8128 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8128
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Matthew D'Ambrosio
OWNER of property located at 26 Sherwood Drive 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 rt
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is 26 Sherwood Drive
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name 0
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Sanitary Sewer Service - o'
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 0
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6. TYPE of Construction—(Please indicate by X) (D
( ) Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
.dist. box and 2 8 'x8 ' drywells per plot plan and
No. application -submitted.
8. Proposed Use
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Sewage system for dwelling j
$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 29 :85
(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.) W
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Dated at the Town of Queensbury this 29th Day.of Sept. 1983
SIGNED BY a<L for the Town of Queensbury
Building and Zoning 1 nspector 043)
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TOWN OF QUEENSBURY
TOWN OF' QUEENSBURY
�v BUILDING & ZONING DEPARTMENT fib -1
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•' ikSEWAGF DISPOSAL PERMIT APPLICATI�'
/�� S�.� 2 71983
1. Owner' s N e �TI �� /1 d �,.5%(� /o .uo f c(.
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Address ' 1 ✓1 �roi 0 . 7M?110114)12n) M
Telephone No. /7c 2
2. Property location (TA /fit
3 . N e of person or firm responsible for installing system
k r1k Telephone No. / F.72 70i f�7
Address cc`j /56/4:/
4. Number of bedrooms (residential buildings only)
5. Daily flow ;1gallons/day
6. Septic tank capacity / 000 gallons
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7 . Topography: OP, rolling, steep
% of slope
J44i/8. Nature of soil and depth
9. If ground water, bedrock or impervious material is apparent at what*
depth does it begin? ft.
} 10. Percolation test: A S is required
B is not required
C If required what is the rate 0 -S.- minutes/inch
11. Water supply: municipal, well, other
12. Type of system proposed: C ryweli the field, other
Any contractor,. corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance..
9029Y". Date
signa ure o applicant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, _ distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself.
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Form 3-82 .
TOWN OF QUEENSBURY
Building Department
lnspectcrs Report Date
Name g3%'(-5..0 e>
Location c9 r-=l'./x i)r-,jD ,r
Permit No. - Weather
(Y/ Z _ - Remarks
Excatta tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
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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 t�
Floors '
Insulation Foundation
Walls
'Ceiling
'*.(5 ,7_,OcZZ&l/L)
Building Inspector
s�/REMARKS
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�,4 ` SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792-7257
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