1985-143 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85- 143
WARREN COUNTY, NEW YORK
PERMISSION is hereby
granted to Calvin Howard
OWNER of property located at Sunnyside East Road Street, Road or Ave. Nr
in the Town of Queensbury, To Construct or place a _ Sewage A lter a tlon 4
at the above location in accordance to application together with plot plans and other information hereto filed and 0
approved and in compliance with the Town of Queensbury Building and zoning Ordinance.
t. OWNER'S Address is RD # 1
Glens Falls , N . Y .
2. CONTRACTOR or BUILDER 'S Name
Daniel Drellos rxa
Sanitary Sewer Service
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3. CONTRACTOR or BUILDER 'S Address �
p . O . Box 224
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Glens Falls , N . Y .
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4_ ARCHITECT'S Nam tTJe pi
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5. ARCHITECT'S Address W
8. TYPE of Construction — (Please indicate by X)
( ) Wood Frame I ) Masonry ( ) Steel ( ?
7. PLANS and Specifications 1000 gallon tank , dist . box and 200 ' leach field
No. per plat and application submitted . �
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8. Proposed Use
Sewage system for dwelling
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100 00 0'
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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.}
Plated at the Town of Queensbury thi-s-y 23rd Day ofApril 1985
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector O
TOWN OF QUEENSBURY TE7WN CIF
BUILDING & ZONING DEPARTMENT
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SFF?AGF DISPOSAL PERMIT APPLICATION
10 Owner ' s Name 4_ �/ ,� }^- � — "� �.+ APR
Address tJi9 i �Z? 7� $ � x7x] � 3j ; � 5 #fi
Telephone No .
2 . ' 'Property location
3 . Nam of person or firm responsible for installing system
/u 1Z?9,�f r=,, 4..�e fc yz c Telephone No . 674?J ' Zr a* r7
Address _� x
4 . Number of bedrooms ( residential buildings only ) ,
5 . Daily flow. gallons/day
6 . Septic tank capacity_ ! 4 L] gallons
7 . Topography : flat rolling , steep
% of slope ��''
so Nature of soil and depth . � � l
90 if ground water , bedrock or impervious material is apparent at what
depth does it begin? s ft .
10 . Percolation test : A ;,/ is required
B is not required
C If required what is the rate Q �.S minutes/inch
Ila Water supply : municipal , we11 other
12 . Type of system proposed : drywell , ile fie, 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 pro ed for in Section 6 , 010 of the
4ueensbury Sanitary Sewage Ordinance .
Date e- 1 �Tvl� f`e� J�
ature of app cant
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 .
le 40
Form 3 - 82
TOWN OF Q►UEENSBURY
Buildine Department
1mmpecbw* Report Date
Name C A I tyl4.)
Location �39 . /=A c- 7 ' cf
Remarks
Exoa tYa ti at]
Footing Forms
Footina & Piers
Foundation
Cement Coat
water roo.fin
Baclkfill
Final Survey
Framing
sheathing
Roof Fel t
Roof-in
siding
Masonry Veneer
Rough Pl
Relief Valves
wall Board
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railings .
Cellar Dr , Tile
Concrete Floors
Plbg . Fixtures
Gar . Fire roofin
Door Closers
Chin ne
Water Meter Inst .
Septic A royal _.
Floors
.insulation Foundation
walls _
Ceiling
Building Inspector
REMARKS
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