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1985-295 BUILDING PERMIT TOWN OF QUEENSBURY No. 85- 295 {{ +2 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to William Miller i OWNER of property located at 3 Mountain View Lane Street, Road or Ave. s N• in the Town of Queensbury, To Construct or place a Sewage Alteration H at the above location in accordance to application together with plot plans and other information hereto filed and F4- approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_ a t . ©wNERSAddressis 26 Mountain View mane Glens Falls , New "York +- l-t 2. CONTRACTOR or BUILDER 'S Name Sanitary Sewer Service 3. CONTRACTOR orBUILDEWS Address h C7+i P . O . Box 224 Glens Falls , New York 0 4, ARCHITECT'S Name rt L'a C 5. ARCHITECT'S Address (iS ¢3 B. TYPE of Construction — (Please indicate by X) 0 ( ) Wood Frame i ) Masonry i } Steel f 1 7. PLANS and Specifications No. dirt . box and 1 - 7 ' xB ' drywe.11 with 24 " # 3 stone per plot plan and application submitted . rn 8. Proposed Use g !v 14 Sewage system for dwelling m fi 10 . OCl PERMIT FEE PAID — THIS PERMIT EXPIRES ,Tune 23 ygB7 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the N town of ueensbury before the expiration date.} Fes Rl ,. O Dated at the Town of Queensbury this 2 l st Day of `Tune 19 85 SIGNED BY 6 1 +� for the Town of Queensbury Building and Zoning Inspector yf TOWN OF QUEENS$URY TOWN alp Y 1 BUILDING & ZONING DEPARTMENT 2' fpR E p V E SEWAGE DISPOSAL PERMIT APPLICATI !� l�9 I! IN f / !, Pei.-- 4 U 14 7 1 . owner ' s Name �. 1� ( l l ill (I=, 1(4 l - I �1 Address C �-a' i E'4 c1 + /t) s $` a z 2 a i � a Telephone No . S7 R - s 00 2 . Property location 3 . Name of person or firm responsible for installing system Telephone No . :7 , Address o C 0-4) 1Y 4 . Number of bedrooms ( residential buildings only ) _ , 5 . Daily flow G`� +� gallons/day 6 . Septic tank capacity b gallons 7 . Topography : at , rolling , steep f slope 8 . Nature of sail and depth C) r 9 . If ground water , bedrock or impervious aterial is apparent at what depth does it begin? ft . 10 . Percolation tests A �..'`� is required B. is not required C If required what is the rate - �'` minutes/ inch 11 . water supply : municipay well , other 12 . Type of system proposed : drywell the 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 aspxovided for in Section 6 . 010 of the 4ueensb,/ury Sanit-iry Sewage Ordinance . Date C.�7 f / f ignature of a 1 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 . Form 3 - 82 &"t � 3 Pr;C.J.000Ll TOWN OF QUEENSSURY Buildia,t Department e e s Reepairt, -- Dante Name L L a .a . L.a�catiee � • Peee No. W aa+tk�ar Remy zks _ Excat�at3on Footin Forms Footin & Piers Foundation _ Cement Coat water roofin BackfiIl ry Final Surve Framin Sheathing Roof Felt Roofing Si In Masonr Veneer y Rou h Plb . Relief Valves wall Board Ext . Porches shed Floor Interior Trim Stairs & Railin s Cellar Dr - Concrete Floors PI . Fixtures _ Gar . Fire roofin Door Closers Chimne water Meter Inst . Se tic A roval Floors Foundation �.... Insulation walls Cei.l.in Building Ins for REMARKS SANITARY SEWER SERVICE Division of G. P. Drellos, Inc. 53 FOURTH STREET GLENS FALLS, N . Y. 12801 TELEPHONE 792. 7257 I _ F I { ! �l