Certification of Lumber Used Letter CITXJT'OWNNILLAGE OF:
JUN 2 1 2021 �
7/Z i3'u
TOWN OF OUEENSBURY
BUILDING& CODAS
CERTIFICATION OF LUMBER USED
FOR LOAD SUPPORTING PURPOSES
Date: p�9 p /
I
p1~24 �
(TI'n-E—i.e..OWNER PRESIDENT)
certify that the q ity and working stresses of lumber being supplied to:
(CONSUMEMCO ACT BUILDER)
meets Or exceeds No. 2 grade of the species in accordance with the
conditions set forth in American Softwood Lumber Standard (PS20-99).
PRODUCING MILL: S
ADDRESS: / i?
PHONE:
E-MAIL:
PROJECT LOCATION: � r�a� a✓ /� c�,�s /!�y
LUMBER SPECIES:
LUMBER DIMENSIONS: �_ X x — X /Z
QUANTITY SUPPLIED:
SIGNATURE:
OFP1C{AL USE ONLY —
DATE REM:
PERMrr s: