2012-030 TOWN OF QUEENSBURY
742 Bay Rona,Quemsb wy,KY t29oa-5902 (518)76t-9zm
et Community Development-Building&Codes (518) 7614M%
CERTIFICATE OF COMPLIANCE
Permit Number. P20120030 Date Issued: Wednesday, January 23, 2013
This is to certify that work requested to be done as shown by Permit Number P20120030
has been completed.
Tag Map Number. 523400-303-020-0002-005-000-0000
Location: 76 BOULEVARD
Owner: BMI G ELMORE
Applicant: BMI G ELMORE
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 n ,/
property owner of the respomdbilily for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the
Director of
Pbmning Board or Zoning Board of Appeals. Building d' ae orcemeor
TOWN OF QUEENSBURY
742 Bay Road,Queenebury,NY 12804.5902 (518)761-8201
Community Development-Building&Codes (518)761.6256
BUILDING PERMIT
Permit Number: P20120030 Application Number: A20120030
Tax Map No: 523400-303-020-0002-005-000-0000
Permission is hereby granted to: HEIDI O ELMORE
For property located at: 76 BOULEVARD
in the Town of Queenebury,to conetmct 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 Queenebury Zoning
Ordinance. Tree of Construction YALU
Owner Address: HEIDI 0 ELMORE Septic Alteration Residential
TIMOTHY T. ELMORE Total value
76 BOULEVARD
QUEENSBURYNY 12804-0000
Contractor or Builder's Name/Address Electrical Inspection Agency
STONE INSTALLATIONS
NY 12804-0000
Plans&Specifications
2012-030
septic alteration residential
$40.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,January 31,2013
(If a longer period is required,an application for an ommeton mwt be made to the code Enforcement Officer
of the Town of Queenebury before the expiration date.)
Dated at the TowfSolfr ab � 1y�: uaty 31,2012
SIGNED BY for the Town of Queenebury.
Director of Building&Code Enforcement