6304 •
BUILDING PERMIT
•
TOWN OF QUEENSBURY No 6304 "
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Thomas Burns U)
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OWNER of property located at 5 Crestwood Drive - Street, Road or Ave.
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in the Town of Queensbury,To Construct c1R 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 Driv e
- Glens Falls, N. Y.
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
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3. CONTRACTOR or BUILDER'S Address
53 Fourth St. o
Glens Falls, New York m
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4. ARCHITECT'S Name 0
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5. ARCHITECT'S Address -
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( 1 Steel ( 1
7. PLANS and Specifications -
No. precast seepage put and _#3 stone per
application U,
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8. Proposed Use
Sewage alteration for. dwelling
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$ 5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 1 19 80
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the fi
town of Queensbury before the expiration date.) ~
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Dated at the Town of Queensbury this Day of 19
SIGNED BY /���'U Z e for the Town of Queensbury
Building and Zoning Inspector
` 'OWN OF QUEENSBURY
BUILDING AND ZONING DEPARTMENT
BAY AND HAVILAND ROADS, R.D. 01
GLENS FALLS, NEW YORK 12801
APPLICATION FOR A PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY
OCCUPANT'S Y ME_. l/ z4 B 2/ /)J m PDDRES S S-C1r-grAg001,1
TELEPHONE OWNER'S NAME
ADDRESS NUMBER OF BEDROOMS
GARBAGE GRINDER?. (YES OR NO) TOPOGRAPHY: FLAT, ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS, ETC.
PERCOLATION TEST WATER SUPPLY: MUNICIPAL, WELL, OTHER
DIAGRAM OF PROPOSED SFPTIC SYSTEM
lj PP° Cam'
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16( f, rt9i-
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OTHER PERTI NT INF RMATION /re
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IT IS HEREBY AGREED THAT IF THIS APPLICATION AND PLANS ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL FACILITIES WILL BE MADE IN ACCORDANCE
WITH DETAILS S OWN
DATE SIGNATURE OF APPLICANT
S t�'s+ir,m,szr.. 57 'A rx le,POn RTAW Rg +"'
(c ate)
TO t' N OF QUEENSBURY
Building Department
Inspectcm Report. Date 5/4 `f l
1-6
Name ' B r11i1Z� itrS
Location Tl'/9 e-J'/Go d O .
Permit No. Weather • ; . _ .
to,3 „it Per Cent
V Complete Ream:aka
Excavation
Footing Forms _
Footing & Piers
Foundation
Cement Coat
Waterproofing
•
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Rough Htg.
Relief Valves
Wall Board
Ext.Porches
Finished Floor •
Interior Trim
Stairs&Railings •
Cellar Dr.Tile
Concrete Floors
Plbg.Fixtures
Gar.Fireproofing r e
Door Closers
Chimney — _^
Water Meter Inst.
Septic Approval e� If
v
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Budding laaalaector
REMARKS S
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