1985-514 BUILDING PERMIT
TOWN OF QUEENSBURY No, 85- 514
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to _ George Finch -
OWNER of property located atgDY✓ Uzerne Road/lrT P_WCCtmb Street Street, Road or Ave. 0
in the Town of Queensbury, To Construct or place a Sewage Alterat ; nn
CD
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 Queensbury Building and Zoning Ordinance_
C)
t . owNEFI'S Address is 42 Luzerne Road '
Glens Falls , New York
2. CONTRACTOR or BUl LDER'S Name
t'P
Queensbury Sewer 0
N
CIS
3. CONTRACTOR or BUILDERS Address
(D
RD # 1
Lake George , New 'York p
w
4_ ARCHITECT'S Name
Z
CR
f}
C.7
5. ARCHITECT'S Address
tY
C1a
s-F
ft
6_ TYPE of Construction — (Please indicate by X) CR
(o
r*
{ ) Wood Frame ( ) Masonry ( 1 Steel ( 1
7. PLANS and Specifications
1040 gallon tank. , list . box and 2 - 60 ft .
No, lines of leach per pleat and application .
rn
B. Proposed Use
fat
Sewage system alteration for dwelling ro
r�
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Sept . 12 CIO
1� 87
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the p)
town of +Dueensbury before the expiration date.) r'r
Y-
O
Dated at the Town of Queensbury this 12 th Day of S eptember 19 85
SIGNED BY 4� for the Town of Queensbury
Building and Zoning Inspector
TOWN OF OUFFNSBURY
PUIEDING & ZONING DEPPRTMFNT
SFVJ F Dlar Pi7SAL PERMIT PP,LICATI N TOWN dfi QL1EEltiiSBLlt3 r
f 0E9V � s :
la Owner ' s Name -ram,._
Address
4.IL213141
4riti
Telephone NO
2 . Property location „ . �..�.,, + � ►� +� D wt.
3 . Name of person or firm responsible for i.nstallina system /
Telephone No .
Address
4 . Number of bedrooms ( residential buildings only )
5 . Daily flow , S gallons/day
6 . Septic tank capacity /�Q� C2 gallons
7 . Topography : flat , rolling , steep
% of slope
8 . Nature of sail and depth _
9 . If ground water , bedrock or impervious m terial is apparent at what
depth does it begin? ft .
IO . Percolation test : A is required
a is not required
C^ If required what is the rate minutes/ inch
11 . Water supply : municipal , well , other
12 . Type of system proposed : drywell , tile field , other f-�IG7
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
Queensburry" Sanitary Sewage ordinance .
Date c� �w �-- 1 •
uf!tl
s nat r
e o 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 system itself .
7
r.�C'.�f ,�-
d l
Form 3 - 82 ( �
TOWN OF QUEENS►SURY
Building Department
laxpeebwe Report It Date
Nl� 7va '
Lacatiao
P`erspiR Na. W+es►ther
Remarks
Excal0a tion
Footing Forms
Footing 6 Piers
Foundation
Cement Coat
waterproofing
Backfill
Final Survs
Fraxd n
Sheathing,,
Room Felt
Roofin
siding
Masonry Veneer
Rau h J-bgkh
Relief valves
Wall Board
ExtIll, Porches
Finished Floor
,interior Trim
Stairs & Railin s
Cellar Dr . Tile
Concrete Floors
p2bef , Fixtures
Gar . Fire roofing -- -
Door Closers
chimney
Water Meter Inst ,
septic A rovel {-
Floors
FoundatIt n_
Inaulatlon Walls _
Ceiling
_..
ML
itilc3 ng Inspector
REMARKS
r
ALI
o
. F __ � _ ,