1395 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 1395
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Mr • La son
OWNER of property located at — 61 Main Street Str!aet Street, Road or Ave.
in the Town of Q.ueensbury0 To Construct or place a _ Sewage Al afinYt
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.
f , OWNER'S Address is
61 Main Street
Glens Falls , New York
2. CONTRACTOR or BUI LDER S Name
C'hrls DrellOS
3. CONTRACTOR or BUILDEWS Address
Sanitary Sewer Service
53-4th Street
Glens Falls New York
4. ARCHITECT'S Name
Same.
$. ARCHITECT'S Address
Same
6. TYPE of Construction — (Please indicate by X)
{ } wood Frame ( I Masonry I 1 Steel { }
7. PLANS and Specifications
No100 " Ttle
a. Proposed Use
Sewage system rt
M
M
rt
$ 5000 PERMIT FEE PAID — THIS PERMIT EXPIRESt�—� �--
lif 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 Day of Se )tember 19 71
for the Town of Queensbury
SIGNED BY
Buil+diry and Zoning nspectar
TOWN OF QUEENSBURY
WARREN COUNTY, NEW %FORK
Application for
A PEFW',IT TO CONSTRUCT , ALTER OR ENLARGE A SEWAGE
DISPOSAL SYST,EN FOR A PRIVATE RE.`� IL)ENCE WI-rT�H11 a FQUE�s� ��URy
.TOWN OF QUEENSaURY r Q
this application to : 5 '
Mail or bring pp 0� �, � �, i�� �
Building & Zoning Department `a '
P-M.
Queensbury Town Office Building 7} ����g1�1y � 11111s
R. D . 1 Bay Road
Glens Falls , New York 12801 a �
This application for a Sewage Disposal Permit Trust be
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 system .
1 . Name and mailing address of applicant :
Mr . Lamson
1 Nsain Street West Glens Falls , New Yoric
2 . Specific location of property : 6
STREET AN NM BER
3 . Application is for :
New construction of private dwelling ,
X Alteration or enlargement of existing sewage disposal system .
4 . Description of building :
a . number of bedrooms
bw garbage grinder
5 . Topography ; Flat
at , ro at steep slope , gentle slope . etc .
6 , a . Nature of soil . ( Describe to a depth of 5 feet if tile
field is to be used or ZU feet if leaching pits are
proposed , giving thickness of various strata such as
top soil , clay , loam , sand , gravel , rock , etc . )
Gravel
b , How determined?
7 . a . Soil percolation test made by
( Refer to Fart III , Bulletin 11 N . Y . S . Department o Hea th
b , Percolation test notes submitted ? YES OR NO
//�'G *�'c'P
B . Proposed sewage disposal system indicated on attached plan or
sketch ? N
YES OR NO
q . Date when construction will com-nence Ses�tembe ] l�71
It is hereby agreed that if this, apy li cation anH ) t #. ,ached j: lans
dated or any amend --rent or nevi :ricer: the r. eo
f ,
-r - -
are approved , � inst�aTlataon of sewage disposal facilities will e
made in accordance with the details thereof as shown on such
^� approved plans .
i( ; ' gnature of app scant
Installed By : Contractor
Owner