142 OFFICE OF THE ZONING INSPECTOR
Building PERMIT NO.
oDate Issued. . . . . . . • . 0 • • • 0. aaoaooaa . . . . . . a . e . . fao a s a 00a. .
Date Denied oaaoao . . 00 000 aa000nan0a0 � a00000nab00aa000a0aeaoaaoaa0 W
Owner . . . . . . . ... a o a o O �fo o a A' �_e 0 0 0 o a a o a a a a a o o a a a o a • a a o o a a e c e a o a e
�i✓� i/�/� �a 01 0e a " s a s
Address . . . . . . . . 0 . n a 3 d b o 0 0 0 0 0 0 0 010 0 00 o 0 0 o e o 0100 • o a 0 0 . 0 a • o 0 0 a • 0 0 . 0 o Q
Location . a . . . ... ....L. .Q S. Qa6..o'er . . . o - o . . . . . . . . . . . . . . . . . . . . . .
0 o a 0 c o 0 0 0 0 0 0 0 0 o n o e 0 0 0 . o o a o o/ 0 0 0 0 0 0 0 0 0 0 0 00 * 0 0 0 00 o e o 0 o e o e o 0 o n o 0 0 0 0
Type of Construction - 4Yee`el-a�dame,, 'Masonry, Steed , Etc. . . a o . a o o a a
• o . o a 0 o e o o e o 0 . 0 a o 0 a 0 0 . o • . o . 0 0 ^ a o 0 C. 0 o 0 o 0 0 o a a o o e o 0 o e 0 o a o 0 0 0 . o 0 0 0 0 0 0
Proposed Use . . . 600 . . 0a o 0 . 000o0000 a 00 . 00 o o 006 a . . . . o o 0000 a o . • O • ao
Architect . o . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .
Address . O . . O . . O a O J 0 a a 0 0 g G �? O D O O O a . 0 0 0 0 0 0 0 0 0 0 . 0 0 0 • . O o 0 0 0 • a 0 a . 0 . '> 0 0
Builder . . . .(-?�!TA.r . . . . . 00 . aa . 00 . o . o a . o a . . a • • e > . . . . . . ae . o . o a e0
Address . . a . a . a "d.'b . asaoa,6or'a . aAQ . o . a6a6ao aoa . aaaaaoI * .
Plans and Specifications No. . . . . . o . . . . . c . . ao . o . . . ooaa • • . a • . 00000e
Application No o . o o . a o o . o 0 . . . . . . 0 0 0 0 0 0 0 0 0 . . . a . . a a . a . 0 a 0 a o a a o o a o 0 0
PERMISSION is hereby granted to the above owner for the construc-
tion of a building in accordance to application No. . . . . . . . . . . . . a
together with plot plans and other information hereto filed and
approved, and in compliance with the Town of Queensbury Zoning
Ordinance.
Date Building Permit Shall Expire . a . aaa '�or* goa o 0 o 0000 . . 19. o .�
ao O
Permit Fee
a c o a o 0 0 0 0 0 0 0 0 0 0 0 0 0 . 0 0 0 o a o
Zoning Inspector
t, Form ## 4
TOWN OF QUEENSBURY
Warren County, New York
Office of the Zoning Inspector
APPLICATION FOR A BUILDING PERMIT
ao
Location of Property. ;r• , , . • , • , �. . . • • • Road,oad, Street, or Avenue
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed. . .; 19
— e. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PB
Own er. . . Z-0.,' ;6,or/;e -. :. .�iv� sio�
• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A;e h=-t-,rcr
Builder. . ..f . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
'-'Type of Building. . . . . . . . . . . . tglC.4,-
• y?; . . -
.
. . . .
-e Building to be. . 1. . . . . .Feet Wide. . . • ` . . .Feet Long. .Stories High
Estimated Cost of Building. .? . �; • .
. . .
,v Proposed Use of Building. . , • , . , • . • . . • . . . . . • • • • •
r Are There Any Other Buildings on the Premises?. . . . . . .
.rIs Any Existing Building to be Demolished? . . . . • ,
k Is the Work. New Construction, Repairs, dr Remodeling?. . . .
. . . . . . . . . . . . . .
Q' R,,; _,r . � c� xpire.
. . . . . . . . . . . . . . . . .
Th ee co ie f a 1 n drawn scale ho ac di
Sion of e to to mep-
e 'b t upon, he exact i -and o ation -th
to o e build ' and ssory u _ gs to be er e are eta ed
t this applicat on.
The undersigned hereby agrees to comply in the said construction with
all the provisions of the Zoning Ordinance as adopted, of the Town of
C.ueensbury.
(If permit is granted it will be on condition that building or al-
terations shall be completed at date to be fixed by Zoning Inspector,
and 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 premisies affected.
TOVYN OF QUEENSSURY
D E 0 E � W E . . . . . . . . .��. -: : . . . . . . . . . . .
D (Signature)
MAY 131968
901(�11�1611�2�3�4�5�6
—X; a Owner, CarrtrSc�or, Armor ��
(Strike out inappropriate Provision)