1805 BUILDING PERMIT
TOWN OF QUEENSBURY No. 1805
WARREN COUNTY, NEW YORK ~'
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PERMISSION is hereby granted to Myron 0. Harrington
OWNER of property located at RD 1 Rainbow Trail Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewage System Altprati on Z
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
RD1 Rainbow Trail
Glens Falls, N.Y.
2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. as per application
8. Proposed Use
Alteration
$ $5.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 26 19 72
(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 26 Day of May 19 72
SIGNED BY )4 r � �,v for the Town of Queensbury
a BuildinZoning Inspector /j„'e
,
TOWN OF QUEENSBURY
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WARREN COUNTY, NEW '(ORK
TOWN OF QUEENSBURY .
Application tor D E ,ILU
iVi i' 2 5 "►Y I
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGB.m. Rm.
DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITHIN I; M111Al2i1IM41516
TOWN OF QUEENSBURY ,+
Mail or bring this application to:
Building' & Zoning Department
Queensbury Town Office Building
R.D. 1 Bay Road
Glens Falls, New York 12801
Thi-s application for a Sewage Disposal Permit must be
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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:
M /130 tt/ 0, Hg pi-iAt q •Al
R D - 1 Ri4i' 13oW fii9 )�
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2. Specific location of property: - i A cJ hen '
STREET AND NUMBER
3. Application is for:
New construction of private dwelling.
Alteration or 1a'"9. of existing sewage disposal system.
4. Description of building : 3
a. number of bedrooms
b. garbage grinder y r
NO)
5. Topography: FL fi
(flat, rol ing, 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
top soil, clay, loam, sand, gravel, rock, etc. ) I.S'/2il/
b. How determined? ----
7, a. Soil percolation test made by
(Refer to Part III , Bulletin 1 , N,Y.S . Department of HeaL:thj-
b. Percolation test notes submitted? •
(YES OR N0-)
8. Proposed sewage disposal system indicated on attached plan or
sketch? Y,�—.s'
PeEt ORS-)
9. Date when construction will commence m _7 02 ., .
It is hereby agreed that if this apv licati.on and attached plans
dated _ or any amendment or revision thereof ,
dispos
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ad approved, on f sewa l be
such made in
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approved plans. •
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Installed By: Contractor m
S nature of app i nt
Owner
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