application Office Use Only
SOLAR PANEL Permit#: : LQ 241�j
1 PERMIT APPLICATION Permit Fee:$
Town of tZcensbuz), Invoice#: d to el
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7,42 Bay Road,Queensbury,NY 12804
P:518-761-8256 www.queensburv.net
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Property Owner's First Name Last Name Title
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Property Address
City State Zip
Section Block Lot Number
❑ Single Family ❑ 2-4 Family Commercial ❑ Other
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Solar PV System: �d kW DC
TOWN OF QUEENSBURY
BUILDING&CODES
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Makesure yourselection matchesthe Construction Documents included withthis application.
❑ Supply side connection with microinverters ❑Load side connection with DC optimizers
Supply side connection with DC optimizers ❑Load side connection with microinverters
Supply side connection with string inverter ❑Load side connection with string inverter
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Contractor Business Name
Contractor Business Add role.
City State Zip
Contractor Contact Name Phone Number
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Contractor License Number(s) Contractor Email
Town of Queensbury Building&Code Enforcement Solar Panel Permit Application Revised July 2017