8152 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8152
WARREN COUNTY, NEW YORK n
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PERMISSION is hereby granted to Mrs. Kenneth Simpson
Holly Lane, Assembly Point 0
OWNER of property located atStreet, Road or Ave. 0
in the Town of Queensbury,To Construct or place a Sewage Al tern t-i can
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.
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1. OWNER'S Address is R. D. #1
Lake George, N. Y.
2. CONTRACTOR or BUILDER'S Name
Condon"s Septic and Drain Service O
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3. CONTRACTOR or BUILDER'S Address tr
17 Grant Ave. N
Glens Falls, New York
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4. ARCHITECT'S Name FJ
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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 200 LF m
No. tile field per plot plan and application
submitted.
8. Proposed Use N
Sewage system for dwelling
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$ 10. 00 PERMIT FEE PAID -THIS PERMIT EXPIRES Oct. 12 19 85 p
(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 12th Day of October 19 83
SIGNED BY �y a` P �Ctor for the Town of Queensbury
Building and Zoning Inspe
TOWN OF QUEFNSBURY
P 411
BUILDING & ZONING DEPARTMENT TOWN �F £ ,��C;RY
U' SEWAGE DISPOSAL PERMIT APPLICATION -I r,
1. . Owner ' s Name ,'// S i ,'j f it F i-/ s 1 1 �'G� '�(� ��
Address I, /7 Of/y' i?) 6- r /`/� ��/�7 "Y r 9 101� y r.M.
Telephone No. 6 (p oC JUa
2. Property location
3 . Name of person or firm responsible for installing system
SFp -b L-stD /J1J g.r4if( C E Telephone No. /9e c:15- y7i
Address /9 iAiiv ,' ,4 f ekiv i ffs ill Y I x- r
4. Number of bedrooms (residential buildings only) •
5. Daily flow gallons/day
6. _Septic tank capacity ft o 6 gallons
7 . Topography: 413110 rolling, steep
% of slope .
8 . Nature of soil and depth CYMeg'f ll(,r
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
B is not required
C If required what is the rate /f'/ minutes/inch
11. Water supply: municipal,OP other
12 . Type of system. proposed: drywell, tile field, other Leda/ . t/J
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.
Date ��//7/(C, PP
signatu of applicant
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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.
.4/6
ffeeord-
Form 3-82 C Li= Veg
•
TOWN OF'QUEENSBURY •
Building' Department
Inspectors Report Date /0
Name .5�//Zl
Location � ��,y 4,4. _ '',.:=,2,r!� .�
Permit No. 6/..5-Z Weather
Remarks
Excatia Lion
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 �/ (��7
y.
Floors '
Insulation Foundation '
Walls
'Ceiling ' '
a-e-// ,e-ebb/° •
`% Building Inspector
REMARKS d
• 274 �el CyLe-d-tx