8180 - •BUILDING . PERMIT
TOWN OF , QUEENSBURY No , o
-
WARREN COUNTY,COUNTY, NEW YORK PERMISSION is hereby granted to • r'- David Stanton.
r•
• OWNER of property located at Haviland Road • - , Street,'Road or Ave.
�•
in the Town of:Queensbury,To Construct or place a Sewage Alteration - .: • - .. rai
at the above.location in accordance-to application together with plot-plans and other information hereto filed and rl
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.`' -
1. OWNER'S Address is =
R. D: #1 Havilan:d• Road ` _ -
•
- _Glens Falls, N. Y. -
•
2. CONTRACTOR or BUILDER'S Name -. - -. . ,
..• Daniel- Drellos • -
Sanitary Sewer Service
3: CONTRACTOR or BUILDER'S Address •
53 Fourth Ste' . ' x
Glens Falls, New York =
- 1-
York Name : - I-.
Si
5: ARCHITECT'S Address = Pi
6. TYPE of Construction—(Please indicate by X) • - - '
' (_ ),Wood Frame ( -),Masonry ( 1 Steel (`.)-. :' - - _. - ,, .
' 7.. PLANS and Specifications
_ replace metal. septic ,tank: with 1000 gallon cement - •til
No, tank per 'plot plan and application submitted: -
•
'a
8. Proposed Use N.
- Sewage system for dwelling _ .
i-f
w .
October- 1 5 rt•
$' 10 a 00 PERMIT FEE PAID-THIS PERMIT EXPIRES 98.
(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 theTown of Queensbury of this 20th '•"- Day October"' , 19--83 •
' SIGNED BY . : a 4 for the Town of Queensbury
- Building,and Zoning InspectyL
TOWN OF QUEFNSBURY
TOWN(0 _ D. _16 BUILDING -& ZONING .DEPARTMENT (� p
SEWAGE DISPOSAL PERMIT APPLICATION HEM
OCT. i y 1983 _
1. Owner ' s Name �S�7T � `O/� / �f /--� 4
( n AA.
�'
Address 1401'
�,�) . A7'� 7l 3p� ip i� wi- 9
Telephone No. �7;2 -A 4tLk
2. Property location
3 . Name of person or firm responsible for installing system
ili
SOliu i flh& N 'f.�t.✓_eq fe1cc'/c ' - Telephone No. / —7c -7
Address �. 7 LA 7 _
4.. 'Number of bedrooms (residential buildings only) 2.../
5. Daily flow 00
gallons/day
6." Septic tank capacity / 000 gallons
7. Topography:
rolling, steep
% of slope .
8 . Nature of soil and depth
9. If ground water, bedrock or impervious material is apparentat what
depth does it begin? 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,* - other
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 provided for in Section 6 . 010 of the
Queensbury 'Sanitary Sewage Ordinance. (--/?)
`
Date /Q / g !a �- (P
signature of 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.
e L,a-c- ole : l-C • 'c - 7?c- :fie•-' /` 7-4 : 0 0.0?
937c4/70") CE re/./ . dc -
Form 3-82
TOWN OF'CUEENSBURY
Building Department
Inspectors Report Date it) —
Name c f(/ it/Location (11.
Permit No. 'lWeather •
ulg O - Remarks
Excavation
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 0
Floors
Insulation
Foundation '
Walls
'Ceiling
a-4f 7 4
Bu 1 ang In Spector
REMARKS
/voa07AL. ��
I` 1 A ' 1 OVA
'
I I
•
'ice,z
•
• oG '
l -