6428 BUILDING PERMIT
TOWN OF QUEENSBURY • No. 6428
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James Scott
OWNER of property located at 1 Kiley Lane Street, Road or Ave.
5
in the Town of Queensbury,To Construct or place a Sewage Alteration to
at the above location in accordance to application together with plot plans and other information hereto filed and Cr)
approved and in compliance with the Town.of Queensbury Building and Zoning Ordinance.
O
r+
1. OWNER'S Address is 1 Kiley Lane . rt
Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name
Jay Sweet
3. CONTRACTOR or BUILDER'S Address
R. D. #1
Lake George., N. Y. I-'•
4. ARCHITECT'S Name
r
CD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) •
•
( )Wood Frame ( ) Masonry ( )Steel (
7. PLANS and Specifications new dry well per application submitted. Cfl
(D
No.
(D
8. Proposed Use
F-'
Sewage system for dwelling.
1-1
sv
rt-
l�-
$5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES - Oct. 1 19 80
(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 27th Day of June 19 80
SIGNED BY • .for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBUR.
TOWN 01,' QUE7NSBURY
BYALDING AND ZONIM DEPARTMEaT
RECEOVE .7..„
LAY AND HAVYLARO ROADS, R. D.,131
GLENS WALLS, NEW "'201.,,'ff 120n JUN 2 6 1980
AM. S-10-g- Fe.2 pti4m.
71819110111112111213141516
EPPLICATION FOR A PERMTA"PO CONSTRUCT, ALTER OR ENLARGA I II a II I " "
A SEWAGE DISPOSKI., STSTP,M tRY.THIN THE TOWN GE OUEENSBURY
r,ICCUPP.5?1T e S NAME ADDRESS_ Ka -S___. j,_ 4e.
_ m
---Mmi e-s S Goll—
TELEPHONE °MEWS NAME
ADDRESS NUMWR OF BEDROOMS
\
GARBAG C4RINDEYO_LoMiS OR NO1 TOPO,SRAPHY: FLAT, ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER,
KATURP Oi:' SOYLT. CLAY, SAFOY, LOAM, GRAM, POCXS, ETC.
PERCCUT/ON TEST WATER SUPPLYg MUMXCIPALt, WELL 0 OTHER
----„--
,,...6.4...T.• •••..2..",,..,... ..ft,C...**...A..*rN.. a••.,mew,aw.n••3‘,Art...y-s.,s.v.-save nwcAl..wema.,a-as.na*za.z,n.,r.szw.a.m..,-.”,,v•.-,o.,..,sw.v.M.srxe rad ........—.. va....ftara.• wro...em.,.....
DiAkIRAM OF PROPOSED SEPTIC SYSTEM
f
my
AO 't crir-a 1-4---Q d
OTRER PERTINENT TIAFORMATYON
• ' ----/k/J---. -/--/----Z(1.27----/-&---d-X-q -
---------------------------- x..‘,.•.
m....,.•sa...m..sr.ws...7.sa*.ka.z.....+1+1,*•,a.a....•er.a.au..ap.o.eacesme.,vedrantara—.ea.—mi , S.CCS..ts•a•C,5....CAMMO axaa•cou aar.aawma c MO O.00.11.OO OO.07 •,•OO•O•O
•0* *ii2O•Or 1O.O.••..2 O 01•4••-o\IE r.O..‘••CP•Wl...O MOO,*9-O,•.,OO.O....00,...... /M•r OSJO JOOPO SO COV,,ga.•4.g 4.,OA......O. O2•`'..O. ‘... -----
IT IS WEAEBY AGREED THAT IF THIS APPLZC1-\T1ON AND PLANS ARE APPROVED,
INSTALLP_TION OF SYNAGE DTSPOR:AL 'FACILITIES WILL DE MADE IN ACCORDANCF
'MTH DEa'AILS SHOWN
DATE. t, q__ _ __2 t- eFs0 SIGNATURE OF
Ce
LANE GEORGE PARR COMMISSION Ti:PPROVAL2
(Siqnat--ure)
(date)
•
TOWN OF QUEENSBURN.
Building Department
•
Inspectors Report • Date ‘`
•
Name ' ,' �o► e5
Location / /�,:
Permit No. 6 4 J W eathe;
Remarks
Excavation
Footing Forms
Footing & Piers J
Foundation
Cement Coat I
Waterproofing
Backfill
Final Survey ^
Framing
Sheathing
Roof Felt j
Roofing •
L
Siding
Masonry Veneer _
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches j
Finished Floor _
Interior Trim
Stairs &Railings
Cellar Dr. Tile
Concrete Floors
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
• Water Meter Inst.
Septic Approval
IFlecrs
Insulation Foundation .
Walls " 1'
iCeil_inq
• Building 1 ;e ;`_o '
REMARKS
Yale/ 2fi/