4006 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 4006
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Heber Dealt s
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OWNER of property located at Lot 115 Midni ht Drive South Street,Road or Ave. y
in the Town of Queensbury,To Constructor place a One-Family Dwell in
at the above location in accordance to application together with plot plans and other information hereto filed and w
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ►�
' 1. OWNER'S Address is
37 Chester Street
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name to t~
Same h
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3. CONTRACTOR or BUILDERS Address
Same
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4. ARCHITECT'S Name �
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
bC)Wood frame . ( 1 Masonry ( )Steel ( )
7. PLANS and Specification
No. 26' 1 54' per plot plan, specifications and application
submitted including sewage system and 2 car attached
8. Proposed Use
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One-Family Dwelling -a
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$5.00 C/O Paid
$ 100.00 PERMIT FEE PAID—THIS PERMIT EXPIRES November 1 1976
(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.) M
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Dated at the Town of Queensbury this 23rd Day of April 1976 ~�
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SIGNED BY , Lfor the Town of Queensbury
Build and Zoning I nspect r
Pa?d
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date z°'1 v 21 19-7
This is to certify that work requested to be done as shown by Permit No. 4006
has been completed.
This structure may be occupied as a One-F A m i
Location Lot 1.1.5 (St;. 11.3) Midni ht Drive South
Owner Heber Realty
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoni g Inspector
CREATIVE "INSTA" PRINTING. GLENS FALLS. N Y 12601 (916179]-6636