6194 BUILDING PERMIT
TOWN OF QUEENSBURY No. E1.94
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Edwin Ball
OWNER of property located at \ Sawn Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration
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. H.
1. OWNER'S Address is R. D. #2
Glens Falls, N. Y.
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address •
53 Fourth St.
Glens Falls, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) -
( )Wood Frame ( I Masonry ( ) Steel ( )
7. PLANS and Specifications
1000 gallon tank and 1000 gallon pre—cast dry well
No. per application submitted
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8. Proposed Use
Sweage alteration for dwelling ~r
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$ 5. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES March 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 21 St Day of Nov. 19 79
SIGNED BY �1 r for the Town of Queensbury
Bu fiingand Zoning Inspector
ivigAJ
TOWN OF QUEENSBURY
Building Department
Inspectors Report • Date /,//
Name =� •,40)1k /!f
Location S IiU.L/
Permit No. -y , Weather
6/ cisy Remarks •
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing •
Backfill
Final Survey
•
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wa l l Board
Ext. Porches ,
Finished Floor
Interior'Trim
Stairs & Railings
Cellar Dr. Tile
Concrete Floors
P1bg. Fixtures
Gar. Fireproofing
Door Closers •
Chimney
Water Meter Inst. 67 •
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Septic Approval !—
Floors
Insulation Foundation
Walls
' Ceiling
Building I pector
REMARKS
TOWN OF QUECINS�._..
RECEIIVE
TOWN OF QUEENSBURY NOV 2 .1 iYi
BUILDING AND ZONING DEPARTMENT o re e� '
BAY AND HAVILAND ROADS, R. D. A 5`o'' P.M.
GLENS FALLS, NEW YORK 128 01 71§19 110J1Al2)1)2 3 4 M 5 I
APPLICATION FOft A PERMIT TO CONSTRUCT, ALTER OR ENLARGE (7 ,
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY
OCCUPANT°S NAME /�/ ,p4/4_ ADDRESS
TELEPHONE OWNER'S NAME
ADDRESS NUMBER OF BEDROOMS
GARBAGE GRINDER? (YES OR TOPOGPAPHY: FLAT, ROLLIM(', STFEP, SLOPE ,
GENTLE SLOPE, OTHER
NATURE OF SOIL: CLA' , SANDY LOAM, GRAVEL, ROCKS, ETC.
PERCOLATION TEST PATER SUPPLY: MUNICIPAL, WELL, OTHER
DIAGRAM OF PROPOSED SEPTIC ;:SYSTEM
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OTHER PERTINENT INFORMATION
IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE Mi E IN ACCORDANCE
WITH DETAILS SHOWN. ir
DATE I l 07 SIGNATURE OF APPLICANTI
LAKE GEORGE PARK COMMISSION APPROVAL: .
(signature
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(date),
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