2009-557 ~ - TOWN OF QUEENSBURY
742 Bay Road,Quueensbury,NY 12804-5902 (518)761-8201
Community Development- Building &Codes (518) 761-8256
uh R TIFI ATE %'jF COMPLIAN- C-Ir
Permit Number. P20090557 Date Issued: Tuesday, November 24, 2009
This is to certify that work requested to be done as shown by Permit Number P20090557
has been completed.
Tax Map Number. 523400-308-018-0001-068-000-0000
Location: 39 NORTH CHURCH Ln
Owner. DOUGLAS & ROBIN KIRKPATRICK.
Applicant: DOUGLAS &ROBIN KIRKPATRICK
This structure may be occupied as a:
Septic Alteration Residential
By Order of Town Board
TOWN OF QUEENSBURY
f �
Issuance of this Certificate of Compliance DOES NOT relieve the r<
o '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.
i
___/_`_�.p_�_______/_'-_/__�__.-_- OFFICE USE ONLY _____________________
TAX MAP NO. I
PERMIT N0. =J✓ /PERMIT FEE
APPROVALS: ZONING TOWN CLERK ul I ; NOV I o 2009
:___-•__--__-__-_-•____---------------------
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APPLICATION FOR SEPTIC DISPOSAL SYSTEM
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT REVIEW BEFORE ISSUANCE OF A VALID
PERMIT. Q
OWNER: !Cf< INSTALLER: `1 N l
ADDRESS: ,3-7 �v /�� C�(� vitC,,i ADDRESS:
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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090557 Application Number. A20090557
Tax Map No: 523400-308-018-0001-068-000-0000
Permission is hereby granted to: DOUGLAS &ROBIN KIRKPATRICK
For property located at: 39 NORTH CHURCH 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. Tune of Construction Value
Owner Address: DOUGLAS &ROBIN KIRKPATRIC
39 NORTH CHURCH Ln Septic Alteration Residential
QUEENSBURY,NY 12804 Total value
Contractor or Builders Name/Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2009-557
SEPTIC ALTERATION RESIDENTIAL
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TOWN OF QUEENSB RY �
BUILDING & PT.-
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