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1985-097 BUILDING PERMIT TOWN OF +QUEENSBURY No. 85_ 97 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Phyllis Bucklin 1 184 FN OWNER of property located at — Bay R ad below Route 14 9 Street, Road or Ave. b in the Town of Oueensbury, To Construct or place a Sewage Alteration I� 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. CU 1 . OWNER'S Address is 0 48 Sherman Ave . M Glens Falls , New York � 2. CONTRACTOR or SUI LDERZ Name D . Granger and Sons. 3. CONTRACTOR or SUILDER'S Address 19 Homer Ave . w Glens Falls , New York m 4. ARCHITECT'S Name C]. N �x 5. ARCHITECT'S Address 0 03 f� 6. TYPE of Construction — (Please indicate by X) f ) Wood Frame i ) Masonry f ) Steel i ) 7. PLANS and Specifications No. 1000 gallon septiC tank , disc . box and rn 190 LF tile field per plot plan and application . S. Proposed Use 'Q Serage system for dwelling M N s-r m $ 10 . 00 PERMIT FEE PAID -- THIS PERMIT EXPIRES +April 5 1987 ram+ l- (If a longer period is required an application for an exteran must be made to the Building and Zoning of the ui inspector C7 town of Queensbury before the expiration data.l Dated at the Town of Queensbury this 5th Day of April 19 $ SIGNED BY for the Town of Queensbury Building and Zoning Inspector ' �,6 TOWN OF QUEFNSBURY TOWN OF OUEEN^aSURY BUILDING & ZONING DEPARTMENT JE 0 [E g 17 SE %rAGF DISPOSAL PERMIT APPLICATI I� �J AV R 4 1985 _ 1 . Owner ' s NameV p.M. 71AJ91�gllgi j 1 1115 s Address A iQ � Air [..a Telephone Nov 2 2 . Property location 3 . Name of person or firm responsible for installina- system ` Telephone No . _' Address 4 . Number of bedrooms ( residential buildings only ) 5 . Daily flow -.7 0 gallons/day 6 . Septic tank capacity J gallons 7 . Topography : flaolling , steep % of slope Be Nature of soil and depth g , if ground water , bedrock or impervious material is apparent at what depth does it begin?„ v �" ft . 10 . Percolation test : A 1►> A" S� is required B is not required ,ram ffi C if required what is the rate Q r- � minutes/inch 11 . Water supply : municipal , well , then 12 . Type of system proposed : drywell , Ile field , they 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 fr the approved application will be subject to a penalty of $ 250 as provi for in S tion 6 . 010 of the +Queensbury Sanitary Sewage Ordinance . �^ _,,.��"' 1 Date f a ign tur+e appl ant 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 �,�,�, Cie' TOWN OF QUEENSBURY BUTAICUnff Department � Date N+a�nrre L.Qcarwo Pee riot Na. We thcr rks Excatyat�.on •7 Footin Forms Footin & piers F+ounda ti on Cement Coat Water roofin Backfill Final Surve Framin Sheathin Roof Felt Roafin Siain Mason:rU Veneer Rou h PI Relief valves Wall Board Ext. Porches Finished Floor Interior Trim Stairs & Railin s Cellar Dr . Tile Concrete Floors p F , Fixtures Gar . Fire roofin Door Closers Chione Water Meter Inst . Se tic A roval Floors Foundation -. insulation Walls Ceiling Building InspeCtnr REMARKS a Opel: �= . �� � 1 (�, D 1,—.—..— �, .`_. .� Ohl e� f e► v o �' 4 Crxe . . . � � � �;` ,�,�t.,�x s � � � � �