4116 BUILDING PERMIT
TOWN OF QUEENSBURY No. 4116
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James C. Piper
OWNER of property located at Meadow Brook Road Street,Road or Ave.
in the Town of Queensbury,To Construct or place a One-Family Dwelling
at the above location in accordance to application together with plot plans and other information hereto filed and 3
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. cD
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1. OWNER'S Address is C7
10-310 Regency Park Apartments '
Glens Falls, New York b
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2. CONTRACTOR or BUI LDE R'S Name 1 f
Oscar Sundberg
3. CONTRACTOR or BUILDER'S Address
Glens Falls, New York
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4. ARCHITECT'S Name O
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5. ARCHITECT'S Address O
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6. TYPE of Construction—(Please indicate by X)
(X)Wood Frame ( 1 Masonry ( )Steel 1 ►
7. PLANS and Specifications OO
No. 56' x 261 per plot plan, specifications and application `i
submitted including sewage system and one-car attached 0A
garagp-
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B. Proposed Use f'•
One-Family Dwelling '<
WOO C/O Paid `►�°
$ °!%.00 PERMIT FEE PAID—THIS PERMIT EXPIRES January 1 19=
(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 9th Day of June 19 76—
SIGNED BY Z &�� for the Town of Queensbury
Building and ZonirIg Inspe
C/o Paid
CERTIFICATE LAXTI
FICATE OF OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 2
19 ZL
This is to certify that work requested to be done as shown by Permit No. 4116
has been completed.
This structure may be occupied as a One-Family Thvellinci
Location IMeadow Rroo'r Road
Owner James C. Piper
By Order Town Board
TOWN OF QUEENSBURY
Building & Zoniig inspect—or
CREATIVE "INSTA PRINTING GLENS FALLS. N V 12801 151e 1793-5658