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proposed and historical infomration
SEP-0097-2020 Residential Septic Alteration Bo WY 49{3H1 7 23g SN yw (| TZ a82 rejeq 3§g Ag pamainey [x00 3113] sg oniagina iA IS IND 4O NMOL a tf fui] bayou a. SS 9 Sapipecns by v ppek Bl 5b Op pee crd AL GE Fo (YT, 999g OUD ceatyode|aug Tae |wegiele P82) JN 4og seman OY, E' Aiclkg al pl Leas wt tp eae? ee, ee 4- Ae Nt yan 49722 panel] “e3 4 Jana, I £7 7] H a1a O-G et Lpradosd wut a] TO BE COMPLETED BY HLDG.DEPT.LON ORS eeeBaeofBinsinApplicationNo. 5 R E 6 &1 Wy B i |Permit Tssued lel3BUILDINGandZONINGDEPARTMENTPermitExpires,19)FEB 0 1988BayandHavilandRoad,R.D.1 Box 98 Zoning Designation,Queensbury,New York 12801 BUILDING &CODE DEPT. |fee PAD ays3\APPLICATION FOR jwet-Cfp —MOBILE HOME FUILDING AND ZONING PERMIT ‘A PERMIT MUST BE OBTAINED GEFORE BEGINNING CONSTRUCTION.ANSWER ALL OF THE FOLLOWING. ‘The undersigned hereby applies for a Building Permit to do the following work which willbedoneinaccordancewiththedescription,plana and specifications submitted,and suchspecialconditionsasmaybeindicatedonthePermitQeesc=(MpTHizune be)2.0.nadeeen (40 PhnbleAd.pet ol,DOREPropertyLocation:U/C sax map No J /LYStreetnumberorbuildinglotnumber Subdivision name (if applicable) The owner of this property ‘THE PERSON RESPONSIBLE FOR SUPERVISION OF WORK AS REGARDS BUILDING CODES IS:Rosado 1 OLY Sowth —ben DalleNameP.O.Address,Tel.No,Name of Installer E wess_Qt?Soreeh>Ce HMrer.Name of plumber (D7,‘Address.Tel.peNameofmason_(fee (,Address.Wel.7c ZONING INFORMATION: A PLOT PLAN MUST BE PREPARED AND SUBMITTED,drawn reasonably to scale and attached hereto,showing clearly and distinctly all buildings,whether existing or proposed and indicate allset-back dimensions from property lines.Givestreetandnumberorlotnumberandindicatewhetherinteriororcornerlot.Show locationefwatersupplyandlocationandconfigurationofsepticdisposalarea,No.of bathrooms COMPLETE INFORMATION REQUIRED BELOW. MOBILE HOME INFORMATION: New Home Placement Size of new Home2 ft xG@Q Ft Single wi te Double wide_}/ Replacing existing Home.a” No.of rooms (excluding baths)'S2y%=* Feneee,: —Fireplace?___Wood #66°T""A=*sige of property _/.J7C)fx Do fe.ecunaecionecniovenatsiees *Existing building(s)Size ft xft..» Byleving bollaingWeePiers-No.of____Size-_ft x __ft.*Baisting buildings)ueDepthbelowgradefe.* - ae a Z *Proposed building,distance from property lineaereLeepeegsized*Front yard ft Rear yard_/=2.fe“tet material »Side yards ft and fewattthickness_S/Wage ae 5 IE on comers setback from sldeStrect ft Total depth below grade ft.:OCCUPANCY — INFORMATION PRIMARY BUILDING -.eee ee fina saa @ ET a a et ©One family dwelling Two family dwellingProposeddateofplacement///NB Multiple dwelling /Number of units \{Permanent occupancyAprox.Value of Home3Yo O00 .mattranaient{occusaneyWatersupply-Well Municipal _{+__Dusiness>*__IndustrialSepticPermitrequired?>__Other +If addition,what vill use be? FURTHER INFORMATION REQUESTED esONTHEREVERSESIDEOFTHISSHEET.*Detached garage/one car/two car/car*TJattachea garage/one car/two car/_car*“private storage building:1/| U Form MHP 5/86 md-v1