1377 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 1377 S.
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Joseph Duell
OWNER of property located at Bay Road Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration
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
Bay Road R. D. -
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Stanley Granger
3. CONTRACTOR or BUILDER'S Address
Boilvard.
4. ARCHITECT'S Name
Same
5. ARCHITECT'S Address
Same
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( )Masonry ( ►Steel ( )
7. PLANS and Specifications tad
No. 1000Gal. Septic Tank 1000 Gal. Dry Well as per plot
plans submitted.
8. Proposed Use C+
Sewage System
$ 5.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 10-1- 19 71
(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 24 Day of August 19 71
SIGNED BY e—c for the Town of Queensbury
Building and Zoning Inspector (j , L )
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Application for
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEWAGE
DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITHIN THE
TOWN OF QUEENSBURY
Mail or bring this application to: TOWN OF QUEENSBURY
Building & Zoning Department ECEPVEDU
Queensbury Town Office Building J� --
R.D. 1 Bay Road - .t 2 3 1971
Glens Falls, New York 12801
A.M. P.M.
This application for a Sewage Disposal Permit must be .?18 1,91i1P1AMP3N }fi
accompanied by a plot plan drawn reasonably to scale A
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:
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2. Specific location of property:
(STREET AND NUMBER)
3. Application is for:
New construction of private dwelling .
X Alteration or enlargement of existing sewage disposal system.
4. Description of building:
a. number of bedrooms 154 -3
b. garbage grinder ►.� a
�^ (YES OR NO)
5. Topography: C
(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
top soil, clay, loam, sand, gravel, rock, etc . ) L-0 a __
b. How determined?
7. a . Soil percolation test made by
(Refer to Part III , Bulletin 1 , N.Y.S . Department of Health)
b. Percolation test notes submitted?
(YES OR NO)
8. Proposed sewage disposal system indicated on attached plan or
sketch?
(YES 0 NO)
9. Date when construction will commence 2-- 3 —
It is hereby agreed that if this application and attached plans
dated or any amendment or revision thereof ,
are approved, inst�lation of sewage disposal facilities will be
made in accordance with the details thereof as shown on such
approved plans.
st y in a led : Contras r - (Signatur`� of applicant
I
Owner
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