2012-027 TOWN OF QUEENSBURY
?y- 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF OCCUPANCY
Permit Number: P20120027 Date Issued: Friday, February 10, 2012
This is to certify that work requested to be done as shown by Permit Number P20120027
has been completed.
Location: 154 QUAKER Rd
Tax Map Number: 523400-302-007-0001-044-000-0000
Owner: MICHAEL& SUSAN KAIDAS
Applicant: PRIMECARE PHYSICIANS PLLC
This structure may be occupied as a:
Certificate of Occupancy (COM) By Order of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the property
owner of the responsibility for compliance with Site Plan, Variance, or l ✓t
other issues and conditions as a result of approvals by the Planning Board Director of Building&Code Enforcement
or Zoning Board of Appeals.
TOWN OF QUEENSBURY
Z 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
BUILDING PERMIT
Permit Number: P20120027 Application Number: A20120027
Tax Map No: 523400-302-007-0001-044-000-0000
Permission is hereby granted to: PRIMECARE PHYSICIANS PLLC
For property located at: 154 QUAKER 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. Tvoe of Construction Value
Owner Address: MICHAEL& SUSAN KAIDAS Certificate of Occupancy(COM)
PO BOX 268 Total Value
CLEVERDALE,NY 12820-0000
Contractor or Builder's Name /Address Electrical Inspection Agency
Plans&Specifications
2012-027
PRIMECARE PHYSICIANS,PLLC - CO ONLY
$50.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,January 30,2013
(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 ow�n�Qr`ue �b1f
,January 30,2012
SIGNED BY
for the Town of Queensbury.
Director of Building&Code Enforcement