8232 BUILDING PERMIT �1
TOWN OF QUEENSBURY
No. 8232
WARREN COUNTY, NEW YORK •
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PERMISSION is hereby granted to Steve Benack
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OWNER of property located at Meadowbrook Road - Street, Road or Ave.
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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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. n
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1. OWNER'S Address is
Meadowbrook Road
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Dale Granger and Sons
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3. CONTRACTOR or BUILDER'S Address •
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19 Homer Ave. E
Glens Falls, New-York
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4. ARCHITECT'S Name O
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
. No. repair/add -to tile field - 100 LF rip
8. Proposed Use
Sewage system for dwelling
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 17th 1985 N
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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
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 17th Day of, Nov 19 83
SIGNED BY /11 otek a_ for the Town of Queensbury
Building and Zoning Inspector( 4
TOWN OF QUEFNSBURY /D L2 O ' '''
BUILDING & ZONING DEPARTMENT
•, SEWAGE DISPOSAL PERMIT APPLICATION _TOWN OF QUEENSBURY
' it rAEOEFLE
1. Owner' s 'Name ��.�, ee..4.),6,c 7
Address \tL&1I io it 1':.CQ_ SI.NUU 1 b 1983
/D.as ,c_e_z
Telephone N, IMI 1:1M112 13 MM
2. Property location
3 . Name of person or firm responsible for installing system
►6 ' ( ..,,'* giy_ Telephone No. ) "72-6 C') 7
Address 4-0_0__
4. Number of bedrooms (residential buildings only)
5. Daily flow • / .S`O• gallons/day
6. Septic tank ca•acity -en gallons
7. Topography: offilik
rolling, steep
% of slope
8 . Nature of soil and depth
9. If groundwater, bedrock or }mpervious material is apparent at what
depth does it begin? 4 ' ft.
10. Percolation test: A "(y r- , is required
- B is not required
C If required what is the rate minutes/inch
11. Water supply municipa , well, other
i 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 before inspection,
does not have an approved permit, or varies from the appr4ved application
will be subject to a penalty of $250 as pro 'ded for in =ecti n 6 .010 of the
Queensbury Sanitary Sewage Ordinance.
Date 27ir_5 4J 1- ')
signature of app icant
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.
) * Wic;_, .e
Form 3-82
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TOWN OF•QUEENS'BURY
Building Department
Inspectors Report Date 110/4.,,/ A,3
Name BI -'-'r
Location
. Permit No. � ..�;4 .,4•)4 Weather
• d a 3 "2,__ 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
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Ceiling
7r/ a
ding Inspector
REMARKS
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rile' AMP".
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