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1848 BUILDING PERMIT .� TOWN OF QUEENSBURY No. / 8Y8 xn WARREN COUNTY, NEW YORK �I C-1 PERMISSION is hereby granted to G -i[� OWNER of property located at La rl Street Road or Ave.Ave cia in the Town of Queensbury, To Construct or place a _ S ewa o� Alt bra f i an r 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. rxD t7 1. OWNER'S Address is � Lake George Road Glens Falls , N . Y . „ 2. CONTRACTOR or BUI LOERS Name 0 W Sanitary Sewer Service CL 53 Fburth St . , Glens Falls , N . Y . 3. CONTRACTOR or BUILDER'S Address G) t'D c!? "Y1 N A. ARCHITECT'S Name to 5. ARCHITECT'S Address K 6. TYPE of Construction — (Please indicate by X) i I Wood Frame ( ) Masonry I ? Steel i 1 i. PLANS and Specifications / } J S. Proposed Use $ ot3 PERMIT FEE PAID — THIS PERMIT EXPIRES 07 O —a% (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 13 Day of June ig 72 SIGNED BY for the Town of Queensbury BUT and Zoning I njo&tor TOWN OF QUE 'ENSOURY WARREN COUNTY, NEW '' Cof:K Application tot GI: A PEWIT TO CONSTRUCT , ALTER OR E :3L.A �,RGE D G � DISPOSAL SYSTEM". FOR A PRIVATE REaILENC:E W TI Tti � f TOWN OF QUEEN.�EURY I A,M. PM. Mail or bring this application to : 7181911(1111121112131415I6, Building 8 ,Zoning Department Queensbury Town Office Building R . Q . 1 Say Road Glens Falls , New York 12801 This application for a Sewage Disposal Permit mast Ee accompanied by a plot plan drawn reasonably to scale showing all dimensions , the size of the lot , the location on the lot of the water supply and sewage systerri . 1 , Name d mailing address of applicant : 2 . Specific location of proferty : STREET 3 . Application is for : New construction of private dwelling . Alteration or enlargement of existing sewage c. sposal system . 4 . Description of Luilding : a . number of bedrooms b , garbage grinder YES OR NO 5 . Topography : at , rolling , steep slope , gentle slope , etc . C - 6 , a . Nature of soil . ( Describe to a def- th of 5 feet if tile field is to be used or lv feet if leaching fits are proposed , giving thickness of various strata such as top soil , clay , loam , sand , gravel. , rock , etc . ) _ b . How determined ? 7 . a . Soil percolation test made by _ { Refer to Part Ill , Bulletin 1 , Department of Health )- b . Percolation test notes submitted ? _�YE ©R NCl 8 . Proposed sewage disposal system indicated on attached plan or sketch ? YES OR 'SIC 9 . Date when construction rvill com-mence 7 It is hereby agreed that if thls ap } lic don and attached ; lars dated or any amend r- nt or r. vv1 an ;: thr^ reof , are apf'.roved , y irist�ablation of sewage disposal facilities will be made in accordance with the details thereof as shown on such approved plans . Installed y : Contras or - T7- 'gnature of applicant Owner �� r� Re V R44- TOWN OF +QUEENSBURY Building Department / Insrs, �,..ars_ R ort Date L4 Name Location ' Permit No. Per Cent Complete RomaLrks Excavation Footing Forms Footing & Piers Foundation Cement Coal Waterproofing Backfill Final Survey Framing Sheathing Roof Felt Roofing Siding Masonry Veneer Rough Plb . Rough Ht . Relief Valves Wall Board Ext. Porches Finished Floor Interior Trim Stairs & Railings Cellar Dr. Tile Concrete Floors Mg. Fixtures Gar. Fire niz Door Closers Chimney Water Meter Inst. Septic A roval toe Building Inspector REMARKS