1834 BUILDING PERMIT
TOWN OF QUEENSBURY No. 1834
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Scotty' s Automotive Service cat
OWNER of property located at Ridge Road Star RoutP Street,Road or Ave. co
in the Town of Queensbury,To Construct or place a SewacP System
at the above location in accordance to application together with plot plans and other information hereto filed and 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. o
1. OWNER'S Address is
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Ridge Road Star Route 0
Glens Falls, N.Y. c>?
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2. CONTRACTOR or BUILDERS Name N•
Co Crandall m
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ►Masonry ( )Steel ( )
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7. PLANS and Specifications
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No. per application
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8. Proposed Use
Sewage System
$ 5.00 PERMIT FEE PAID—THIS PERMIT EXPIRES July 1 1972
(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 7 / Day of June 19 72
SIGNED BY � N, . for the Town of Queensbury
Building and Z ing Inspector c a_/l
TOWN OF QUEENSBURY
WARREN COUNTY. NEW 'IORK TOWN OF QUEENSBURY
Application for gst
J U N F 1972
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE PM
DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITHIN VV.,g 1 1 234'5 6
TOWN OF QUEENSBURY <11 'I112J' I `1' "' ' ('
A
Mail or bring this application to:
Building 8 Zoning Department
Queensbury Town Office Building
R.D. 1 Bay Road
Glens Falls, New York 12801
This application for a Sewage Disposal Permit must be
accompanied by a plot plan drawn reasonably to scale
showing all dimensions, the size of the lot, the location
on the lot of the water supply and sewage system.
1. Name and mailing address of applicant:
Ail )2et /0-/- /4-"e° /-2 00
2. Specific location of property:
(STREET AND NUMBER)
3. Application is for:
e w construction of private dwelling .
Alteration or enlargement of existing sewage disposal system.
4. Description of building:
a. number_ of bedrooms
b. garbage grinder
YES OR NO
5. Topography: c.
(flat, rolling, steep slope, gentle slope, etc. )
6. a. Nature of soil. (Describe to a depth of 5 feet if tile
field is to be used or 10 feet if leaching pits are
proposed, giving thickness of various strata such as
top soil, clay, loam, sand, gravel, rock, etc. )
b. How determined? /far414—(..._
7. a. Soil percolation test made by
(Refer to Part III, Bulletin 1 , N.Y.S. Department of Health)
b. Percolation test notes submitted? it/0
e,► Plc t- /74 (YES OR NO)
8. Proposed sewage disposal system indicated on attached plan or
sketch?
(YES OR NO) y
_ .-. . . . • 111 - - -- -- ---- _ ,_ 9 /` c 1
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NOTE-Try and provide extra room
for tile field expansion or
replacement when and if needed
24" to — - -
36"
Provide extra plugged outlets
QQ, 5 min for future use if possble
ob-
Distribution Box
20'min • Septic Tonk
House Sewer
Tln '
HOUSE
•
100'min
between any well
and the field
•
F tnln4ll
1S'min
Lot Line
FIG. 3 - TYPICAL LOT LAYOUT
FOR TILE FIELD
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