1985-669 BUILDING PERMIT
TOWN OF QUEENSBURY No. RS- 669
WARREN COUNTY. NEW YOrRK
PERMiSSIfJN is hereby granted to Samuel �
OWNER of property located at qsci Dr i me
Street, Road or Ave_
0
in the Town of Queensbury, To Construct or place a
rt
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-
1 . OWNER'S Address is 7 St . Andrews ]Drive
Glens Fallsr New York
2. CONTRACTOR or BELDEFRIame
Cr7
ndon ' s Septi_C Service3. CONTRACTOR or Bddress ¢Grant Ave . m
lens Falls , New York
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4. ARCHITECT'S Name K
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C
C[r
$_ ARCHITECT'S Address
[7. PLANS
YPE of Construction — (Please indicate by X1
l l Wood Frame f ) Masonry i ) Steel l )
rh
(4
and Specifications2 -- 6 ' x8 ' drywells per plot and application mNo. submitted .
Hroposed Use r't
S6
Sewage System for dwelling
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w
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lb _ OU PERMIT FEE PAID — THIS PERMIT EXPIRES Nam;' ' 15
19 87
(If a longer period is required an application for an extension must be made to t h a Building and Zoning inspector of the
town of Queensbury before the expiration date.)
15th Da of November 19 85
Dated at the Town of Queensbury this Y
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEFNSBURY TOWN OF QUEENSO" r y
BUILDING & Z ON ING DEPARTMENTaFSEre?AGF DISPOSAL PERMIT .APPLICATION [C1 '—" ft1
j'77 c� i7
� . Owner ' s Name .
Address
Telephone No . 7 f e�r -
2 _ Property location
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3 . Name of person or firm responsible for installing system
r ' Telephone No . '27C3
Aggress d 6&� _._ U
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow gallons/day
allons
6 _ Septic tank capacity /to 40 ' g
7 . Topography : lat rolling , steep
of slope /
86 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
ll . Water supply : municipal , . well , other
12 . Type of system proposed : drywell , the field , other
Any contractor , corporation , individual , etco engaged in " the construction
of a sanitary sewage disposal system who covers the same before inspection ,does not have an approved permit , or var3..es from the approved application
will be subject to a penalty of $ 250 as provided . for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance _ F
Date/� L /�
slgnaure o scan
app t
t
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions , including distance from any structure , distance from
ic water supply , etc . Include all dimensions of
property line and domest
the system itself . /
Form. 3 82
TOWN OF QUEENSBURY
02!e) ? Building Department
Inspacbma Revmw* —
Name
Lacairioa
Parsmt a`
Remarks
Sxcat''ra ti on
Footin Foxrr+s
Footin 6 Piers
Foundation
Cement Coat
Water rc7ofin
BacJFfill
Final survey
Pr
sheathing
Roof Fel t
Roo fin
,Siding .
Masonr Veneer
Rou h Pl
Relief varLves
Wall Board
Ext , Porches
Finished Floor
Interior Trine
Stairs 6 Railin s
Cellar Dr . Tile
Concrete Floors
Pl . Fixtures
Gar . Fire roofin
,poor Closers
Chimne ------------
Water Meter Inst .
septic A roval
Floors
Foundation
.rnsulation Walla
Ceilin
of lding xns,pactor
REMARKS
$ V
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