5660 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 5660
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Ellen Frick (Mountain View Motel)
OWNER of property located at I� Route 9 Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration o td
at the above location in accordance to application together with plot plans and other information hereto filed and N
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. r
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1. OWNER'S Address is IAR. D. #1
Lake George, N. Y. a
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2. CONTRACTOR or BUILDER'S Name
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Action Septic m
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3. CONTRACTOR or BUILDER'S Address
5 Spruce Court
Glens Falls, N. Y.
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( ) -
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7. PLANS and Specifications CD
sewage alteration per application submitted a
No. W
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8. Proposed Use H
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Sewage system for dwelling a
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$ 5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 79
(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 3 0th Day of . January 19 79
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SIGNED BY /� R n for the Town of Queensbury
Building a d Zoning Inspector g
TOWN OF QUEENSBURY.
Building Department
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Inspectors yRRe rt ate ///9-
Name L7 , /Jiit() 71Ved
Location , 9
Permit No. SSG, Weather
Per Cent
Complete Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
• Cement Coat
Waterproofing
Backfill
• .Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding •
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor
Interior Trim
Stairs&Railings
Cellar Dr.Tile
Concrete Floors
Plbg.Fixtures
Gar.Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Building Inspector
REMARKS
TO
RECEEIVIE -LiT
Tow rill MIEN S'BURY
BUILDING & ZONING Dr'ARDENT j AN 3 0 6/9
BAY & HAVIUND ROADS RD#1. oo r.,......
GLENS Eta.I.LS, NEW YORK 1284)1 Aiirgi9M4.2p.12131411516 '
,8 & 45 RAI LAI Aa
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APPLICATION FOR A rERMIT TO CONSTRUCT, ALTER on ENLUME
it 52,14.AGE DISPOSAL SYSTEM 'WITHIN THE TOWN OF OUT1 1NSI4T1t'l
OCCO ANV C., N AY?
TELEPHONE OR'S HAN2.
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ADDRESS /, L/ ,c,. .) .../ \ NUMBEr OF BEDROOMS -__.-----
GARBAGE GRINDER? czE:-.7. CT( NO) TOPOGRAPIM FLAT ROLLID3, STEEPS SLOPE;
GENTLF. SLOPE, 05:HER
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N,ATUBE OF SOIL: CLAY, SANDY, LOA-, OPAVIII- ROCIC3 ETC -_____------
PER,COLATICN TEST WATER SUPPLY: MUNICIPAL, MIL, MIER
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DIAGRAM OF PROPOSED SEPTIC SYSTEM
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OTHER PERTINENT INFORMATION
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IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE „Ca:PROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOWN.
DATE 1,1- \'Lz....a...L SIGNATURE OF APPLICAkrf C)t.....___i (J/ --I':-------
LAM GEORGE PARK COMNISS/ON APPROVAL:
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(cizmature)
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