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121 0FFICE (),F THE Z014,1-AX INSI"Er-'M PEIV,11T April 26, 968 0 Date Dented 4, Irflrr Edward Howe > 23 Prospect Drive Glens Falls , X.Y. T'/PeL of Cr,)natruction Wood frame, a*'.f Use Family Room Dwelling Torol Arv,hl,tevt , o , , t, — � — , ,, —.. -,, I n 1 11 a . a I . - , -, i, r, - n s - i �. 2 � 0 ® 1. . 0 !" s 1 r ier Owner,111 tr 'k.t drp ae 1411p,nq and PKMISSION is hereby granted to the abo%�e over for, the con- *r,r ing in acordonce application NO 089 , t iett,ca-, of a buile c V',, T,nS -jer. with . other inforntatton hereto filed et plot plaris and An- owt of (,kveensbt!rq Mtn jr.j cc pliat ice w,j�t.t the T ember ,3 1 9,6 8) 10.00 iermit Fee *Al, zonIng Truspee C" Form $ �' TOWN OF QUEENSBURY Warren County, New York Office of the Zoning Inspector O8 9 APPLICATION FOR A BUILDING PERMIT Location of Property. . . . . . . . . . . ... .. . . . .Road, St eet, or Avenue 47- P.)p ncation No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed. ._�. . . . . 19. V�r Fla:-, No. . . . . . . . . . . . . . . . . . . . . . . �. . .; . . . . . .Permit No. .. . . . . .'�X�'hv In i,fchitect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Eu-Iider. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � pe of Building. . . .l. �ti`.`� . . . . . ... . . . . . . . . . . . 1n to be y. rJr �. . Feet A t.'i e. J . . . . .Feet Long. . . .F. . . . .S tor_4 es 1' ;, lC" mated Cost of Buildir:g. . . . '< . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :;.:osed Use of Luilding. . . . .,r?'G? 1.. . . . . . . . . . . . . . . . . . . . . . . . . 5 . :.,ere Any Other Buildings on t e Premises?. . . to be Demolished?. .Any Existing Building . . . . . . . . . . . . . . . . . . . . .. . . . . . I,_ r:r, Work New Construction, Repairs, o.r Remodeling?. . . . . . . . . . . . . . . . . . . u< � e Building Permit Shall expire. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. . . i'i e copies of a plot plan drawn to scale showing the actual dime-- s :ors of the lot to be built upon, the exact size and location on the o_ t?ie building and accessory buildings to be erected are attached ` _ns application. The undersigned hereby agrees to comply in the said construction w:1.t1h all the provisions of the Zoning Ordinance as adopted, of the Town of C:.leensbury. (If permit is granted it will be on condition that building or al- tc,rations shall be completed at date to be fixed by Zoning Inspector, ar,d if not so completed permit shall be revoked by him. ) REMARKS: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I hereby agree that all work and materials will be in strict con- formity with the laws governing building in this Town, and further agree to post conspicuously a copy of the Building Permit, protected from the weather, on the nremisies affected. � ECG, (Si9 nasture) f �J / t o _--------------------------- ✓ .eC�! �� �`_ Owner, o 'Cz�atc is (Strike out inappropriate Provision : TOWN OF QUEENseuny pF (_� D APR 2 41968 A.M. P.M. N�s�igil�i