7774 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 7774
WARREN COUNTY, NEW YORK "
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'PERMISSION is hereby granted to Mario Scar selletta, Jr.
OWNER of property located at 6 Pinewood Avenue Street, Road or.Ave.
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in the Town of Queensbury,To Construct or place a Sewage Alteration 13)
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. N
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1. OWNER'S Address is 6 Pinewood Ave.
Glens Falls, New York -
2. CONTRACTOR or BUILDER'S Name Jay Sweet •
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Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
R. D. #1.
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Lake George, New York b
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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 1000 gallon septic tank, dist. box and 200 ' tile rmi .
field per application submitted.
8. Proposed Use
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Sewage system for dwelling.
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$ 10. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES . April 6 1g. 85 r�l
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
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town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 6th Day of April 19 8 3
SIGNED BY E .54u vN for the Town of Queensbury
Building and Zoning In*ctor(
`7C, - / _3 TOWN OF QUEFNSBURY
BUILDING & ZONING DEPARTMENT
SEWAGF DISPOSAL PERMIT APPLICATION
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Owner ' s Name ( _ �G4p.64-a-c-c- 7Y'4
Address �/ N�� �O� ° ° ° e a a a •
UO 9 � � BtiT(�i(T[�UI�6lo OL
yy diJ� m� 127
Gi<d ,
Telephone No.y9 1Q ;rid
2. Property location y .e e(v S (3(.t ,I/ CI
3 A El 3 3 tn
3 . Name of person or firm responsible for installing tyge m3flb a0 NM0
O( Pe p Telephone No. ' r. yeT
Address cbc /2.
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4. Number of bedrooms residentia(residential buildings only)
5. Daily flow 117cgallons/day
6. Septic tank capacity ' O-0 gallons
7. Topography:(11iD rolling, steep
% of slope
8. Nature of soil and depth C. d- Li
9.-- --If -ground -water, -bedrock-- or impervious material is -apparent at what -
-. depth" does it begin? - ft. -
10. Percolation test: is required .
B is not required
C If required what is the rate S minutes/inch
11. Water supply: municipal, ell, 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 ���pf/`/ / LS -/"/ Y3
signat re o applican
On separate sheet of paper submit a di gram 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 itpelf.
/40 , 561/16'-i LY-77-r
Form 3-82 6 6 Y
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TOWN OF QUEEN S U Y
Building Department
Inspectors Report Date 41 5 9 i
Name , E7 7774
Location ,f_ze&—1, n^.1)
Permit No. P Weather
'77 7 C( Remarks
Excat}a tl 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
Water Meter Inst.
Septic Approval ie,"
Floors
•Insulation Foundation
Walls
Ceilin
Building Inspector
EMARKS
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