8225 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8225
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Loren Blackburn
OWNER of property located at 525 Bay Road 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 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 525 Bay Road W
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name II
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A P Plumbing and Hearing
3. CONTRACTOR or BUILDER'S Address
44 Beacon Street
Glens Falls, New York
4. ARCHITECT'S Name Ul
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W
5. ARCHITECT'S Address
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W
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
new 6"x6 'x12'/18° #3 stone drywell seepage pit
No. per plot plan and application submitted.
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8. Proposed Use
Sewage system for dwelling m
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 10 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
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town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 10th Day of November 19 83
SIGNED BY ifv a „L./ for the Town of Queensbury
Building and Zoning Inspector 1i/!
TOWN OF QUEEFNSBURY TOWN OF QUEENSBURY
6 s - / BUILDING & ZONING DEPARTMENT .0 .
SEWAGF DISPOSAL PERMIT APPLICATIO =-)
/-„oken NOV 91983 - 4
1. Owner ' s Name /1-57
_ ID°G F�-�- Pa
t _to A.M. P.Ni..
q 7)8)9p.op.412j112 64B516
Address 3 0 1 ,,-�.r ,
Telephone No.
2. Property location S" & /r1 ilk
' 3 . Name of person or firm responsible for installing system --
�, �y""� _,,,, .0x.4,%`l y ;�" " ;21 Telephone No. %��' y ' p'-3 &, o
Address `f -e _Q.C d 1-i . -5 7—, l-; �-e,., s /= -r /7.
4. Number of bedrooms (residential buildings only) 3
5. Daily flow 5-( gallons/day
6. Septic tank capacity f ,�'" 0 0 gallons
7 . Topography: flat, rolling, steep
% of slope /2",/t7
8 . Nature of soil and depth c- ..a t''
9. If .ground water, bedrock or impervious .material. is .apparent- at what .
depth does it begin? ft.
10. Percolation test: A required
B / is not required.
C If required what is the rate .& ` 7 minutes/inch
11. Water supply: municipal, well, other l
12. Type of system proposed: drywell, tile field, other,A .,,,_.r,,.l'�
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 �� * /: J ;' -
signature of applicant
On separate sheet of . . . : . ... _
p 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
TOWN OF'QUEENSBURY
Building Department _p
Inspectors Rwort Date UU
Name R2g7 Zfil
ton
Permit No. 119 6` Weather
Remarks
Excatation
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
Ce:;]
Building spector
REMARKS
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