6322 BUILDING PERMIT
TOWNBUILDI OF QUEENSBURY
No. 6322
01 ' \ --1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Wayne J. Fisher
OWNER of property located at 18 Clark Street Street, Road or Ave.
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 G
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is 18 Clark St.
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
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Sanitary. Sewer Service
3. CONTRACTOR or BUILDER'S Address
53 Fourth Street
Glens Falls, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address ry
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
1000 gallon seepage pit and #3 stone per application
No. submitted.
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8. Proposed Use
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Sewage system for dwelling/
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$5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 1 19 80 0
(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 6th Day of Nay 19 80
SIGNED BY for the Town of Queensbury
• Building and Zoning Inspector .
TOWN OF QUEENSBur<TOWN OF QUEFNSBURY D , E U E
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R.D. 41 MAY 6 1980
GLENS 'FALLS, NEW YORK 12801 L
A.M. 5°_ 1 e t- Acoli4
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARfE7)M10PM M 3 4 5 6
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY ✓' .L
OCCUPANT'S NAM C J z I e`- ADDRESS //d4 /
TELEPHONE OWNER°S NAME
ADDRESS NUMBER OF BEDROOMS
GARBAGE GRINDER?. (YES OR NO) TOPOGRAPHY: FLAT, ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER
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NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS, ETC.
PERCOLATION TEST WATER SUPPLY: UNIICIPAL, WELL, OTHER
DIAGRAM OP PROPOSED SEPTIC SYSTEM
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OTHER PERTINENT INFORMATION b7 TAT f
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IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS SHOq .
DATE ?, ed SIGNATURE OF APPLICANT
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TOWN OF QUEENSBURY
Building Department
Inspectors Report . .,Date //_///'
Name VTerL
Location / (PC/4' '
Permit No. (n,3 2 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
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