1903 BUILDING PERMIT
TOWN OF QUEENSBURY No 1903
WARREN COUNTY, NEW YORK 1-4
cn
In
PERMISSION is hereby granted to Mr. Herman Shires
tr1
OWNER of property located at Assembly Poi►it Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage System
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
Box 187 Assembly Point Road
Lake George, New York
2. CONTRACTOR or BUILDER'S Name
F. Bushey
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( 1 Steel ( )
7. PLANS and Specifications
No. As per application
cn
cn
8. Proposed Use
Alteration Sewage System
ro
0
$ 5,00 PERMIT FEE PAID—THIS PERMIT EXPIRES 8-1 - 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 6 Day of Jul y 19 72
SIGNED BY for"'Town of Queensbury
ui ing and Zoning In ctor 1
TOWN OF QUEENSBURY
WARREN COUNTY, NEW ''OFK
Application for
A PERMIT TO CONSTRUCT, ALTER OR ENLARGE A SEW WN OF CUEENc F=JR',
DISPOSAL SYSTEM FOR A PRIVATE RESIDENCE WITH' g E G
TOWN OF QUEENSBURY �' `r" t 724w jJ
Mail or bring this application to: JUL6 1972
Building & Zoning Department A.M. P.M.
Queensbury Town Office Building 7 8 g I 1 1 2 3 4 5 6
., , I. I.q .�I�I. I ,I. II. i..
R.D. 1 Bay Road
Glens Falls, New York 12801
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.
4,1
1. Name and mailing address of applicant :
/ lt , ,
o a
a...
P
2. Specific location of property: ..,.<
( S 1T A.J r .��'�,BER�
TR
3. Application is for:
New construct ion of private dwelling.
eration or enlargement of existing sewage Disposal system.
4. Description of building:
a. number of bedrooms
b. garbage grinder nl(7
(YES OR NO)
5. Topography: + "
(
lat rolling, steep slope, gentle sTO-pe, 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. )
--1-..
b. Ho w d4termined? -
7. a . Soil percolation test made by Noy Department of Health)
(Refer to Part III , Bulletin 1 ,
b. Percolation test notes submitted? AYE NO)
8. Proposed sewage disposal system indicated on attached plan or
sketch? a -.
(YES OR NO)
9. Date when construction will commence "' `, --- -
It is hereby agreed that if this apE lication and attached plans
dated 11 , or any amendment or revi inn: thereof ,
are app ved i sta anon of sewage disposal
as shown on
aftssuchwill
be
made in acco dance with the details
approved plans. , ,,
..e/ii
"I./ ' ''' ,„t , 70.4/ , 74/". '1'''
Ins a e By: ontr for m ignature of app icant)
Owner W
TOWN OF QUEENS8RY
WARREN COUNTY, NEW ''OF.K
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:
Building 8 Zoning Department
Queensbury Town Office Building
R.D. 1 Bay Road
Glens Falls, New York 12801
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:
�r
340 -..#1k,....,) 4/A A-e _45 _____
Q_eN /I/ r7 CZiady P - "
-
2. Specific location of property : ‘211.:
NUMBER)
( STREET AN )
3. Application is for: —,—,
New construction of private dwellin
ra ion or en a emen o existing sewage disposal system
4. Description of building:
a . number of bedrooms
b. garbage grinder jtJQ
(YES OR NO)
5. Topography: ,'.._
(
rolling, steep slope, gentle slope , etc. )
6. a. Nature of soil.
(Describe
feetaif depth
leaching pits are
tilefield is to be used or
proposed, giving thickness of various strata such as
top soil, clay, loam, san , gravel, rock, etc. )
b. How d termined?
7. a . Soil percolation test made by "`"ti.
(Refer to Part III , Bulletin 1 , N.Y.S . Department of Health)
b. Percolation test notes submitted? ,w1140
(YES OR NO) .
8. Proposed sewage disposal system indicated on attached plan or
sketch? . '.-
(YE . OR NO)
9. Date when construction will commence _ --i_./....40e...._,
It is hereby agreed that if this application and attached plans
r or any amendment or revision thereof ,
a.
areed appr e n to lataon of sewage disposal facilities will be
made in acco ance with the details thereof as shown on such
approved plans. </' ' .. . 4--- r
41 141", 10.4,e ,,...elcit.44-,
gnature of applicant
lnsta lid y: Contras or
Owner
1
(51/4.47'
1
4 I
/*)
- ;
.\.n
N
, !
i
,
.
A 74,
G
-1_
1 1 '
11 1 t‘c
*S.
. \ 1
t 1 1
I
If n '
‘.4.„----
i
i
I
CV-11-4"1 (ACW.A--:.-ZA- '''--;.;?",CN.,.•
',.