7843 BUILDING PERMIT
TOWN OF QUEENSBURY No 7843
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1 1�� � � WARREN COUNTY, NEW YORIC
PERMISSION is hereby granted to David Feheley
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OWNER of property located at 5 Dor set Place Street,Road or Ave.
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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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
5 Dorset Place
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Dale Granger
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3. CONTRACTOR or BUILDER'S Address CJ
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4. ARCHITECT'S Name rtiy
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5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( I Masonry ( ) Steel ( )
7. PLANS and Specifications 2 drywells 7 'x7 ' each per plot plan and
No. application submitted. to
8. Proposed Use
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Sewage system for dwelling
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 11 19 85
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 11th Day of May 19 83
SIGNED BY , rye for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT TOWN OF QUEENSBURY
SEWAGF DISPOSAL PERMIT APPLICATIOR E Q w E
1. Owner' s Name i IM 4m,�e F
Address es * 1 A.M. P.M.
Ant LLOJIArCitwiti Telephone No. ;
2. Property location -y,,LA-
3 . Name of person or firm responsible for installing system
Telephone No.
Address
4. Number of bedrooms (residential buildings only) `3
5. Daily flow gallons/day
6. Septic tank capacity /0 6® gallons
7. Topography: EVEr0wrolling, steep
% of slope
8. Nature of soil and depth c-# j)
9. If ground water, bedrock or impervious material is apparent at what.
depth does it begin? Writ, /J ft.
10. Percolation test: .A is required
B is not required
C If required what is the rate ® minutes/inch
11. Water supply: . unicipal,' 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 pro 'ded for Section 6 .010 of the
Queensbury S nitary Sewage Ordinance.
Date � !I �� ke-e'" t-
signatu •r of p icant
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.
Form 3-82 i '
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date r2
Name �'A' C:
Location _ Z' P
Permit No. 7e 5 Weather
-Pd '/Z/4-fJ&&-22, c .go xfs Remarks
ExcatM ti on
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
WaterMe
ter p pr Inst.
Septic Approval
Floors '
Insulation Foundation
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Walls
Ceiling
Building Inspector
REMARKS
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