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2006-396 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20060396 Application Number. A20060396 Tax Map No: 523400-296-013-0001-057-002-0000 Permission is hereby granted to: KOUBA, GEORGE E. For property located at: 159 MONTRAY Rd 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. Tyne of Construction Value Owner Address: RUTH KOUBA Fireplace 165 MONTRAY Rd Garage- 1 Car Attached QUEENSBURY,NY 12804-0000 Single Family Dwelling $140,000.00 Total Value $140,000.00 Contractor or Builder's Name/ Address Electrical Inspection Agency Plans &Specifications 2006-396 1259 SQ FT SINGLE FAMILY RESIDENCE 309 SQ FT ATTACHED GARAGE &FIREPLACE $181.98 PERMIT FEE PAID- THIS PERMIT EXPIRES: Friday,June 29, 2007 (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 Town o bury; JThu Th ay,June 29,2006 SIGNED BY for the Town of Queensbury. Director of Building&Co dNement TOWN OF QUEENSBURY FILE 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 low Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20060396 Date Issued: Monday, September 25, 2006 This is to certify that work requested to be done as shown by Permit Number P20060396 has been completed. Tax Map Number: 523400-296-013-0001-057-002-0000 Location: 159 MONTRAY Rd Owner: RUTH KOUBA Applicant: RUTH KOUBA This structure may be occupied as a: Fireplace By Order of Town Board Garage - 1 Car Attached TOWN OF QUEENSBURY Single Family Dwelling Issuance of this Certificate of Occupancy 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.