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-0014-2019
Tax Map No: 227.13-2-24
Permission is hereby granted to: Thomas Kubricky
For property located at: 53 ROCKHURST RD
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
Owner Name: Thomas Kubricky Septic Disposal-Residential $0.00
Owner Address: 1166 Route 9 Total Value $0.00
Gansevoort,NY 12831
Contractor or Builder's Name/Address Electrical Inspection Agency
Tom Kubricky Company Inc.(TKC)
1166 State Rte 9
Gansevoort,NY 12831
Plans&Specifications
Septic Variance,BOH 4,2019
Septic Alteration
$ 150.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,March 2, 2020
(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 of Queensbury; Friday,March 1,2019
SIGNED BY: JJ�'d�f for the Town of Queensbury.
Director of Building&Code Enforcement