8102 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8102
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Eleanor Harris
OWNER of property located at Minnesota Avenue Street, Road or Ave. o
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.
1. OWNER'S Address is Minnesota Ave.
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Scott Enterprises
3. CONTRACTOR or BUILDER'S Address H
Box 1504 Bay Road
Lake George, New York
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4..ARCHITECT'S Name
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5. ARCHITECT'S Address (D
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications Cn
1000 gallon septic tank, dist. box and 2 fD
No. 61x8 ' drywell seepage pits per plot plan �
and application submitted. m
8. Proposed Use
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Sewage .system for dwelling rfDt
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept_ 19 19 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.)
Dated at the Town of Queensbury this 191-1h Day of Sept_ 19 83
SIGNED BY //I L:Gd, a. dn for the Town of Queensbury
Building and Zoning Inspector
TOWN` OF QUEENSBURY j
BUILDING & ZONING DEPARTMENT L7F2``l
TOWN OF ��`%� �S
SEWAGF DISPOSAL PERMIT APPLICATIO E E `l
1. Owner' s. Name zta4 uli2 /49122/s 5E►'r
1 61S$3
Address / / 1/E—SO/A : /aCi (N. Cc,014 ii9t f AA. D c - 1314fP. .
Telephone N'o. r0(" Y-20re
2. Property location
3 . Name of person or firm responsible for installing system
fivrapiliSFS Telephone No. %%2 -aaaS7
Address . ,e4,/ /ea soy lsoy MAT: �& /2 G� Y 12 79
4. Number of bedrooms (residential buildings only)"
.5. Daily flow CJ/.c?-, gallons/day .
6. Septic tank capacity MOO' gallons
.7. Topography: f.lat, rolling, steep,
% of slope
8 Nature of soil and depth S4z'
9. If ground water,. bedrock or impervious material is apparent at what
depth does it begin? , E 2,e) ft.
'10. Percolation test: A is required
B is not required
C Ifrequired what is the rate minutes/inch
11. Water supply: municipal;) well, other 770w,/ OF QUAeWS/Jae),
• 12. Type of system proposed: drywell tile 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 prov' ed for in Section 6 . 010 of •the
Queensbur.y Sanitary Sewage Ordinance.
Date V/Yff3
signature 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.
a� .
13-) Qt.
600
/6-0-x".
Form 3-82 f ��
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TOWN OF'QUEENSBU RY
Building Department
Inspectors Report Date ?/P '
Name
Location
. Permit No. Imo'/Oi0-
Remarks
ExcaOation
- Footing Forms
Footing & Piers
Foundation •
Cement Coat
Waterproofing
Backfill
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
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
Building Inspector
/REMARKS•
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