1985-239 BUILDING PERMIT
TOWN OF QUEENSBURY Ho g 5 - 239'
WARREN COUNTY, NEW YORK
PERMISSION is thereby granted to u ; c^ hard Fr iSF^an
OWNER of property located at of �i Atldrt tws Drive
Street, Road or Ave.
in the Town of Queensbury, To Construct or place a _ s ewa gi tEr a{- f on
at the above location in accordance to application together with plot plans and other information hereto filed and p,
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. �y
1. OWNER"s Address is 9 St. . .Andrews Drive
Glens Falls , New York 0
2. CONTRACTOR or BUI LDER S Name
Condon ' s septic and Drain Service
3. CONTRACTOR or BUILDER'S Address
17 Gr at A.v e .
Glens Falls , New 'York cn
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4. ARCHITECT'S Name
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6. ARCHITECT'S Address •'
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6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame I 1 Masonry I 1 steel { )
7. PLAINS and Specifications
No. 2 - 6 ' xB ' dryWellS ( if precast existing will restone )
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S. Proposed Use
sewage system for dwelling m
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PERMIT FEE PAID - THIS PERMIT EXPIRES _ May 34 19 87
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(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.) N
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Dated at the Town of Queensbury this Day of , May 19 85
SIGNED BY , � for the Town of Queensbury
Building and Zoning Inspecto
TOWN OF OUFFNSBURY TOWN OF QU �
BUILDING & ZONING DEPARTMENT IE V9 IELo
G Z/ Z- '911 SEWAGF DISPOSAL PERMIT APPLICATT
1 . Owner ' s Name Ar A1.M: 1 Ir �ee . M
Address 7 1?J ?')� Y r 5 X) 1777,
�+ Telephone No . 77 "7 U3 L
2 . Property location
3 . Name of person or firm responsible for installing systemr�„�; p /t .r .
Telephone No . 7yE E :
Address AL&E S F a
4 . Number of bedrooms ( residential buildings only )
5 . Daily flow gallons/day
6 . Septic tank capacity 04) 0 gallons
7 . Topography : flat rolling , steep
% of slope
8 . Nature of soil and depth ,5� -
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? ft .
10 . Percolation test : A is r ecru ired
is not required
C if required what is the rate minutes/inch
llo Water supply : < Tnunicipallop well , other
126 Type of system proposed : drywall , the field , 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
signature f 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 .
IV folLe
Form 3 - 82
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TOWN OF Q►UEENSSURY
Building Department
1.8pectom R, APICIrt Datae���"-y
LAWMItion, T
Pewmma No. 5 W�tlrex�r
Remarks
Exca0a ti on
Foot-in Forms
Footin & Piers
Foundation
,Cement Coat
waterproofing
BacJkfill
Final Surve
Framin
sheathin
Roof Felt
Roof in
Siccing
masonryveneer
Rou h PZ
Relief Valves
Wall, .Board
Ext . Porches
Finished Floor
interior Trim
Stairs & Railin Is
Cellar Dr . Tile
Concrete Floors
pl Fixtures
Gar . Fireproofsn
poor Closers
Chiaarie
Water Meter inst .
Septic A roval
Floor - —
Insulation waaIs
Ceilin ----
Building Inspector
xf REMARKS
Opp e
y
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