1985-408 BUILDING PERMIT
TOWN OF +QUEENSBURY
No. 8 5- 4 08
}} WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to John Jarrett �
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OWNER of property located at 1 9 P i nPwnod Ayer] a Street, Road or Ave.
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in the Town of Queensbury, To Construct or place a Sewacfe Alteration
at the above location in accordance to application together with plot plans and other information hereto filed and rr
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t . OWNER'$ Address is 19 pinewood Ave .
Glens Falls , New York
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2. CONTRACTOR or BUI LDE RZ Name
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Sanitary Sewer Service
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3. CONTRACTOR or BUILDER'S Address p
P . 0 * BOX 224 0,
Glens Falls , New York
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4_ ARCHITECT'S Name @
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5. ARCHITECT'S Address
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6_ TYPE of Construction — (Please indicate by X) En
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( ) Wood Frame { 1 Masonry I i Steel
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7. PLANS and Specifications
No, di st , box and 2 7 ' x8 ' drywells and # 3 stone per r~t
plot plan and application submitted * ,M
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8. Proposed Use rI
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Sewage system for dwelling 0
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES August 5 19 $ 7
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before ifte expiration date_)
Dated at the Town of Queensbury this 5 t h Day of August i9 85
SIGNED BY for the Town of Queensbury
Building a rxf Zoning Inspector
TOWN OF OUEENSBURY
{ A BUILDING
OF QUEENSE €
BUILDING & ZONING DEPARTMENT � :'1 LE
SEWAGE DISPOSAL PERMIT APPLICATION
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1 . Owner ' s Name I k�j A ed,j p..+
Address E,(�f? 718i91�q � 2 � 0 1516
Telephone
2 . Property location_ t L_
3 . Name of person or firm responsible for installing system
i �_ k Telephone No .
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Address P t i Q J( Q . F
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow gallons/day
6 . Septic tank capacity. /� 0 0 gallons
7 . Topography : flat , olling teep
of slope
8 . Nature of soli and depth20
90 if ground water , bedrock or impervious material is apparent at what
depth does it begin? f t .
10 . Percolation tests A is reauired
B s not recr Irejd,;�
C If required what is the rate minutes/inch
11 . Water supply : municip well , other
12 . Type of system proposed :. drywel 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 as gr vi for in Sec ' on 6 . 010 of the
+Queensbury Sa nary Sewage Ordinance .
Date
atu e of appl>kta4il t
On separate sheet of gaper 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
TOWN OF QUEENSSURY
Building- Department
Date
N�rmre
I km Zill e9. c''
Permit NO. - Cr' Q W We tbAW
,Remarks
ExcaVat on
Foot-in Forms
Footi.n & Piers
Foundation
Cement Coat
Water rvo€in
Backfill
Final Serve
Framin
sheathin
Roof Felt
Roofing
Siding
Masonry veneer
Rou h Pill
Relief Valves
Wall Eoard
Ext . Porches
Finfshed Floor
interior Trim
Stairs & Railin s
Cellar Dr , Tile
Concrete Floors
Pl . Fixtures
Gar . Fire rootin
Door Closers
Chimne
Water Meter xnst .
Septic ..Approval
Floors
Foundation _..
insulation Walls
Celli
Aa"22
B it my Inspector
RrM"KS
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