2009-464 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development -Building & Codes (518) 761-8256
CE"'I"IFI ATE CIF COMPLIANCE
Permit Number: P20090464 Date Issued: Friday, March 20, 2015
This is to certify that work requested to be done as shown by Permit Number P20090464
has been completed.
Tax Map Number: 523400-239-012-0002-040-000-0000
Location: 27 HOLLY Ln
Owner: JAMES GOEDERT
Applicant: JIM GOEDERT
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Compliance DOES NOT relieve the
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090464 Application Number. A20090464
Tax Map No: 523400-239-012-0002-040-000-0000
Permission is hereby granted to: JIM GOEDERT
For property located at: 27 HOLLY Ln
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ARTHUR CHRISTIE
JENNIFER SLOYAN Septic Alteration Residential
3 HIGH St E Total value
SHANDAKEN,NY 12480-0000
Contractor or Builder's Name/ Address Electrical Inspection Agency
IBS SEPTIC &DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
QUEENSBURY,NY 12804
Plans &Specifications
2009-464
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday, September 24,2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the f::e e
bury; �I' rsday, September 24,2009
SIGNED BY 'V d : " for the Town of Queensbury.
Director of Building&Coc e Enforcement