building permit TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
1W
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: RC-000593-2016
Tax Map No: 279.19-1-8
Permission is hereby granted to: Mike Regan
For property located at: 55 JENKINSVILLE 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
Tvce of Construction
Owner Name: Nancy Burke Single Family-Addition $1,000.00
Owner Address: 55 JENKINSVILLE RD Total Value $1,000.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Mike Regan
55 JENKINSVILLE RD
Queensbury,NY 12804
Plans&Specifications
Residential Addition 108 s.f.
Cross Ref. Z-AV-1-2017
$100.00 PERMIT FEE PAID-TMS PERMIT EXPIRES: Tuesday,January 30,2018
(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 of r�reetn , —Don a ,J 2017
SIGNED BY: \( N'��" for the Town of Queensbury.
Director of Building&Code Enforcement