1985-222 BUILDING PERMIT
TOWN OF QUEENSBURY No. B - 222
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Darwin A . Williams , Jr .
to
OWNER of property located at 39 Ogden Road Street, Road or Ave. lei
in the Town of Queensbury, To Construct or place a Sew age System for mobile Home
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.
1, OWNER'S Address is 71 Br iwood Circle
Glens Falls , Nev. York l�
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2. CONTRACTOR or BUILDERS Name
'.xr- ame �
3. CONTRACTOR or BUILDER'S Address
Same
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
(D
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6. TYPE of Construction — (Please indicate by XI 0
Iy
( 1 Wood Frame I I Masonry I ) Steel I I
7. PLANS and Specifications
1000 gallon septic tank , 200 ft . leach field
No. disc , box per plot plan and application suxsnitted .
S. Proposed Use co
a Ste`
Sewage system for mobile home dwelling d�
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i-�
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES May 23 19 87 per" tW
(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.}
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Dated at the Town of Queensbury this 2 3 r d Day of May 19 85 rt
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SIGNED BY for the Town of Queensbury
RuiId1ngand Zoning Inspecto 1'
` TOWN OF QUFFNSBURY
C!W{v OF QUEENSSURY
BUILDING & ZONING DEPARTP'sE
SE1KTAGF DISPOSAL PERMIT APPLIC 4 Cc [�E 9 u E
1 . Owner ' s Name
&M. V WGWP.M.
Address i' ? 819PPR
7� 2 3 6 6
�} ( Telephone NA . .r` 9c , '/1 o 2
2 . Property location " 4 7 C� •v l ,
3 . Name of person or firm responsible for installing system
Telephone No .
Address
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow E { `� (� gallons/day
6 . Septic tank capacity C, C; s"] 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
depth does it begin? ft .
10 . Percolation test . A is required
B 77 ;4 , is not required
C If required what is the rate minutes/inch
11 . Water supply : municipal , well , other^
12 . Type of system proposed : drywell , tile 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 . ry
Date �?- l ,' - Gcll] c ranir3
signature or 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 .
ti
Form 3 - 82
S,J� �'.
EENSBL,iRY
TOWN OF Q�
Building p, p&wtment
.09 Join
Location yliartlaer
Perunit No.
,Remarks
Jill
SxcatYa ti.on
Footin Forms .
in & Piers
Foot
Foundation
cement coat
Water roofin
gackfill
Final Surve
Framan
sheathin
Roof Felt
Roofin
Siding
Masonr veneer
Jill IIIIII
Rou h Pl
Relief valves
Jill, 1111
Wall Board
Ext . Porches
Finished Floor
Interior Trim
Stairs & Raillin S
Cellar per .
Tile
Concrete Floors
Pl . Fixtures
Gar . Fire roofin
poor closers
Chimne
Water Met ero al .
Se tic �► Floors
Founda tian ---�--
InsuZation Wa3s -�
Ceilil ---
-+� Bull rig Insctor
REMARKS
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