8154 BUILDING PERMIT
TOWN OF - QUEENSBURY No 8154
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Elaine Hubert
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. OWNER of property located at 15 Lupine Lane Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewage Alteation 0
at the above location in accordance to application together with plot plans and other information hereto filed and
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t7'
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1. OWNER'S Address is rt'
15 Lupine Lane
•
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name -
Andy Scarpellino
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3. CONTRACTOR or BUILDER'S Address • r
4 Seward Ave.
Glens Falls, New York
4. ARCHITECT'S Name •
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( ) Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications 1000 gallon septic tank, dist. box and 2 6 'x8 '
No. seepage pits with 18-24" stone per plot plan
and application submitted. in
8. Proposed Use
Sewage system for dwelling m
1-1
ft
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Oct. 12 1985
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(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.) O .
Dated at the Town of Queensbury this 12th Day of nrtnher 19 83
SIGNED BY a• � for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT EGE O -U -
SEWAGE DISPOSAL PERMIT APPLICAT 'J
OCT 419dj,
1. Owner 's Name . . ovie, /Yu4, .J A.m: /0'
f Sic V i1°11-912)112181 W?19
Address /S. 1-e✓t/A'e' l�g-.r (7_ � Pes, f 0 u >
Telephone No..
2. Property location _9-ram:
3. Name of person or firm responsible for installing system.
/94 SCia✓ CAvc, • Telephone No. ??07- �SS
Address
4. Number of bedrooms (residential buildings only)
5. Daily flow ,TO gallons/day
6. Septic tank capacity /M 0 . . gallons.
7 . Topography: flat, rolling, steep
% of slope 370
8 . Nature of soil and depth ,?'�i,T-C/--- /0 rS'
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? AJA- ft.
10. Percolation "test: A is required
B X. is not required
C If required what is the rate minutes/inch
11. Water supply: municipal, well, .other. M20/v/Ci j2y J ( 1,r,54 /g/1
12. Type of system proposed: drywell, tile field, other A'7cl/e/i
Any contractor,. corporation, individual, etc. engaged inthe 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.
Date 3
ig ure ad ant
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 t/C_ I"
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TOWN OF QUEENSBURY
Building Department
Inspectors R Date /d f`t`Z/
Name
Permit No. - Weather
1 f Remarks
Excatia ti on
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
Floors
Insulation Foundation
Walls
Ceiling
Bui ing Inspector
REMARKS
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