1986-014 BUILDING PERMIT
TOWN OF QUEENSBURY 86-14
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James D. Urch
12 Hummingbird Lane w
OWNER of property located at 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 James D. Urch
12 Hummingbird Lane
Glens Falls, New York 12801
2. CONTRACTOR or BUILDER'S Name
Ronald Grimes --__ N
3. CONTRACTOR or BUILDER'S Address 0
RR #1
Lake George, New York o'
H.
1-t
4. ARCHITECT'S Name Gi
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( ) Wood Frame ( ) Masonry ( 1 Steel ( ) cn
fD
7. PLANS and Specifications ow4
New: 2 — 6'x8' drywells per plot plan and application submitted.
No.
ct
8. Proposed Use
Sewage system for dwelling H.
10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 15 19 88
(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 15th Day of January 19 86
SIGNED BY ec,c-4 67, for the Town of Queensbury
Building and Zoning Inspector �€-
• cc77
_lown o/ Queenihury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTICPPT� DISPOSAL PERMIT APPLICATION
Owner ' s Name Jz `a1J I), 1) K- ; Tel. —71Z-001
Address /2 - -014 J' j t140 Z b
Person/Firm installing system. t,
Number of bedrooms (residential only)
Total daily f low: (compute @ 150 aal.per bedroom per day)_ /J a
Topography: flat rolling steep - (circle one) Degree of slope 10 %
Nature of soils: sand-loam-clay- other- Depth ft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? jy//4 ft.
Percolation Test - Not required / Required -Rate /VA(/- min/inch.
Domestic Water Supply �Municipa - Well - Other
IMPORTANT!
On a separate piece of paper , submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, °pondor wetlands. Include all
dimensions of the system itself.
Description of proposed system:
Septic tank size /a) 7gal.
Tile field- Length of each trench —ft. Total field ----ft.
Size of stone #
Seepage Pit(s) Number / Size (, ftX ft. Size of stone# ')
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 Town of Queensbury Sanitary
Sewage Ordinance. / ,�
/�/ecu - 07 - C� 'X �' dip Pia r
k gnature of App icant Date
01/86 and/vl
TOWN OF QUEENSBURY
Building Department
Inspectors Report Date /.)-D- CL
Name /2'g(n7/7S
Location f-/-u, �' - � c)
Permit No. 8 [a — / Weather
/ Remarks
Excavation
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 µ--
Water Meter Inst.
Septic Approval J%— S-
Floors j
Insulation Foundation
Walls
Ceiling
Utgizevh/r1,7273.--tre
Building Inspector
REMARKS
0I / i 7 Stip o 6X
TOWN OF QU•EENSBU Y
Building Department
Inspectors Report Date • /(Name
Location
Li, r� � !t hQl
//AMA
Permit No. F 6 -/ Weather
Remarks
Excavation
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. ��,,77 _ Cc
Septic Approval ' IL;c6.d , -- 9
Floors
Insulation Foundation _ ^^
!Walls
Ceilin9
a
(6 )//41
Building Inspector
REMARKS
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