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159 tzj Cn ,June Ig 1968 James Ellsworth R, P. Dream Lake, East of Bay Road, Queensbury Exibting house Dream Lake Bedroom extra living_spAqe .. ., !,j' f4l? hf," C o r Pt �t ta r & 1"g lt% -a r,ion r n la --�4 '1� T nc-v .Deeember., ,31 — ., ; - 33[X= 2.00 zoning Inspector Form # 4 TOWN OF QUEENSBtJEY Warren County, New York Office of the toning Inspector AppLtCATION IM AA NptfnDING PERKM Location of Property. a' 1L� . .h.t�s-1 rs... . . . . .Eoad, Street, or Avenue Application No. . . .. . .Fit ..� ..19.��. . Plan No. .. ... • . . . .. ..... . . .. . . .. ...... .... ..1... .1P No. . .... . .... ... Ornes.. . . Y. .. . . ... ....'�. .�4�� . ..... .. Builder. . . . 1� r jy%/• •T�n�✓•�y�• rf �✓� . .�;. .BLt j•�r.... • i. . . .• • e• Q�` /SCCCI V Jam' �• . s•.i ..... • . .•.• e•• Type of Building... . .... • . • Building -to be.i. .. j*•% .Feet Wide.. .. . .l. .Foot Long. . . . . . ...stories High EatLrted Cost of building. . .?�.: .,r��j •.%.•• ••. •• . . . • . . • • . •.•. . Proposed Use of Building. . .�-. / � R.:..� � `��.-a�.. .. ... . . . . . . . . . . Are There Any Other Buildings on the PrGMises?. . ....�::.. . .... . . . . .... a . Is Any Esisting Building to be Demolished?.... . !:: .... . . .. . • . . .. . e. Is the Work NeweCvns , SOP&LOws or 1_ingZ�= • .. . . . . . . . . . . . Date Building Permit Shall Expire. . . . . . . . w . . . . . . . . .. . ... . . .. .. w. ..19. a . T1►vM& copies of a plot plan draws to scale showing the actual dimen- sions of the lot to be built upon, the exact size and location an the lot of the building and accessory buildings to be erected are attached to this application. The undersigned hereby agrees to co0ply in the said construction with all the provisions of the Zoning Ordinance as adopted, of the Town of Qnsensbury. (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.) n �i 11�� .. . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . .. . . . . . . . . . . . . . . .. . . . . . .. . • • e • • . . s . . w • . • e a . • r • e • • • w . . • • • • e . . • e e . s o 0 o a . • a.• . . see • • o . o • . . . . a e • o e a o 0 • • . • . • n • • • • . e e • w • + r . o • • . + • r • • e r • . . . c • a • a s • a s • • • • .. w e o • e o. • m • . s • o . s • o a o 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 wilding Permit, protected from the Vftr, pal tjrprewisas affected. G 7 Signature 9a ye 0 �. / � �� O�uc Contractor, Architect or Agent l `f ' (Strike out inappropriate Provision)