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5738 BUILDING PERMIT : TOWN OF QUEENSBURY No. 5738 WARREN COUNTY, NEW YORK r m 0 PERMISSION is hereby granted to Leon San OWNER of property located at Baker 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- approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is Ra D. #2 Glens Falls, N. Y. 2. CONTRACTOR or BUI LDER'S Name Same . td 3. CONTRACTOR or BUILDER'S Address x ID Same 0 sv 4. ARCHITECT'S Name ¢ 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) 1 )Wood Frame ( ) Masonry ( 1 Steel ( 1 7. PLANS and Specifications Z No. 6"x6*x8 " seepage pit per application submitted 8. Proposed Use ~ rt Sewage alteration for dwelling m n sv rt H. 0 $ 5a 00 PERMIT FEE PAID.-THIS PERMIT EXPIRES August 1 19 79 (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 2 Oth Day of April 19 79 Q SIGNED BY l v� for the Town of Queensbury B• ilding and Zoning Inspector TOWN OF t9UEENSBURX TOtt»d OF QUEENSBURY BUILDING MID ZONING DEPARTMENT � BAY AND HAVILAND ROADS, R. D. r�D GLENS FALLS, NEW YORK 12801 ��(�R � o N 7181911Q111112111213141516. APPLICATION FOR A PERI,IIT TO CONSTRUCT,. ALTER OR ENLARGE A SEWAGE DISPOSAL SYSTEM Pn7ITHIN TffE TOT"l OF OUEENSBURY OCCUPANT'S NAME �.e�ry ►n/ - ADDRESS �p `.t°ELEPHONE_7 9d, O, OWNER 8 S NAME z e ,,/ ��.✓✓ ADDRESS �,�� M©MBER OF PPDROOMS 2 GARBAGE GRINDER? �(YES OR NO) 'TOPOGRAPHY: FLAT POLLING, STEEP, SLOPE, GENTLE SLOPE, OT14ER. NATURE OF SOIL: CLAY, ANDY LOAM, C RAVEL, ROCKS, ETC. PERCOLATION TEST t%TF°R SUPPLY-. McJRICIPAL, FELL, OTHPR 3DIAG OF PROPOSED SEPTIC SYSTEM 4 pad �'3 /fie /0D OTHER PERTINENT INFORVIATIOA7 j ��2- C� �kd")` —57,o, .p IT IS FE:RF'BY AGPE—F-n THAT IF THIS APPLY ATY:OF AND PLANS ARE APPROV'D, INSTALLATION OF SnYAGE DISPOSAL FACILITIES WILL BE MADE IN ACCOFDANC1s WITH DETAILS SHOW. DATE Lo fl 7 SIGNATURE OF APPLICANT LAKE GEORGE PARR COMMISSION APPROVAL: TOWN OF QUEENS-BURY Building Department Inspectors Report Date - Nam r Location ,;- Permit No. -'7 3 R Weather Per Cent Complete Remarks Excavation Footing Forms Footing & Piers Foundation Cement Coat Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plbg. Rough Ht . Relief Valves Wall Board Ext.Porches Finished Floor Interior Trim Stairs&Railings Cellar Dr.Tile Concrete Floors Plh .Fixtures Gar.Fireproofing Door Closers Chimney Water Meter Inst. Septic Approval wilding Inspector REMARKS