1985-049 BUILDING PERMIT
TOWN OF QUEENSBU 'R.Y No. 85_ go
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Karl Smoczynski IN Street, Road or Ave.
OWNER of property located at
Sewage Alteration
in the Town of Queensbury, To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed an
ith the Town of Queensbury Building and Zoning Ordinance.
approved and incompliance w
ii
1, OVVNER`S Address is
21 Lynnf field Drive: �
Glens Falls , New York C
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to
2. CONTRACTOR or BUILDER'S Name
."3
Walter Graham to
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3_ CONTRACTOR or BUILDER'S3,+ 1r Main Street
Hudson Falls , New York
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4, ARCHITECT'S Name
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6_ ARCHITECT'S Address M
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g. TYPE of Construction — {piaase indicate by X1 C
{ I Wood Frame { I Masonry I 1 Steel { 1
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7. PLANS and Specifications
new seepage pits - 2 @ 6 ' x8 ' /' 18 'r - 24 " # 3 stone
No. — as built plan upon
( new 1000 gallon tank if necessary
inspection) U
B. proposed use
cu
Sewage syst+ for dwelling
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$ 1D . {34 PERMIT FEE PAID — THIS PERMIT EXPIRES NI? r
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector o the t
town of pueensbu ry before the expiration date_) !
19 �,
Dated at the Town of Queensbury this
D ay of
,ti _ �% . � for the Town of Q.ueensbury
SIGNED BY _ Building and honing Inspector $
TOWN OF QUEFNSSURY -ti-O+ 144 OF GtUE�U"Y
BUILDING & ZONING DEPARTMENT V
SEGti'AGE DISPOSAL PERMIT APPLICATION LLL!!!! 1111]]]]���� I' R
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1 . Owner ' s Name r=cA
A,.M, 2 SJ4151
7 8 9
Address r � {�..,
Telephone Nos
26 Property location
3 . Name of person or firm responsible for installing system
„ Telephone No , �
Address ra e
4 . Number of bedrooms ( residential buildings only)
Qallons/day
5 . Daily flow gallons
g , Septic tank capacity
7 , Topography : flat , rolling , steep
of slope
Be Nature of 8011 and depth
impervious material is apparent at what
9 . If ground water , bedrock or ft .
depth does it begin?
is required
10 , Percolation test : i9 not required nch
minutes/i
C If required what is the rate��
11 . Water supply :
municipal , well , other
12 . Type of system proposed : drywell , the field , other ^ - �--- -
ration , individual , etco engaged in the construction
Any contractor , corpo ste1n who covers the same before Inspecion '
of a sanitary sewage disposal sy roved application
does not have an approved permit , or varies from the approved
will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinances
mate sxgna ure o applicant.
ram of the proposed septic system
On separate sheet of paper submit a diag structure , distance from
with all dimensions , including distance from any
line and domestic water supply , etc , Include all dimensions of
property ,r
the system itself .
ft
ee
Form 3- 82
of
TOWN OF CkU - URY
gnildins Department.
lama'sRepmtIIIII.
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l�acaR:a1 W estlaer
Parma No. Remarks RemarKs
Sxcat�a ti+on
Footin For'n"
Footin Piers
Foundation
Cement Coat.
Water roofin
'5ackfiXl
Final Bursts
Fran
5heathin
Roof Felt
,lgoofin
siding'
Masonr Veneer
Rou h Valves
Wall Board
8xt . parches
Finished Floor
Interior Trim
stairs & Railin s
Cellar ,Ur . Tile
C Floors
oncrete
PI , Fixtures -- -
Gar . F1re roofin
r Closers
Chimne _
Waterlyeter -I
Sic A royal
e t
Floors
Foundation -^�r
Insulation WaI�
-- -- - ---
Ceilin
r T .I7lSpector
Builc3in9
REMARICS
02 ' r�
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I 7�j t
`r
911
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