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1985-237 BUILDING PERMIT TOWN OF QUEENSBURY No. 85_ 237 WARREN C©LINTY, NEW YOR K pERMISSION is hereby granted to c l if f ord Goss OWNER of property located at Sullivan Road Street, Road or Ave. in the Town of Cl.ueensbury, To Construct or place a Sewacie Alteration 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. 0 I"t EARCHITECTrS ress is RID # 1 Lake +George , New York � 0 un to R ar BUILDERS Name D . Granger and Sons sn sv R or BUILDERS Address Homer Ave . C Glens ra. 11sr New York 0) S Name 0 'S Address 6, TYPE of Construction — (Please indicate by XI tl'1 ( I Wood Frame i 3 Masonry C I Steel ( ) CEI S� 7. PLANS and Specifit*itions M 1000 gallon tank . dist . box and 187 ft . leach � No, field per plot plan and application submitted . � r+- m re 8. Proposed Use (U rt- Sewage system for dwelling 0 j 0 $ 10 . 00 , PERMIT FEE PAID — THIS PERMIT EXPIRES Mav 30 19 87 (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.) Dated at the Town of Queensbury this 3 Otl: Day of May 19 85 SIGNED SY � � . , ..� for the Town of Queensbury Building and Zoning I nspecto� TOWN OF C)UFFNSBURY TOWN 'OF QUEEN+SSURY BUILDING & ZONING DEPARTMENT � [E SErr?AGE DISP©SAL PERMIT APPLICATI �,yJ •�,}� � " ad 1 . owner ' s Name 4 �11� C� 4116 8 . 17 f� + a e 4 1 Y 1 Address III PqPqPq Telephone No . 2 . Property 1 ati.on_ Q *1 � 3 . Name of person or firm responsible for installing system ,3 L� Telephone No . 742 6 fa, Address 4 . Number of bedrooms ( residential buil Lpqs only) 5 . Daily flow 44.j b 9allons/day 6a septic tank capacity _ � crrr 9 gallons 7 . Topography : fl , rolling : steep of slope 86 Nature of soil and depth_ <N ,L� - 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin? ft . 10 . Percolation test ; A is required g _---- is not required C If re uared what is the rate minutes/ inch ll . Water supply - municipal , well , other 12 . Type of system proposed : drywell the field ' other Any contractor , corporation , individual , etce 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 Quee7vr —/ ni *�ary Sewage Ordinance . Dat // signature ofapplicant, On separate shelat of paper submit a diagram of the proposed septic system with all dimens ons , including distance from any structure , distance ' from property line ar) d domestic water supply , etc . Include all dimensions of the system itse ' f . Form 3- 82 TOWN OF QUEENSBURY Buildins Deupsrtmetot jeepoetwe ReportLOCSI r Westhex__ Per it No. 7 5' - 2 3 / Remarks Exca►ya tion Footin Forms Footin & Piers Foundation Cement Coat Water roofin Backfi2l Final Surve Framin Sheathing lgoof Felt Roofin Sidin masonr veneer Rou h P3 Relief valves pfiI ,Board Ext . Porches Finished Floor Interior Trim stairs & Railin s Cellar nr • 'Tile Concrete Floors Pl Fixtures Gar . Fire roofin Door Closers Chimne Water Meter Inst . Se tic A roval Foundation Insulation walls �..------�- Ceili.n Building Inspector REMARKS b/ t r f 4 f At I A�`1 r1'r`-,'ter � � A.3✓� ��. � 1 (T,.'"Y'-- �� 5 �!�' t ... . r I^�'^. "r"' i' � ,