1765 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 1765
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Rnna 1 d R Lind nrla Hi aqi n S
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OWNER of property located at I of #17 Fores-t Lane Street,Road or Ave. �
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in the Town of Queensbury,To Construct or place a Dwelling Sawaap Sys+cm C,
at the above location in accordance to application together with plot plans and other information hereto filed and a'
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. po
1. OWNER'S Address is r'
R. D. #2 West Mountain Road
Glens Falls, New York
12801
2. CONTRACTOR or BUILDER'S Name
Continental Homes Frank Stahl
3. CONTRACTOR or BUILDER'S Address
Rt. 3 Nashua N.H.
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
X )Wood Frame ( )Masonry ( )Steel 1 )
7. PLANS and Specifications t-+
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No.44'X24' as per plot plans and specifications submitted enc. r+C
sewage system
8. Proposed Use J
One-Family Dwelling Sewage System o
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5.00 C/0
$ 40-OD PERMIT FEE PAID—THIS PERMIT EXPIRES 12-1- 19___72 t"
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(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.) �p
Dated at the Town of Queensbury this 11 Day of May 19 72
SIGNED BY e or fozzi r a Town of Queensbury
Building and Zoning Insp
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CERTIFICATE OF -OCCUPANCY
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 6" I '7 2
This is to certify that work requested to be done as shown by Permit No. 1765
has been completed.
This structure may be occupied as a Dwelling
Location— `,o f ''17 n -a_ l a n e
Owner c ° Linda 1-1 ig rgins
By Order Town Board
TO OF QUEENSBURY
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Building & g Inspector
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