8459 BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 8459
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Ed LaRoe •
OWNER of property located at Illinois 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is •
Illinois Ave.
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Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Roger Jones - '
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3. CONTRACTOR or BUILDER'S Address •
Johnsburg, New York
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) • 0
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( ) Wood Frame ( ) Masonry ( )Steel ( ) Iv
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7. PLANS and Specifications 1000- gallon tank, 2 6 'x8 ' drywells and
No. dist. box per plot plan and application submitted. g
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8. Proposed Use •
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Sewage system for dwelling •
$ 1.0. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 3 19 86
(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 3rd Day of May 19 84
SIGNED BY o,.0 2_ /�.g r for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT RI E E V I
' SEWAGF DISPOSAL PERMIT APPLICATION
MAY 3, 1984
1. Owner ' s Name / ;� R J pa 10 -
r 718191101 12111213141516.
Address - �.� ti��_ r
Telephone No.
2. Property locati - .( a 7 .- T Y /
3 . Name of person or firm responsible for installing system
Telephone No. .,)-5/ ' C
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Addr
4. Number of bedrooms (residential buildings only)
5. Daily flow , j C! gallons/day
6. Septic tank capacity / 0 0 gallons
7. Topography: fla , rolling, steep
% of. slope •
8. Nature of soil and depth
Or
9. If ground water, bedrock or impervious material is apparent at what��.,,
depth does it begin? _- C17_ • '• ft.
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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, 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 51--- g
signatury of apt 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.
Form 3-82
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TOWN OF•QUEENSBURY
Building Department
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Inspectors Report C t-a Date f7't 4V n. a
Name 12 c,e_4(7 :)toms e_ C • / ?
Location (/(Ain ,
Permit No. 7 q 5 9 Weather
L� D�%ett � •
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 i,-
Floors '
• Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS
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