8151 BUILDING PERMIT
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TOWN OF QUEENSBURY No 8151
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to William Philion
OWNER of property located at - 107. Coolidge Avenue 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 N
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. .
1. OWNER'S Address is b
107 Coolidge Ave. �.,
Glens Falls, New York1-1
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2. CONTRACTOR or BUILDER'S Name
•
Dale Granger. and Sons
3. CONTRACTOR or BUILDER'S Address
Glens Falls, New York I-'
4. ARCHITECT'S Name n
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5. ARCHITECT'S Address (D
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6. TYPE of Construction—(Please indicate by X)
( ►Wood Frame ( ► Masonry ( )Steel ( )
7. PLANS and Specifications
No. 1000 gallon tank, dist. box and 190 ° leach field
per plot plan and application submitted. cn
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8. Proposed Use
Sewage system for dwelling m
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Oct, 12 19 85
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 12th Day of OCt. 19 83
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEFNSBURY TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT [ 1J E G E p 1'! 1
SEWAGE DISPOSAL PERMIT APPLICATI
kj �, OCT 71983
1. Owner ' s Name (11)(),0(n,1,1 �A.,yyk 1 { i 611 A.M. Ai id /t7c ‘17,M s
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Address [ 67 le.(t)() 1 /
(10 . F Telephone No.
2. Property location
3 . Name of person or f 'rm responsible for installing system
q (c")•-Y Telephone No. l J7--`(6 /
Address C l V%&1 A
4. Number of bedrooms (residential buildings only).
5. - -Daily flow 4("j. gallons/day.
6. Septic tank capacity. ( i e., t) ( (7-171, Crl t gallons
7. Topography: f at, oiling, steep
of slope •
8 . Nature of soil and depth Q7LM.
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 O.•' minutes/inch
11. Water supply: . municipal, ell, other
12 . Type of system proposed: drywell, ile field,"other
Any contractor, corporation, individual, etc. engaged in the construction
of a sanitary sewage disposal system who covers the same fore inspection,
does nothave an approved permit, or vari ' from the app ved application
will be subject to a penalty. of $250 as p o ided for i ection . 6 . 010 of the
Queensbury Sanitary Sewage Ordinance.
Date / l /r3 4/1
0_ A--1'f�/
( signature of applicant
On ' se separate sheet of paper submit a of septic system
p p p t diagramthe proposed y
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. . Include all dimensions of
the system itself.
Neal `0 0 0 D0-A..4r D i S1 d3
Form 3-82 . �
TOWN OF QUEENSBURY
Building Department
inspectors Report Date /'C! -%s " 0
Name / / d i',/,zz-/V'
Location /0 7 Co I ) r b .,4V�
Permit No. " =�+:— aS'7 Weather
R A'C-&77-= Remarks
Excavation
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill '
Final Survey
Framing •
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough P1bg.
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 1✓'-
Floors
Insulation Foundation
Walls
Ceiling "
W - ' a-3.-.&.-._)
Building Inspector
REMARK /a4/T-40
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