8254 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8254
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Gary D. Bowen CJ
OWNER of property located at Haviland Road Street, Road or Ave.
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(1)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.
1. OWNER'S Address is R. D. #1
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Walter Graham
3. CONTRACTOR or BUILDER'S Address
Hudson Falls, New York H
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications •
1000 gallon septic tank, dist. box and 200 ft. tile
No. field per application and plot plan submitted. U,
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8. Proposed Use
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Sewage system for dwelling
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 29 1985 w
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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 I-',.
town of Queensbury before the expiration date.) 0
Dated at the Town of Queensbury this 2 9 t�/h Day of Nov. 19 8 3
SIGNED BYG ~,�og for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY TOWN OF QUEENSBURY
t" BUILDING & ZONING DEPARTMENT RECEIVE
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SEWAGE DISPOSAL PERMIT APPLICATION NUV J 9198.
1. owner ' s Name � � !\ uw _e_
D, •gp (,U �� A.bi. ��
Address 1-40\\./ 1 L A D ZC) n r'
L 0 s k L-L-(> , M . ) 2 6 0 / Telephone No. 7 z- 3 1 6 ) a
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2. Property location (--A i j L i 7- . 10 11 f0
3 . Name of person or firm responsible for installing system .
`KL{,Q�w1(, CyzG1.4 _, Telephone No.
Address . -
. 4. Number of bedrooms (residential buildings only) .
-5. -Daily flow gallons/day: .
6. Septic tank capacity IL) DO . gallons .
7 . Topography: flat, olling steep
% of slope '
8 . Nature of soil and depth ��Ol�wt ZD• t
9. . If ground water, bedrock or impervious material is apparent at what
depth does it begin? IUUk1�- ft.
10. Percolation test: A is required --
B X is not required
C. If..re4tired what is the rate minutes/inch
11. Water supply: municipal well, other
12. Type of system proposed: drywell,. tile fiel , other
Any= contractor, corporation, individual, etc. engaged-yin 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
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I 1 / 3 ►,Q
signat e of appli cant
- 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
ZooL ./ -
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date / Z
Name1}i�(!
Location /1/4-u/t0/1) 41),
Permit No. Weather
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 V
Floors
Foundation
Insulation WaI1s
'Ceiling
S7;741..4
Bui ding Inspbctor
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REMARKS
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