87-234 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 87-234
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Sophie LaRose
OWNER of property located at Bay Road Street, Road or Ave.
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in the Town of Queensbury,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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. r
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1. OWNER'S Address is RD #1 0
Lake George, New York
2. CONTRACTOR or BUILDER'S Name
Jay Sweet
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
RD #1 w
Lake George, New York
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4. ARCHITECT'S Name a
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
1 )Wood Frame 1 ► Masonry 1 )Steel ( 1
7. PLANS and Specifications to
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1000 gallon tank, dist. box and 150' leach field per w
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plot and application. ro
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B. Proposed Use
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Sewage system for dwelling m
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 11 1989
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this llth Day of May 19 87
SIGNED BY M a a� for the Town of Queensbury
Building and Zoning In; n��
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