1985-449 BUILDING PERMIT
TOWN OF QUEENSBURY No. $ 5- 449
\\/\ WARREN COUNTY, NEW YORK _.
PERMISS(ON is hereby granted to Noble Counter
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t .J 1 Michigan axed Central Avenues Street, Road or Ave.
OWNER of property located a
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To Construct or place a Sewage Alteration n
in the Town of Queensbury, p
at the above location in accordance to application together with plot plans and other information hereto filed and c
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1 . OWNER'$ Address is -RD Michigan Ave .
Glens F' allsr New York
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CONTRACTOR or IBUI f_DER'S Name
Carl Tucker
CONTRACTOR or BUILDEWS Address
RD # 3
Glens Falls , New York �
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address C+
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6_ TYPE of Construction — (Please indicate by X) M
{ ) Wood Frame { ) Masonry { I Steel { } G
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[7.:F,L:A:NS and Specificationsl000 gallon tank , list . box and 2 - 6 ' x8 ' drywells
Na. 24 +* stone # 2 per plot andapplication sukxTlitted .
Propo� Use W
Sewage system for dwelling �
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i0 . 00 August 22 19 87
$ PERMIT FEE PAID -- THIS PERMIT EXPIRES r �
{if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (
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town of Queensbury before the expiration date_) Pi
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Dated at the Town of Queensbury this ^y� Queensbury
*?. nc pay of August 19— -
SIGNED BY / l �x _ for the Town of ueensbury
Buildingard oning lnspecto
TOWN OF OUFFNS13URY TC7WN OF QU1SENSSURY
BUILDING & ZONING DEPARTMENT U E 0 ��
SFWA+G�F DISPOSAL PERMIT APPLICATION e) _ �y S� i « co
1 . Owner ' s Name Ale Cc::) u •-n tc,,rr 40mo
Address l i 17 } i c L� ." G y, .fib-..... e • it
Ai //J %.2 �7' v / Telephone No . �Ja2
2 . Property location ` �� r- a-y.,eA- ep, 4 ,f
3 . Name of person or firm responsible for installing system
__�� r xdC e • fiefepheane No . ' y� / e' 7
Address R f�� S JO �e r -3rr 6: t,, //1�1,
4 . Number of bedrooms ( residential buildings only ) ;L�,
5 . Daily flow 3Q0 gallons/day
6 . Septic tank capacity gallons
? . Topography : lat rolling , steep
of slope
8 . Nature of soil and depth
90 if ground water , bedrock or impervious material is apparent at what
depth does it begin? ft -
10 . Percolation test : A is required
B is not required
C. if required what is the rate minutes/inch
11 . Water supply : (munic-ipail well , other
12 . , Type of system proposed : drywell , tile field , 3 S ? �
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 Ordinanceo
Date
signature of applicant
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 systems itself .
Form 3 - 82 � �
TOWN OF QUEENSBURY
�... su>>almg. Department
in"mwwwo Report Date
Nam.
I am ioni
Permk No. 9 3' !4d �Ie W+e+►ther
Remarks
xxcaQa turn
Footin Forms
Food & piers
Foundation
Cement Coat
Water roofin
Baclrfill
F3na1 Survey
Frazai
Sheathing
Roof Felt
Roo fin
Sidi
masonry-veneer
Rou h Pl
Relief Valves
Wa.I3. Board
Sxt . Porches
Fin i hed Floor
I,nt�srior Trim
Stairs & Railin s
Cellar Dr . Tile
Concrete Floors
P ro Fixtures
Gar . Fire roofin
Door Closers
Chi,mne
Water Meter Instm
Se tic A rr3val
Floors Foundation —
Insulation Walls
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,Hu Ica y Inspector
REMARKS
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