8879 BUILDING PERMIT
TOWN OF QUEENSBURY No. 8879
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WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to William Ciatworthy
402 Ridge
OWNER of property located at g Road Street, Road or Ave.. 1...,
in the Town of Queensbury,To Construct or place a Sewage Alteration 5
at the above location in accordance to application together with plot plans and other information hereto filed and t7
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is 402 Ridge Road o
Glens Falls, New York rt
2. CONTRACTOR or BUILDER'S Name -
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
53 Fourth St.
Glens Falls, New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address O
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6. TYPE of Construction•—(Please indicate by X)
( ) Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
1000gallon concrete septic tank o
No p per plot plan and
application submitted.
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8. Proposed Use
Sewage system for dwelling
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 15' 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 15th Day of November 19 8 4
SIGNED BY a , ,,Q for the Town of Queensbury
Building and Zoning Inspector g - .
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5-9' L-j J� TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION /e �e-G ��- •
vN OF QUEENSBURY
1. Owner l II f 1 Name k/ik �/lJ l 1 (/fit(�-� 6.4q -7-60
li�(,U�/ (� E
Address )-. Ld , poA.
TeleRiEne No. 7) oY fr 9 .P
7i£3J9�10111)12) I6
2. Property location•- v +II2 v e e)3)4I5 o
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3 . Name of person or firm responsible for installintt system
cA/u 1 -1 Tafriu,k( f;etq c-e Telephone No. q9 -- 7,)-P7
Address
4. Number of bedrooms (residential buildings only)
5. - ,Daily.-:flow
6. Septic tank capacity /v !V gallons
7. Topography: flat rolling , steep
% of s- ope
8 . Nature of soil and depth /
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
10. Percolation test: A is required
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 I/' / �- a¢
ignature of app 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.
0-VD 9 �, c'o.'adeT& Sep-tc 01(
Form 3-82 • .
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date ( S
-11
Location VD 1_ i r COT. ;
Permit No. �{ t� ��4d Weather
7 9 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. f`
Septic Approval i,./'
Floors •
Insulation
Foundation
Walls
Ceiling
2((s.2%M_
' Building Inspector
REMARKS
SANITARY SEWER SERVICE
Division of G. P. Drellos Inc.
53 FOURTH STREET GLENS FALLS, N.Y. 12801
TELEPHONE 792-7257
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