8398 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8398
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to John Farnan
OWNER of property located at 19 Sylvan Avenue 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 rr�
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 19 Sylvan Ave.
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Daniel Drellos
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
:53 Fourth St.
Glens Falls, New York
•
4. ARCHITECT'S Name
CD
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
dist. box and 2 8 'x8 ° drywells per plot plan
No. and application submitted. m
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8. Proposed Use uC1
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Sewage System for Dwelling
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 19 19 86 cat
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the O
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 19th Day of April • 198 4
SIGNED BY ��
G for the Town of Queensbury
Building and Zoonniinnngg Inspector G
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATIONTOWN OOFQUEENSBURY
1. Owner' s Name ZIJilLJ ' ` �At
Address £L/ iI/ gA' AVN 1 ) 1984
A.M. /6' 0 0 P.M. 04:
Telephone "tfe 1 2 4 5 6
I e a a
2. Property location
3 . Na of person or fir respons . le for installing system
Q 'kW( Telephone No. 3
Address
4. Number of bedrooms (residential buildings only)
5. Daily flow I/ v gallons/day
6. Septic tank capacity 0 ) L- gallons
7. Topography: 400110; rolling, steep
% of slope /�
8. Nature of soil and depth cm /VLF
7
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 jf required what is the rate ()--.minutes/inch
11. Water supply: •: , well, other
12. Type of system proposed: ywel , 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 2 —/o Fy (-- _)aftz,t
signature scant
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.
c;2— (P r DA/
Form 3-82 /� l s7a ( 6 ow N s z k
SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792-7257
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