2006-882 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20060882 Application Number. A20060882
Tax Map No: 523400-303-016-0001-072-000-0000
Permission is hereby granted to: FRANCIS & DOROTHEA FORTUNE
For property located at: 12 LYNN Ave
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. Type of Construction Value
Owner Address: FRANCIS & DOROTHEA FORTUN Septic Alteration Residential
12 LYNN Ave Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/ Address Electrical Inspection Agency
IBS SEPTIC & DRAIN
ATTN: IVAN BELL
2 LOWER WARREN St
QUEENSBURY, NY 12804
Plans &Specifications
2006-882
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, December 15, 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 To of Qu bu Fr y ec mber 15, 2006
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
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TOWN OF QUEENSBURY
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742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 j
Community Development- Building &Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number. P20060882 Date Issued: Monday, December 18, 2006
i
This is to certify that work requested to be done as shown by Permit Number P20060882
has been completed.
Tax Map Number. 523400-303-016-0001-072-000-0000
Location: 12 LYNN Ave
Owner. FRANCIS & DOROTHEA FORTUNE
Applicant: FRANCIS & DOROTHEA FORTUNE
This structure maybe occupied as a:
Septic Alteration Residential
By Omer 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, r:
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.