4115 BUILDING PERMIT
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK No. 411 5
PERMISSION is hereby granted to Russell Mar+i nrla 1 0
OWNER of property located at Tea Hi 11 Rnari Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Two-Family Dwelling
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 cD
R. D. #1
Lake George, New York
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2. CONTRACTOR or BUI LDERS Name c+
N.
Same c.
3. CONTRACTOR or BUILDERS Address
Same
4. ARCHITECTS Name
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M
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5. ARCHITECTS Address �+•
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6. TYPE of Construction—(Please indicate by X) ¢,
X )Wood Frame ( )Masonry ( )Steel
7. PLANS and Specifications
NIA. 261 x 421 per plot plan, specifications and application
submitted_ including sewage system, o
8. Proposed Use
N
Two-Family Dwelling 9
$5.00 C/O Paid
$54.00 PERMIT FEE PAID—THIS PERMIT 'EXPIRES _ January 1 1977 �
(If a longer I—'ng period is required an application for an extension must be made to the Building and Zoning inspector of the h+•
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 8th Day of, .Tune 1976
SIGNED BY ff for the Town of Queensbury
BuildinVand Zoning Inspe to
Gl6 19a7- / SSt4
C/O Paid
CERTIFICATE OF OCCUPANCY
TOWN OF QUEENSDURY
WARREN COUNTY, NEW YORK
Date iq _
This is to certify that work requested to be done as shown by Permit No. 4115
has been completed.
This structure may be occupied as a Two-Fa m i 1 X Dwe 1 1 i n a
Location Tee Hill Road
Owner _ Russell Mar _' ndal p
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoning Inspector
CREATIVE "INSTA" PRINTING. GLENS FALLS. N T 12601 15161795.5656