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1985-089 BUILDING PERMIT TOWN OF +QUEENSBURY No �_$ 9 +Qql c 1 C, } WARREN CCIUIVTY, NEW Y[]RK PERMISSION is hereby granted to Leonardo Lombardo twi I !S S3 , l5 E4rl M OWNER of property located at Rake 9 north Route 14 Street, Road or Ave. p in the Town of Queensbury, To Construct or place a Sewacr n 7 Pry ; n at the above location in accordance to application together with plot plans and other information hereto filed and O approved and in compliance with the Town of Q.ueensbury Building and Zoning Ordinance. O 1 . OWNER°SAddressis RR # 1 Box 1948 w Lake George, New York 0 2. CONTRACTOR or BUILDER'S Name Frank Shaw Septic 5arvi.ce 3. CONTRACTOR or BUILDER'S Address Kobor Road Gansevoort , New York 0 G rt* m 4. ARCHITECT'S Name W b ri' 5. ARCHITECT'S Address 0 & CD 6. TYPE of Construction — (Please indicate by X) I ' { } wood Frame I l Masonry I ) Steel I l co 7. PLANS and Specifications No. 1000 gallon ]-folding tank per application submitted . rfi 8. Proposed Use E Sewage system for restaurant w m r $ 100 00 PERMIT FEE PAID — THIS PERMIT EXPIRES A ril 3 79 87 `t 0 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensbu ry before the expiration date.} ct r, to Dated at the Town of Queensbury this �] �3 rd Clay of April 1985 � SIGNED BY Y,+'I ry for the Town of O.ueensbury Building and Zoning Inspector TOWN OF Q.UEFNSBURY 'TOWN OF QUEENSSURY BUILDING a ZONING DEPARTMENT � SEWAGE DISPOSAL PERMIT APPLICATI APR 2 1 . Owner s Name/� ,�,g A.M.' e�'tJ • P. Address_ el Ai A1�f li,/d God Cr �' ;� �7 t°� 5( S~ Telepri ne No . 2 . Property location AI&6 ' 4AZ ,5je Roule r`l A) 0 � ! `� 3 . Name �fof ,,p//erson or firm responsible for installing system / J'Vk '5•+7LfGCJ � Cl.� tG .J ' ISr Telephone No . � 3 — � /Z Address [1 Q ► RO nISr� (/ 0 1 4 . Number of bedrooms ( residential buildings only ) .5 . Daily flow Q gallons/day 6 . Septic tank capacity gallons 7 . Topography : flat rolling , steep of slope 8 . Nature of soil and depth 9 . If ground water , bedrock or impervious material is apparent at what i depth does it begin?T ft . 10 . Percolation tests A is required B is not required C if required what is the rate minutes/inch 11 . Water supply : municipal , ell other 12 . 'Type of system proposed : drywell , file fiel other 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 from the approved application will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . Date____ �y signature of applicant, 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 . l / 00 Form 3- 82 TOWN OF QUEENSIBURY Building DePurtmcut Xm P*eport n '1" III --- NamJUSPOe l..oreieu S_ Wmther p No. Remarks ExcatYa tiara Footin Forms Footin & Piers Foundation Cement coat Water roofin ,Bac]cfill Final SUrve Framin sheath-in Roof Felt Roof-in sidin Masonr veneer Rou h Pl b Relief valves Wall.. Board Ext . Porches Finished F7.00r Interior Trim Stairs & Railln s Cellar Dr . Tile concrete Floors ] i Fxtures Gar Fire roofin . - D+vor Closers Chimne Water Meter Inst . se tic A royal Floors Faurldratior� .�.-----�- xnsulation Walls -- Ceilia75r ----..�.... ]Bull n9' Inspector REMARKS L� { dlb