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1985-162 BUILDING PERMIT TOWN OF QUEENSBURY No. 85- 162 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Frank Smith H OWNER of property located at 2- L 1 Fuller Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a Sewag 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. 1 . OWNEWS Address is RD # 2 Glens Falls: New York 2. CONTRACTOR or BU1 LOER'S Name f; Daniel Drellos l� Sanitary Sewer Service m *i 3. CONTRACTOR or BUILDER'S Address P . 0 . Box 224 O pi Glens, F'allst New York 4. ARCHITECT'S Narne 5_ ARCHITECT'S Address B. TYPE of Construction — (Please indicate by X) G] ( ) Wood Frame ( l Masonry ( ) Steel ( ) fD 7. PLANS and Specifications 1000 gallon septic tank , dirt _ box and 1 7 ' X$ ' w No. drywell with 24 " # 3 stone per plot and application M submitted * $t w rt B. 'Proposed Use Sewage system for dwelling tj $ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES April 30 1987 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queensb"ry before the expiration date.l Dated at the Town of Queensbury this 3 0th,� Loning Day of F� April 198 `5SIGNED BYGe �`- ' for the Town of Queensbury Building and Znspeclar Town OF OUFFNSBURX BUILDING & ZONING DEPARTMENT i ttY SE[ikTAGF DISPOSAL PERMIT APPLICATI0XDWf 1 . Owner ' s Name Ln Address V Telephon W:: i '�: 41 4 2 . Property location 3 . Nam of person or firm responsible for installing system ,rr�� Telephone No . 77 '72z ` �i LS- `7 Address_ 4 . Number of bedrooms ( residential buildings only ) 50 Daily flow Z7 'L`7- Gallons/day 6 . Septic tank capacity_ Z t"7 c� 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 t/ is required g is not required C If required what is the rate (9 mi.nutes/ inch 11 . Water supply : municipal pal well , other 12 . Type of system proposed <azdrywel tale 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 &� igna ire of a i ant On separate sheet of paper submit a diagram of the proposed septic system with all dirn -�-nsions , including distance from any structurey distance ofrom property lira and domestic water supply , etc . Include all dimensions of the system i. t- self . 40 ---�, 6 � to Form 3 - 82 I f DI ' Jr& � /( TOWN OF QUEEI4ISSURY g�ildisa�' D,,e�ymrt,�cnt Dstc N�s�ae f+t+��+► `' # h►► I r • wowther OCA Perinit Rerna rkS Excat'�atson - FOOti n Forms Fo©tin & Piers Foundation dement coat Water roafin Back f i l l Final Survey Framin Sheathin Roof Felt Roofin Siding Maoonrtjveneer Rou h Pl Relief valves Wall Board EXt • Porches Finished Floor interior Trim ilings stairs & Ra Cellar Dr . Tile Concrete Floors Pl Fixtures Gar - Fire roofin Door Closers Chime xnst . Water Meter Se tic A rcval �^''� -�---- Foun�n ---- Insulation Walls Cei2ir7 Building xnsPe REMARKS SANITARY SEWER SERVICE Division of G. P. Drellos, Inc. 53 FOURTH STREET GLENS FALLS, N . Y. 12801 TELEPHONE 792-7257 'Z 4M3 � L so 0 s its M 40