8271 BUILDING PERMIT
TOWN OF QUEENSBURY Na 8271
WARREN COUNTY, NEW YORK
301 .
PERMISSION is hereby granted to L. Caswell Teague•
OWNER of property located at 19 Cottage Hill 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. C
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to
1. OWNER'S Address is E
2. CONTRACTOR or BUILDER'S Name !L
William J. Condon a
3. CONTRACTOR or BUILDER'S Address .
17 Grant Avenue
Glens Falls, • New York -
4. ARCHITECT'S Name
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5. ARCHITECT'S Address r
LC
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6. TYPE of Construction—(Please indicate by X)
F
( )Wood Frame (. ) Masonry ( )Steel ( )
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7. PLANS and Specifications -
1000 gallon tank, dist. box, 2 drywells
No. 6x8x8 each per plot plan and application
submitted.
8. Proposed Use .
Sewage system for dwelling
a
• . _
LC
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$ i l _ 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Deg'_ 8 19 85
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the F
(own of Queensbury before the expiration date.) r
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Dated at the Town of Queensbury this Rth Day of necPmber 1983
SIGNED BY k'
for the Town of Queensbury
Building and Zoning Inspector
• TOWN OF QUEFNSBURY
y� (, ( ( BUILDING -& ZONING. DEPARTMENT TOWN OF QUEENSBU?Y
• I / SEWAGE DISPOSAL PERMIT APPLICATION D F E _�j/ E ^'1
:/ L L . c as well
1. Owner' s Name ee
,", . tV . l 0 C-
Address iq C(•'-/--f-A g / `/l kc . A. ►. I e.ed "f •P.M.
is
.� .�.-.-.jan -i a ,�+ a .1
1Vj1__ 9 i
QOPF
9 5�0� r }1 ulll 1lU�e IJII
l5S20tk._ - f iz� i Telephone No. 4/ O ay e
2. Property location .
3 Name of person ,or firm. responsible -for }instal-ling system CorljDorl,/S -
,,ge,-fr", (/1/4 Telephone No.7ye a,��' .
Address'ff- _OR AA) f A-Ur (..61E FA/4.S r/y (,)-&o I
4 Number of bedrooms (residential buildings only) 3 - -
5. Daily flow • gallons/day - • -
6. .. Septic tank capacity /G'C 0 lj 4`///y ea,vC kS 16 V/ Uf 74 gallons
7. Topography: ' rolling, steep
of slope
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8 . Nature of soil . and depth. J4/J/,/Dy/.. /0
9_.: If ground water, bedrock -'or' impervious material is apparent at `what - ,_
depth does it;begin? fU0 - ft. ...
10. Percolation test: - A is .required
B . is not required
-= C If required what is the rate minutes/inch
11. Water supply- municipal; well, other
12. Type of system proposed:• drywell, tile ,field� other
Any contractor, cprporatio`n ` individual, etc. - engaged irr-7,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 _ins Section .6 . 010 , of': the
,, • Queensbury Sanitary Sewage`"Ordinance. - -
_ G • _ ..
sign re of-applicant -
On separate sheet of :paper submit a `diagram of the proposed ::septic system , -
=,with al•l dimensions, `including. distanc.e,--from`-any, structure, distance from h'.
property -line and domestic,water supply,' etc Include `.all ..dimensions:" of
the system.itself. . . - - ;
Form '3-82
TOWN,OF QUEENSBURY
Building Department Inspectors Report Date / 2
Name
Location /9 Cr ,,, .a Kr'<
Permit No. O Weather
S a 1 ( 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
Plbg. Fixtures
Gar. Fireproofing
Door Closers
Chimney x.
Water Meter Inst. 7 cw.:\
Septic Approval (/
Floors
Insulation Foundation
Walls
Ceiling
B ilding I spector
REMARKS
APR ° efiR. --P o -- -
Mr.
ue, — 73- ags-1
i 9 Co -F��- 6 c 1-,J ,'1/ Ad
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