8526 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8526
•
WARREN COUNTY,NEW YOR K
PERMISSION is hereby granted to Lawrence and Carolyn Broeren
ti
OWNER of property located at 45 Wincrest Drive 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 O
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
45 Wincrest Drive
Glens Falls, New York n
0
2. CONTRACTOR or BUILDER'S Name
Jay Sweet -
0
CD
3. CONTRACTOR or BUILDER'S Address II
• R. R. #1
Lake George, New York
4. ARCHITECT'S Name
5. ARCHITECT'S Address
N.
C)
CD
6. TYPE of Construction—(Please indicate by X) fA
rt
( )Wood Frame ( ) Masonry ( )Steel ( ) rJ
N•
7. PLANS and Specifications
new dist. box, 2 - 6 'x6 ' seepage pits with 24" #3
No. stone per plot and application submitted.
8. Proposed Use
Sewage system for dwelling m
_ L
CD
$ 1 0_ Oo PERMIT FEE PAID—THIS PERMIT EXPIRES May 23 1986
(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.) ct'
II
Dated at the Town of Queensbury this 23rd Day of May •19 84 • . rl
N•
O
SIGNED BY rn a. 2 for the Town of Queensbury
Building and Zoning Inspector -
TOWN OF QUERNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE' DISP SAL PERMIT APPLICATION
1. Owner ' s Name C� 'b` f('0 e, r- Ca o/yh AQw��iic e
Address S'"-- �J� � ( 16)-- O e J^C h
ti
Telephone No.
2. Property location
3 . Name of person or firm responsible for installing system
Ja t/ Telephone No.
Address(R)6.-6/ ( 67" Yy-P
//•
4._ Number of bedrooms (residential buildings only)
5: Daily flow /5� gallons/day
6. Septic tank capacity (,717---2.7-2) gallons
7. Topography: 441W rolling, steep
% of slope
c l_8 . Nature of soil and depth 636;,44,-)
9. If ground water, bedrock or impervious material is apparent at what
depth does it, begin?
10. Percolation test: A is required
B XI_ is not required
C If required what is the rate `' yf5minutes/inch
11. Water supply- municipa , well, other
12. Type of system proposed: drywell )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 rovided for in Section- 6 . 010 of the
Queensbury Sanitary Sewage Ordinance •
Date ` � 6
sig ture of applicant
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.
D/60,
Form 3-82
•
TOWN OF'QU'EENSBU RY
Building Department
Inspectors Report Date ,S 1-3; 4
Name ., -A2e3R
Location
Permit No. g,-"a G Weather
Remarks
- Excatjaton
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 '
• Insulation Foundation '
Walls
'Ceiliri
• Building spedtor
•
REMARKS
b/Z7r-ir-/
j /a
.v8 3
�0