8261 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8261
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Grace C. Carter
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OWNER of property located at 13 Centennial Drive Street,Road or Ave. p
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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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. . C]
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1. OWNER'S Address is
13 Centennial Drive
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
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Daniel Drellos
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address F-
53 Fourth St.
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Glens Falls, New York •
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4. ARCHITECT'S Name - ct
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ') Masonry ( )Steel ( 1
7. PLANS and Specifications
dist. box and 8 'x8 ' drywell per application and plot
No. plan submitted. -
8. Proposed Use pi
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Sewage system for dwelling•
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$ 10. 00 PERMIT FEE PAID—THIS PERMIT EXPIRES Dec. 5th 19 85
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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 h'
town of Queensbury before the expiration date.) C
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Dated at the Town of Queensbury this 5th Day of Dec. 1983
SIGNED BY 7f l GGr�I' 0 ✓� ' 64 for the Town of Queensbury
Building and Zoning Insp- or • - -
TOWN OF QUEENSBURY . •
ger, �• A l BUILDING & ZONING DEPARTMENT
TOWN OF.QUEENSBURY(
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_� y�.0 SEWAGF DISPOSAL PERMIT APPLICAT sr lc o� FQ�r5 II
1 . owner s. Name
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(;\ COE 11983
Address 1 C-e/u(-QUA- ( 1 /Y 9�10�1 �12�1�2]3�415I6`
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Telephone No. . 7q - 7 4 0
2. Property location
3 . Name of person or firm responsible for installing system
_7 v__ i p 1 'fu sawi_pic()/( `P Telephone No. • 770177r7.
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Address .
4. Number of bedrooms (residential buildings only) ,) .
5. Daily flow SOO gallons/day,
6. Septic tank capacity /
!l gallons
7 . Topography: flat; rolling, steep •
% of slope
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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 K is required
B is not required
C If required what is the rate ® minutes/inch
11. Water supply: municipai;) well, other
12. Type of system proposed: drywel ) 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
Queensbury Sanitary Sewage Ordinance.,
Date / (7) -
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• signature of ap 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 .
. / — Z' ' — , • _ . . ' . .. . _ ._ . .. ,.
Form 3-82 I e
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• TOWN OF QUEENSBURY
Building Department •
Inspectors Report Date /2-
Name
Location t"3 a E A a i- 4JOf
Permit No. 2 (p Weather
= e2 5 Remarks
Excatia 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
Water Meter Inst.
Septic Approval !�
Floors '
Fot nda tion
Insulation Walls
"Ceiling "
cas;-4.
Bu ling Inspe for
REMARKS
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SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792-7257
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