1724 BUILDING PERMIT
TOWN OF QUEENSBURY Na 17?4
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Michael L s Danahy �-
OWNER of property located at 93 Rainbow Tra i 1 Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewaga. System
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),
1. OWNER'S Address is r
10 B. Kennworthy Avenue
Glens Falls, New York
12R01
2. CONTRACTOR or BUILDER'S Name
Owner
3. CONTRACTOR or BUILDER'S Address
Owner
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( I Masonry ( ) Steel ( )
7. PLANS and Specifications .
"' as per attached plot plans submitted.
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8. Proposed Use
Sewage System
0
$ 5.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 9_1_ 19 79 1-1
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the w
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town of Queensbury before the expiration date.) H.
F-�
Dated at the Town of Queensburyf this 1 Day of May 19 72
SIGNED BY / for the Town of Queensbury
Building and Zoning Inspector CO, 1-V/ )
i TOWN OF QUEENSBURY
WARREN COUNTY, NEW '!ORK
Application to
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE
DISPOSAL SYSTEM. FOR A PRIVATE RESIDENCE WITHIN THE
TOWN OF QUEENSBURY TOWN Op Ei�lJ �3p 1�
Mail or bring this application to : H E� 1-YA
fj
Building & Zoning Department MAY 1 .IJ('l .
Queensbury Town Office Building pnn
R.D. 1 Bay Road .7� I11 9110� 112i112131�p15j6
Glens Falls, New York 12801
A
This application for a Sewage Disposal Permit must be
accompanied by a plot plan drawn reasonably to scale
showing all dimensions , the size of the lot, the location
on the lot of the water supply and sewage system.
1. Name and ,mailing address of applicant:
2. Specific location of prope ty a 3 /4e..- 4.---L2(STREET AND NUMB
3. Application is for:
New construction of private dwelling .
Alteration or enlargement of existing sewage disposal system.
4. Description of building: 3
a. number of bedrooms
b. garbage grinder
/� (Y—Es OR NO
5. Topography: �,�
(flat, rolling, steep slope, gentle slope, etc. )
6. a. Nature of soil. (Describe to a depth of 5 feet if tile
field is to be used or 10 feet if leaching pits are• proposed, giving thickness of various strata such as c
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top soil, lay, loam sand, gr el, rock, etc . ),
b. How determined? Tr
7. a. Soil percolation test made by N.Y.S . Department of Health)
(Refer to Part III , Bulletin 1,
b. Percolation test notes submitted? (YES OR NO)
8. Proposed sewage disposal system indicated on attached plan or
sketch?
(Y OR NO)
9. Date when construction will commence
It is hereby greed that if this application and attached plans
dated _Z 2- or any amendment or reviinn thereof;
are appr e , inst� at l3on of sewage disposal facilities will be
made in accordance with the details thereof as shown on such
approved plans.
installed By: Contractor
'ignature o a scant
Owner
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