2006-380 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060380 Application Number. A20060380
Tax Map No: 523400-296-014-0001-040-000-0000
Permission is hereby granted to: JOHN & CARI KASSEBAUM
For property located at: 12 EDGEWOOD Dr
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: JOHN&CARI KASSEBAUM
12 EDGEWOOD Dr Septic Alteration Residential
Total Value
QUEENSBURY,NY 12804
Contractor or Builders Name/ Address Electrical Inspection Agency
IBS SEPTIC
NY 12804-0000
Plans &Specifications
2006-280
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday,June 06,2007
(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 TowneW
W T June 06,2006
SIGNED BY for the Town of Queensbury.
V Na
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
4z Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20060380 Date Issued: Friday, June 16, 2006
This is to certify that work requested to be done as shown by Permit Number P20060380
has been completed.
Tax Map Number. 523400-296-014-0001-040-000-0000
Location: 12 EDGEWOOD Dr
Owner. JOHN & CARI KASSEBAUM
Applicant: JOHN & CARI KASSEBAUM
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 DirectorofBuilding&Code Enforcement
Planning Board or Zoning Board of Appeals.