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1687 BUILDING PERMIT TOWN OF QUEENSBURY No 1687 WARREN COUNTY, NEW YORK • PERMISSION is hereby granted to Mr. Ortman OWNER of property located at Cor. Honeysuckle & Sunset As sy. Pt. Street, Road or Ave. in the Town of Queensbury,To Construct or place a Sewage System 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. 1. OWNER'S Address is Assy. Point New York CD 2. CONTRACTOR or BUILDER'S Name • Franklyn P. Bushey 3. CONTRACTOR or BUILDER'S Address Star Route Glens Falls, New York 12801 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications CD G o � H No. as per application 100' tile field c+ x 8. Proposed Use Sewage Alteration . C) $ 5.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 9_1_ 19 72 c• o (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 19 Day of April 19 72 SIGNED BY }9„, for the Town of Queensbury Building and Zoning Inspect r 60. ,/ \ TOWN OF QUEENSBURY WARREN COUNTY, NEW '(ORK Application t©i A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A .SEWAGE DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITHIN THE TOWN OF QUEENSBURY TOWN N CD F QUEEN'ray: Fn . Mail or bring this application to: r Building & ZoningDepartment • U� i� Queensbury Town Office Building R Z ��72 R.D. 1 Bay Road Glens Falls, New York 12801 71819110111112111213141516 This application for a Sewage Disposal Permit must be accompanied by a plot plan drawn reasonably to scale Fa 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: , . �/ �s w/ A-5 �� p f� 2. Specific location of propert-y_:_____ ' .«Lfr„,- G TRE `I / 'vD' NUMBER) 3. Application is°'f01niaeliklz Alteration or enlargement of existing sewage disposal system. 4. Description of building: " a. number of bedrooms _ b. garbage grinder 7-1-/e7 • (YES OR NO) --, 5. Topography: " --at-, /rol- ing , • steep slope, ge,nt_le' s ope, etc. 6. a. Nature of soil. (Describe tot ai leaching depth pof 5 feet pits if tile field --is to be used or 10 f proposed, giving thiCkn'ess of various strata such as top soil, clay, loam, 'sand, gravel ,: rock, etc ). e'%-- b. How determined? ... -� • �= � , 7. a. Soil percolation test made by d✓r1 (Refer to Part III , Bulletin 1 , N.Y.S . Department of Health) - b. Percolation test- notes submitted? e (YES OR NO) • 8, Proposed sewage disposal system indicated on attached plan or sketch? l✓.� �-` �'� / A (Y OR NO) . r ' - ' a . Date when construction will commence 4 0 77 9. / and attached plans It is hereby agreed that if this application dated _ _ or any amendment or revi lon thereof , .-----7-;. �; ,..,- „c ..w2 e disposal facilities will be . (0 • . . , . ,... , . . . •._, ,,, . _ , . . .. . . . N -- . -_. . , . - .-. I' i f ji • • --,-:-..- ,- • 7 ... _._ ... . ,. . ,...„----- , . . ,,.. a / i . .... „ . . . • ...•• . _ . . • , ...., . • , . . . . .0t.,„ .... , • _...p ,4,i,,,,.,. \ • \„ 2v ziks A:9 . . , ,..s .._ . .-''.J-, -- '‘ \-- '-. - • _ . .(-4 .. L(4.4 pl V!ti/ I— -- . . . . • , _ ....... . . •-. , ... . ... . . . . . . . . . ., . • 1 . \ . .._