1985-018 BUILDING PERMIT
TOWN OF +QUEENSBURY No.
85 _ 18
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Paul R ± sholr
OWNER of property located at iz Bronk Drive Street, Road or Ave. b
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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_ in
O
t. OWNER'S Address is
Brunk Drive
Glens Falls , Neu, York
2. CONTRACTOR or BUtLDER'S Name
Frank Shaw Septic Service
3. CONTRACTOR or BUILOER'S Address
Gansevoort , NeTA.r 'York �
a
x
4. ARCHITECT'S Name tz�
F�-
C
N
5_ ARCHITECT"S Address
6. TYPE of Construction — 1Please indicate by X)
( I Wood Frame [ } Masonry I ) Steel ( I
7_ PLANS and Specifications
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No. 750 gallon septic tank , dist . box and 2 - 41x6 '
drywells , # 3 stone per plot and application submitted
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B. Proposed Use
Sewage system for dwelling rt
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P.
$ 1 € 0 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Feb . 6 1987 0
(tt a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queen sbury before the axpi ration date.)
Dated at the Town of Queensb
ury this 6th Day of February 19 85
SIGNED BY , Y/3J for the Town of Queensbury
Building and Zom�laspector
TOWN OF QUEENSBURY
BUILDING & ZONING DEPARTMENT TOWN OF OUEENSOURN;
SEWAGE DISPOSAL PERMIT A.PPLICAT [, ro E � 17 I E
1 . Owner * s Name - r t. LJ @] Mb
Address
Telephone No . / ,�2
2 . Property location
3 . Fume of person or firm responsible for installing system
Telephone No . 2 :}
Address
4 . Number of bedrooms ( residential buildings only) --
5 . Daily flow S �a -t gallons/day
6 . Septic tank capacity / s` Ur gallons
7 . 'Topography : la , rolling , steep
of slope
8 . Nature of soil and depth / .
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? ft .
10 . Percolation test : A is required
B is not required
._Q if required what is the rate minutes/inch
ll . Water supply : munici-pa] well , other
12 . Type of system proposed : ywell ile 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.A JQ
signature of applYcant
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
3 S 72&e)q�
TOWN OF QUEENSSURY
Building Department
Z�bors Report
„'L G
;1 01900t is'
P wamik No. I Westhee
Remarks
B,Vcava tI on
Footin Farms
Footin A Piers
Foundation
Cement Coat
Water roofin
Baclkfill
Final Surve
Frami
Sheathin
Rpof Felt
Roof-in
,ridin
masonru Veneer
Rou h P1
Relief [calves
Wa11 Board
sxt . Porches
Finished Floor
Interior Trim
Stairs & Bailin s
Ce] Iar T)r . Ti1e
Concrete Floors
,p,t Fixtures
Gar . Fire roofin
�r Closers
Chimne
Water Meter Inst .
se tic A roval
Floors .-�-�-
roundation
Insulation Walls
Ceilin
Building inspector
REMARKS
-74S
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