendations:-
~ .
Until such time as electric power is available at the site th
question this application can not receive my approval. When the
above is available I will investigate.. and render my .decision:
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Signed,~,,,,~~~~.tt--~~~vr,~'
Assistant Building Inspect r
Action of the Town Board
--
Approved
Disapproved
,&
'~ Other • -
3 •
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By Resolution Number of the Town Board of the r
Town of Queensbury, Warren County, New York.
Dated this day of 19
Signed
(Town Clerk, Town of Queensbury
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