2012-005 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20120005 Date Issued: Friday, January 13, 2012
This is to certify that work requested to be done as shown by Permit Number P20120005
has been completed.
Tax Map Number: 523400-295-014-0001-047-000-0000
Location: 15 QUEEN DIANA Ln
Owner: RICHARD R WILL
Applicant: RICHARD R WILL
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, `U
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.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20120005 Application Number: A20120005
Tax Map No: 523400-295-014-0001-047-000-0000
Permission is hereby granted to: RICHARD R WILL
For property located at: 15 QUEEN DIANA 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. Type of Construction Value
Owner Address: RICHARD R WILL
15 UEEN DIANA Ln Septic Alteration Residential
QUEENSBURY NY 12804-0000 Total value
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2012-005
septic alteration residential
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,January 10, 2013
(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 Qneensbur), Tuesday,January 10, 2012
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement