1985-195 BUILDING PERMIT
TOWN OF +QUEENSBURY No, 85- 195
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Donald Latterell
F—'
OWNER of property located at 528 'West Mountain Road Street, Road or Ave. ¢
in the Town of Queensbury, To Construct or place a Sewage Alteration
at the above location in accordance to application together with plot plans and other information hereto filed and N
approved and in compliance with the Town of Clueensbury Building and Zoning Ordinance. fD
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1 . OWNER'S Address is
RL! # 2 West Mountain Road Box 246
Glens Fails , New 'York
2. CONTRACTOR or BUILDER 'S Name
Sanitary Sewer Service :z
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3. CONTRACTOR or BUILDER'S Address
P . O. Box 224 0
Glens Falls , New 'York �
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4. ARCHITECT'S flame
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5. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame I 1 Masonry I Steel l )
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7. PLANS and Specifications
1 -- 71x8 ' drywell with 24 " # 3 stone per plot
No. plan and application submitted . fD
S. Proposed Use
Sewage system for dwelling M
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES May 15 19 87
(If a longer period Is required an application for an extension must be made to the Building and Zoning inspeMor of the
town of Clueensbury before the expiration date.)
Dated at the Town of Oueensbury this 15th Day of May 19 85
SIGNED BY r for the Town of Oueensbury
Building and Zoning Inspector
TOWN OF QU ENSOURY
TOWN OF QUEENSBURY n [� � � IE
BUILDING 6 ZONING DEPARTMENT fiil�==k��„'I
AGE DISPOSAL PERMIT APPLICATION ��� �� �. J
.NIT. f J -' /:` '�C ',o"P,iu�.
1 _ Owner " s Name /� ' 7 $ 9 1 1121314 5 6"
Address__...
Telephone No .
2 _ Property location
3 . Name fef, person or firm r"POnslblAe for installing system
v Telephone No .
Address
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4 . Number of bedrooms ( residential buildings only) .
5 . Daily flow. ';z) (7 gallons/day
6 . Septic tank capacity L) gallons
7 . Topographye flat , rolling , steep
% of slope
80 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 is not. required
C If required what is the rate Q ` minutes/inch
il . Water supply : municipal well , other
12 . 'Type of system proposed : drywall ile 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 ACZ Provided for in section 6 . 010 of the
Queensbury Sanitary Sewage Ordinan
Date r /
zgnat.ure o pl cant
On separate sheet of paper submit aagram 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 . r
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Form 3 - 82
`' -~- -
TOWN OF C EENSSURY
Building Department
limpaetam Rapmt Date /
Name C . *+ <L
n
Pcrnait Na ?�5=-._ f �'4 'Wcatlaer
.Remarks
Iixca0a Lion
Footing Farms
Footing & Piers
Founda ti can
Cement Coat
waterproofing
BaCAE1ll
Final Surve
Framing
sheathing
Roof Fel t
Roofing
Siding
Masonru Veneer
Rough P2 bg
Relief valves
wall, Board
virt . Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr . Tile
Concrete Floors
PJL2 . Fixtures
Gar . Fireproofing
Door Closers
Chimney
water meter Ins t .
Se tic Approval
Floors
Insulation Foundation
Walls �-
Ceilin
Building Inspector
REMARKS
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SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N . Y. 12801
TELEPHONE 792.-7257