building permit TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: SEP-000752-2017
Tax Map No: 226.15-141
Permission is hereby granted to: Jay Cardinale
For property located at: 10 CROSSOVER 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
Tyne of Construction
Owner Name: Jay Cardinale Septic Disposal-Residential $0.00
Owner Address: 10 CROSSOVER LN Total Value $0.00
Lake George,NY 12845
Contractor or Builder's Name/Address Electrical Inspection Agency
Plans&Specifications
Residential Septic Alteration
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,December 6,2018
(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 Town o r7i/vred a ber 6,2017
SIGNED BY: 6�%_ for the Town of Queensbury.
Director of Building&Code Enforcement