8224 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8774
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Priscilla Roof
OWNER of property located at 116 Meadowbrook Road Street, Road or Ave.
Sewagetn.Alteration
in the Town of Queensbury,To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and N:
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 116 Meadowbrook Road
Glens Falls, New York 0
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2. CONTRACTOR or BUILDER'S Name
Carlton Tucker
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3. CONTRACTOR or BUILDER'S Address
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R. D. #3 Sherman Ave. • d1
Glens Falls, New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address 0
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6. TYPE of Construction— (Please indicate by X) SD1,
( ) Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. . 7 'x7 ' drywell seepage pit per plot plan and application
submitted.
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8. Proposed Use
Sewage System for Dwelling •
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 10 1g85
(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.) ft
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Dated at the Town of Queensbury this 10th/ Day� of Nov. 19 83
SIGNED BY ILG�v /�.,ta� for the Town of Queensbury
Building and Zoning Inspector
_TOWN OP OLIEet4seur
_ • TOWN OF QtTEBNSBURY MU
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BUILDING & ZONING DEPARTMENT LT)
SEWAGF DISPOSAL PERMIT APPLICATION NOV 9 1983
NM.
1. Owner ' s Name /�j-.i c i /Va 71819)1014Z 2)11213141516
Address //,‘
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X//f /2. 4" • Telephone No. 773 - 1d y3
2. Property location
3 . Name of person or firm responsible for installing system
Telephone No. 73F/
Address A).0 sft.ei-44 i . �� /// ///. /� v/
4. Number of bedrooms (residential buildings only) `-•-• 7 _
5. Daily flow gallons/day
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6. Septic tank capacity /o0v (oi..L ice . r< ) gallons
7. Topography: t rolling, steep
of slope
8 . . Nature of soil. and depth •
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 minutes/inch
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11. Water supply unicip , well;;:other
12. Type of system proposed: rywell the 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
QueensburySanitary Sewage _Ordinance.___ __—____ _______.__
Date �� j � �� � •
ignature 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.
Form 3-82
TOWN OF QUEENSBURY
Building Department
Inspeetare Report Date f
Naine ' �Gr `) '. r
Locatiaa /J/i ;
Permit No. 02`7` Weather
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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
Floors
Insulation Foundation -
Walls
'Ceiling
lBuilding I Spector
REMARKS
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TOWN OF QEENSBURY
Building Department
hupedors Report Date 'S244.6
Name e-)p., •
Location //,� km•
Permit No. T/ 2 2 Y Weather
Remarks
Excat)a 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
P1bg. Fixtures
Gar: Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval -,1714
Floors
Insulation Foundation
Walls
Ceiling '
.47,,f2esate)
Buildi gInspector,:
REMARK
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