1986-188 BUILDING PERMIT
TOWN OF QUEENSBURY Na. R6-188
SCA s 1 _v/i iO\ARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Rose Corlew
OWNER of property located at 94 Main St. Street,Road or Ave.
Sewage Alteration
in the Town of Queensbury,To Construct or place a n
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 Queensburym Building and Zoning Ordinance.
1. OWNER'S Address is 94 Main St.
Glens Falls, N. Y.
2. CONTRACTOR or BUI LDERS Name
Sanitary Sewer Service
ad
3. CONTRACTOR or BUILDER'S Address
P. 0. Box 224 n
Glens Falls, New York
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame 1 ) Masonry ( )Steel 1 )
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T. PLANS and Specifications
sewage alteration - replace tank 1000 gallon
No. per plot and application submitted. y
n
CD
8. Proposed use Sewage alt. for dwelling n
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 5 19 88
(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.)
Dated at the Town of Queensbury this 5ythDay of May
�� t:z 1986
SIGNED BY //f�fitt� c- v" for the Town of Queensbury
Building and Zoning Inspector
cC77 TOWN2 OF QUEE���Np8'�8;u„r
_/own of Queeniburl� M I5 G E H V E U,
i . ^ BUILDING and ZONING DEPARTMENT JJJ UUU
Bay and Haviland Road, R.D. 1 Box 98 M IR 5 01986
Oueensbury, New York 12801 A.M w r-ee PP.M.J
718,911414111213)41516
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SEPTIC DISPOSAL/ PERMIT APPLICATION n1
Owner's Name f: (26 2yf ((fi't Vc�C•latx. (1 Tel. L� /y = I �'t. i.
Address Ott I4f^I/-/ & , ( (�Jp. > - OJtr /1JJhit)d'
Person/Firm installing system C1i it' IrF)pki 17.4.0tc [4441/'-c.
Number of bedrooms(residential only) 7---
Total daily flow: (compute @ 150 gal.per bedroom per day)_�1O D
Topography: lat rolling - steep - (circle one) Degree of slope _%
Nature of soils: Oloam-clay- other- Depth ft.
Ground water-- at what depth? ft.
Bedrock or impervious mat 'al--at what depth? ft.
Percolation Test Not required Required -Rate min/inch.
Domestic Water Supply Municipal Well - Other
IMPORTANT!
On a separate piece of paper, submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, pond or wetlands. Include all ,
dimensions of the system itself.
Description of proposed system:
Septic tank size /Obi) gal.
Tile field- Lengthof each trench ft. Total field ft.
Size of stone #
Seepage Pit(s) Number / Size ftX__ft. Size of stone#
•
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 Town of Queensbury Sanitary
Sewage Ordinance. �j / ' t +l-ik` V�'�/C5
9'gna[ureof pIica Date
01/86 and/vl
Septic System Inspections:
A. All applications for septic system installation,
alteration or repair, as required by the Town of
Oueensbury Sanitary Sewage Ordinance, shall be
submitted to the Building Department at least
24 hours before start of construction and shall
include a plot plan showing:
1) the proposed location of the system
2) location and distance to lot lines
3) location and distance to structures
4) location and distance to any water supply
5) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and
approval by the Building Inspector. Failure to
comply with this requirement may result in the
uncovering of the system by the ,instal '.er and a
fine of up to $250.00.
C. An approved copy of the plot plan shall he
available•on the construction site. Failure
to produce said plot plan at time of inspection
may result in an immediate work stoppage.
❑. Should unforeseen problems during construction
prevent proper installation, alteration or
repair of an approved system, a new proposal
must be submitted to the Oueensbury Buildina
❑epartment before further construction.
TOWN OF QUEENSBURY
Building Department
Inspectors ReportDate 40 xIP G
Name fje?,"/ (qr.'r;A R 4 b c On) .
(Amnion (,)rubs
Permit No. Co — , S Weak
Remarks
ExcaOtion
Footin• Forms
Footin• & Piers
Foundation
Cement Coat
Water sroofin•
Backfill
Final Survey
Framin•
Sheathin•
Roof Felt
Roofin•
Siding
Mason Veneer
Roush P1.• .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railin•s
Cellar Dr. Tile
Concrete Floors
Pl.. . Fixtures
Gar. Fire•roofin•
Door Closers
Chimne
Water Meter Inst. V
Se•tic A.•roval r/
Floors
Foundation
Insulation Walls
Ceiling
.r 3k2 g Inspector
REMARKS
SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792;7257
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