1985-082 BUILDING PERMIT
TOWN OF +QUEENSBURY
No. 8 5-8 2
?)bifez ' �- ] - 1 �, { WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Glens Fzlls N i nna 3 Bank & 'TrL st Comj2any G7
W citp M
OWNER of property located at Uipper Cy l tin Stir l-_ _ Street, Road or Ave.
In the Town of Queensbury, To Construct or place a Sewage A,l -�czra {- i Qry _ fa
at the above location in accordance to application together with plot plans and other information hereto filed and - ~'
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ur
t . OWNERSAddrassis Upper ,Glen St . yy
Glens Falls , New York l�
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Iy
2. CONTRACTOR or 8U1 LOER'S Name
Paul Breton W
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3. CONTRACTOR or BUILDER 'S Address
Michael Road
South Glens Falls , New York
4_ ARCHITECT'S Name
"cy
rCf
5. ARCHITECT S Address
fD
6. TYPE of Construction — (Please indicate by X)
Pt'
( ? Wood Frame ( I Masonry ( ) Steel
7. PLANS and Specifications
alteration/repair to existing system - new 240 LF
Na. the field per plot and application submitted .
8. Proposed Use
Sewage system for bank
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1000 PERMIT FEE PAID — THIS PERMIT EXPIRES April 2 19 $ Ida
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{If a larger period is required an application for extension must be made to the Building and Zoning inspector of the (D
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fawn of Oueansbury before the expiration date.)
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Dated at the Town of Queensbury this _ 2nd Day of April 19 85 p-
�y �,, � /s �y tj
SIGNED BY z^^ L { 0�5d. .for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEFNSBURY
BUILDING & ZONING DEPARTMENT TOWN C)F QUEENSBUI:1Y
SFFtTAGF DISPOSAL PERMIT APPLICATION F= ro IE 0 V F= t� [
1 . Owner ' s Name �' s ; ' I'r 7 F o i✓ J3� L�i,"JI
Address ,� ram• p,M.
Telephone Z46 a r
2 . Property location G-G ,�• 5
3 _ Name of person or firm responsible for installing system
Telephone No .
Address �?f� 5�rrt � �.' t] S C� '
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow gallons/day
6 . Septic tank capacity_ _ / 0ep r gallons
7 . Topography . flat , rolling , steep
% of slope f7 r
am Nature of soil and. depth 14 A
9 . If ground water , bedrock or impervious material is apparent at what
depth doses it begin? ft ,
10 _ Percolation testv. A is required
B 'his not required
C if required what is the rate minutes/inch
11 . Water supply : municipal , well , other
12 . Type of system proposed : drywell , the field , other Rev<^,c .+,r
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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
Queensb7ury /Sanitar/y Sewage Ordinance . (�
Date 7 / .a� �' /,'fir
signatur 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 . --
Form 3- 8 2 W.l�G'
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