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1985-625 BUILDING PERMIT TOWN OF QUEENSBURY No. 85- 625 ��/fyi\ ��]{/'��� "/�^�'� ,/f}y�] WARREN COUNTY, NEW YO R K V Y l i ( (�/ ~P� y PERMISSION is hereby granted to Joanne LaBombard C4 D OWNER of property located at U1 Indiana Avenue Street, Road or Ave. � ti in the Town of Queensbury, To Construct or place a Sewage Alteration (D at the above location in accordance to application together with plot plans and other information hereto filed and pi approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_ txl B 1 . OWNER'S Address is # 4 Box 13 Glens Falls , New York , 2. CONTRACTOR or BUILDERS Name Jay Sweet Queensbury Sewer �. 3. CONTRACTOR or BUILDER'S Address P) R.R. # 1 fy Lake George , New York c 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) to f Y Wood Frame f I Masonry I I Steel f i !y 7. PLANS and Specifications 'M (D dist . box and 1800 leach field per plot and . NO' application submitted . '- rf- Ip 8. Proposed Use Sewage system for dwelling 'y r- D $ 10 00 PERMIT FEE PAID - THIS PERMIT EXPIRES [Zc-± 95 198: (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 7 5th—....Pay of on i-r- bgM' - SIGNED BY • 16 for the Town of Queensbury Building and Zoning I nspector OTKN OF OUFF'NSPURY -TOWN OF QUEENSBURY BUILDING & ZONING DEPARTMENT !E g E � {� SFVTAGF DISPOSAL PERMIT LICATI2 � y ��y n� ,Y t ,, I . Owner ' s Name -- C{{� / c' '►'7r '�-�'� Address :7' Aj c t �{' C # L C ..r-- 7� ��. 1'� 11213141516 Telephone No . 2 . Property locations tG� G[ r' ct--i c._ �s--• E� 3 . Name of person or firm responsible for installing system ILc' Telephone No . p ` Address _ aC TY 4 . 11%Zumber of bedrooms ( residential buildings only ) _ S . Daily flow' gallons/day E . Septic tank capacityaalions 7 . Topography : flat rolling , steep % of slope C� so Nature of soil and depth 9 . If ground water , bedrock or impervious material is apparent at what depth does it begin ? ft . 14 . Percolation test : A is required B is not required C if required what is the rate minutes/ - 1 l . water s u 1 --__-_- PP Y � �uniciP ,l. , well , other 12 . Type of system proposedsCrywell 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 pxrovided for in Section 6 . 010 of the Queensbury Sanitary Sewage Ordinance . D a t e xgnature • c applicant On separate sheet of paper submit a dig ram 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 . r Farm 3 - 8 2 t/' �''u. C� /"`-,�' z c ,c--- t •r- <a! _y� 4 TOWN OF QUEENSBU R.Y Building Department Date_ ©l1'8 144 Parmk No.- 'weather to j r c�' s !`v Remarks £sxcat}a t.x on r Footing Forms Footing & Piers Foundation Cement Coat waterproofing Ba ckfi l l Final Survey Framing Shea thin Roof pelt Roofin 51ding Masonry Veneer Rough PI bg Relief valves wall Board Ext . Porches Finished Floor Interior Trim Stairs & Railings cellar Dr . Tile concrete Floors PI . Fixtures Gar . Fire roofin Door Closers Chi mne pq Water Meter Inst . Septic Approyal Floors Insulation Founda tIon Wall ceili22 � Bulldingr Inspector REMARKS Lam- f3a - aft ( Z-e rx-cs � riw r rc 4. i� w F Gc' r-v? � �e 4 Q r