8866 BUILDIING PERMIT
- OWN OF QUEENSBURY No.: $866`
WARREN COUNTY,.NE_W.YORK• '
-.Frederick ,Quackenbush
_ PERMISSION is hereby granted to I-I
•
36 Arbutus .Drive
OWNER of property located at Street,Road or Ave A'
• in the Town of Queensbury,To Construct or place"a' Sewage Alteration P
at the above location in accordance to application together with plot plans and other information hereto filed and n
77'
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ` - (D
b'
1. OWNER's Address is: 36 Arbutus. Drive O
cn
• Glens Falls, New,York - o''
2. CONTRACTOR or BUILDER'S Name -
Dan Galusha
. .. a�.
- 3. CONTRACTOR or BUILDER'S Address
Johnsburg," New York ',:.
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sr
4: ARCHITECT Name U1
hi
N.
5. ARCHITECT'S Address - _: ,
' 6:,TYPE of Construction—(Please indicate by X).
( "►-Wood Frame ( )Masonry ( )Steel: ( 1
7. PLANS and Specifications'
new 'di st. box 'and 3' - -8 'x4' drywel l s "per , - ,
No: plot _plan: and application submitted. , _ (D
8. Proposed Use"" Ci
N
-
Sewage- system for dwelling' ? " -
10. 00 Nov.,. . 86
$ PERM'IT;FEE PAID -THIS PERMIT EXPIRES - 19
(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.) "
7th Nov. 84
Dated at the Town of Queensbury this -Day of 19`
SIGNED BY 7,na fu, a•_ for`the,Town of Queensbur• y
andZoning _
Building. Z n .Inspector C _
G
TOWN OF QUEENSBURY 'JINN �r La�=av �.�e
BUILDING & ZONING DEPARTMENTRECEVE
I
I I SEWAGE DISPOSAL PERK IT
APPLIICATION NOVA 51Jt Pd
9 h h O - Fc't- F. I.'
1. Owner' s Name Q(�� A°'��
�iz Zv G� 4-et 6j, 718I P �0�11I1211121314l 516
,
Address 3( A t ,1)//i (�,(,cq e,n 4�rc�
Telephone No.
2. Property location 77 ii174-3
3 . Name of person or firm responsible for installing system
y c� Akt. Telephone No. 03'/-a lS f�
Address }-�
4. Number of bedrooms (residential buildings only) 3
5. Daily flow gallons/day
6. Septic tank capacity 42406 r I gallons
7. Topography: flat, rolling, steep
% of slope
8 . Nature of soil and depth �i;,_-
9. If ground water, bedrock or impervious material is apparent at what
depth does it begin? ft.
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 d„�,„
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 ►V6y �� ..f////
signature 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.
fir. 6�c� 3 S eX 474 el e Form 3-82
`ems' x
TOWN OF QUEENSBURY
Building Department
Iaispectars Report Date / 7 `�
Name )9,t-ni -jl i, HA u eke(ivr
Locatima Ap d v pi 5 an/ .
Permit No. Weather
• Remarks
ExcatM tion
Footing Forms
Footing & Piers
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing rj •
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 t
Floors
Insulation Foundation
Walls
Ceiling " '
• • Building Inspector
REMARKS
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