7509 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 7509
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Rev. Andrew Tellier %h
OWNER of property located at Ridge Road Street,Road or Ave.
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 tD
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1-3
t. OWNER'S Address is R. D. fa
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Dick Lee Excavation
3. CONTRACTOR or BUILDER'S Address
65 Meadowbrook Road ¢;
Glens Falls, New York 4
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications
300' tile field per plot plan and application submitted.
No.
8. Proposed Use In
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Sewage System for dwelling
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$ 10. 00 PERMIT FEE PAID -THIS PERMIT EXPIRES Dec. 1 1982 m
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
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town of Queensbury before the expiration date.) f'f
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Dated at the Town of Queensbury this 25th Day of August 1982
SIGNED BY for the Town of Queensbury
Buildi g and Zoning Inspector
.1) TOWN OF OUFFNSBURY
BUILDING & ZONING DEPARTMENT TOWN OF QUEENSBURY
5 l i SEWAGF DISPOSAL PERMIT APPLICATION G E
UG 6 51.82
1. Owner ' s Name 1-e.
Address r171D ER 7IsI P.' I2I3I4) I6
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C�11�5L1Ll Telephone No. 3 1 3
bps: 4 7- (3oz
2. Property location
3 . Name of person or firm responsible for installing system
•"r) Il' \,- ;* A [i(j1� Telephone No. &i13-Z3G3
Address
4. Number of bedrooms (residential buildings only) S
5. Daily flow 730 gallons/day
6. Septic tank capacity 2 O Op gallons
7. Topography: flat, rolling, steep •
% of slope
8 . Nature of soil and depth Ci0,f1►-
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? 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: drywell, tile field, 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 g 2� I L (-Lk
signature of app icant
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
TOWN OF QUEENSBURY
Building Department
inspectors � 3�
�R%lt�t�." Date �-
Name
Permit No. (71 Bather
7C1Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing1616)--
Sheathing
Roof Felt Pit t„
Roofing
Siding 1 C. Al
Masonry Veneer I (
Rough Plbg.
Relief Valves I
Wall Board ` \ t1't-
Ext. Porches
Finished Floor A (1
Interior Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval �,/fre 4/yroVv41
Floors / /_
Insulation Foundation
Walls
'Ceiling
Buildin/Inspector
REMARKS
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