1985-030 BUILDING PERMIT
TOWN OF QUEENSBUR`M' �� 85, 30
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Donald Hess
OWNER of property located at *� Lower Dix Ave . Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a Sewage Alteration
at the above location in accordance to application together with plot plans and other information hereto filed. and 0
O
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. :5
Aj
1 . OWNER'S Address is 105 bower Dix Ave .
Glens Falls , New York x
tD
il]
fIf
2. CONTRACTOR or BUILDERS Name
Donald Howard
3. CONTRACTOR or BUILDERS Address
155 Lower Dix Avenue
Hudson Falls , New York `D
1 "
ty
4_ ARCHITECT'S. Name O
iZf
ri
Ij
Y•
5. ARCHITECT'S Address 7C
C
(D
S. TYPE of Construction — {Please indicate by X}
( ) Wood Frame l ) Masonry f I Steel ( }
7. PLANS and Specifications 200 ft . .tile field per plot and appllca�ti-on
No. submitted . tip
gy
W
Lq
B. Proposed Use (D
Sewage System for commercial building
rt
(D
n
w
$ 100 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Feb . 28 1987 0
Y•
Slf a longer period is required an application for an extension must he made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date,}
Dated at the Town of Queensburythis 2 8 th Day of February 19 $ 5
SIGNED BY for the Town of Queensbury
Building and oning Inspector
TOWN OF QUEENSBURY -rawN aF QuEsNspony �r
BUILDING & ZONING DEPARTMENT (i�h V �
SEWAGE DISPOSAL PERMIT APPLICATI t�
1 . OFEB
Owner ' s Name M;MA
Address cC ,-k._� _ , 0 a`s� ' � � � ;�1s1
Telephone No .
2 . Property location ,_..r1-fir �r n
3 . Name of person or firm responsible for installincr system
'Telephone No . 2Z1 'i 2 0 i/
Address G ^
4 . Number of bedrooms ( reside,,n�t�i--al buildings only)
5 . Daily flaw �,/ r ,,+`r.a'... . gallons/day
6 . Septic tank capacity % / gallons
7 . Topography : flat , rolling , steep
% of slope
86 Nature of soil and depth
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? 1/', �7� ft .
10 . Percolation test : A is required
B is not required
C If required what is the rate minutes/inch
11 . Water supply : municipal well , other.
12 . Type of system proposed : drywel l < Ile f iel� other
Any contractor ,. corporation , individual , etc * engaged in - the construction
of a sanitary sewage disposal system who covers the same before inspection ,
does not have an approved permit , or varies from the approved application
will be subject to a penalty of $ 250 as provided for in section 6 . 010 of the
Queensbury Sanitary Sewage ordinance .
Date
signature o app3acant'��
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions , including distance from any structure , distance from
property line and domestic water supply , etc . Include all dimensions of
the system itself .
Form 3- 82
,14
,�+y rc�
�V�� �� ,Q,,�rtm,ent
Suirl d�ins 2
D�
Rrt��� G �..
R Kcatya On
FooL Formsin & Piers
F,Otin
Founr3a Coat Cement roo
Water fin r-�-
gackfill �-- � -
Final 5nrve
alnxn
r thin
Roof Felt
Roof 3.n �-
Sidin Veneer
�tasonr pl �J
you tiralves �---
r
Relief
Wall- Roax,d �� �----
gyrt - 1'o ches Floor
�- � .
Inj
Shed Trim
Interio Bailin s
Stairs r . Tile
cellar a Floor$ ---�^�
concr Faxes xes
PFire roofin
Garr C1OSers
L)o
o
c 13imne Meter InSt .
Water roval
Se tic �► FlDo ��-r- --�
FolIndat n '-
wa l l s _ � -----
Insulation cein
B�y7, yng xnsPe°tor
�FMAFtK5
ego
I
Mif
Jill
f _i
it
`$
I
1 ►.