3781 BUILDING PERMIT
TOWN OF QUEENSBURY No. 3781
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Louise K. Clark
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OWNER of property located at Lot 132 Heinrick Circle Street,Road or Ave. o
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in the Town of Queensbury,To Construct or place a One-Family Dwelling
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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.
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1. OWNER'S Address is ►—'
Old Cootch Road y
Glens Falls, New York "•
2. CONTRACTOR or BUILDER'S Name
Martin C. Mosher
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3. CONTRACTOR or BUILDER'S Address c+
R. D. #3, Upper Sherman Avenue w
Glens Falls, New York N
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4. ARCHITECT'S Name (D
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x
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( )Masonry ( )Steel ( 1
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7. PLANS and Specifications
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281 x 721 per plot plan, specifications and applicatior 41
No. including 2-car attached garage and sewage system. w
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8. Proposed Use I,
One Family Dwelling
$5.00 C/0
$50.00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 1 19 76 cQ
(If 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 10th Day of October 1975
SIGNED BYi for the Town of Queensbury
Building adff Zoning Inspector
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7 CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date ebruary 3 19 76
This is to certify that work requested to be done as shown by Permit No. 3781
has been completed.
This structure may be occupied as a One-Family Dwelling
Location Lot 132 Heinrick Circle
Owner Louise K. Clark
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE ''INSTA" PRINTING GLENS FALLS. N V 12801 ISIS1793-5656