8656 BUILDING PERMIT
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TOWN OF QUEENSBURY No 8656
WARREN COUNTY, NEW YORK CD
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PERMISSION is hereby granted to Thomas Burns
OWNER of property located at 5 Crestwood 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
' approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 5 Crestwood Drive
Glens Falls, New York
2. CONTRACTOR or BUI LDER'S Name
Sanitary Sewer Service u,
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3. CONTRACTOR or BUILDER'S Address (D
53 Fourth St.
Glens Falls, N. Y. 0
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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
1 dist. box, 2 7 'x8 ' drywells and 24" #3 stone
No. per plot plan and application submitted.
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8. Proposed Use
W
Sewage System for dwelling
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$ 10. 00 • PERMIT FEE PAID —THIS PERMIT EXPIRES July 26 1g 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.) o
Dated at the Town of Queensbury this 26th Day of July 1g 84
SIGNED BY `--)J7d, a' /�! L'Y�� for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUFFNSBURY
BUILDING & -ZONING DEPARTMENT
TOWN OF EE QUNSBURY
APPLICAT =:•• SEWAGE DISPOSAL PERMIT E 0L� Q 1 II
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1. Owner ' s Name O gu,,s/} JUL ,' 5iJ
Address
e'iNc5" ,1 3� 3
Telephone �.
2. Property location V M/ E
3 . Nam ,� Jperson or firm responsible for installing system
< /" i r'/1/ JC)7A/V64eci(Ge-
a Telephone No. 7Cj' - 7 G,I.Jr,'
Address
4. Number of bedrooms (residential buildings only) 4
5. Daily flow XS a gallons/day
6. Septic tank capacity // DO C7 gallons
7. Topography: tigeripi rolling, steep
% of slope •
8. Nature of soil and depth S/vit/- lea e n d'
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A Ot is required
B " is not required
C If required what is the rate 6 s minutes/inch
11. Water supply: municip. , well, 11other
12. Type of system proposed: drywe /l, 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 prov' d for in Section 6 .010 of the
Queensbury Sanitary . Sewage Ordinance.
/7
Date /.--. PY alAY4-, 1111!,<X,,ZeZ - _
ignature o ewplicant
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.
rep/4-64- 1D OKEIST-1V- - 3/j C.)-
Form 3-82
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TOWN OF•QUEENSBURY
Building. Department
Inspectors Report Date .7 ,3-y
Name �� Q ihzA1S �/� 4,�r9 . 4 5
Loca 40_; �(..l�b13 17 .O�/�l"1� 6[/NZ/l
Permit No. �- / Weather
76 , 4 • Remarks
Excatia tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
i 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
P1bg. Fixtures
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval Lo'-'-^
Floors
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Insulation FoundatiOn
Walls
Ceiling
Building Inspector
REMARKS
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SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
i 53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792-7257
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