1985-123 BUILDING PERMIT
TO1rIV' N OF QUEENSBURY No. 85- 123
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WARREN COUNTY, NEW YC}RK
PERMISSION is hereby granted to James Ries
21 Moorwood Drive Street. Road or Ave.
OWNER of property located at C+
in the Town of Queensbury, To Construct or place a fD
ether with lot plans and other informa#ion hereto filed and �
at the above location in accordance to application to9 p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_ 7r1
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1 . OWNER'S Address is 21 Moor mod. Drive N
Glens Falls , New York
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service. !u
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3. CONTRACTOR or BUILDER 'S Address O
p . o . Box 224
Glens Falls , New York.
4. ARCHITECT'S Name .
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5. ARCHITECT'S Address
6. TYPE of Construction — [Please indicate by X)
I ) Wood Frame f } Masonry { ) Steel I }
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7- PLANS and Specifications
1 dist . box , 2 7tx8 ' drywells with 24 " # 3 stone �
No. application £,ubm±tted . [D
per plot plait and
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8_ Proposed Use r6
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Sewage system. for dwelling c)
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April 16 •!g 87 �
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
(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.)
35
Dated at the Town of O.ueensbury this 16th 'Day of
April yg
for the Town of Queensbury
SIGNED BY
Building and Zoning Insppector
TOWN OF QUEFNSBURY TOWN (OAF' QUFMN913uR"
a F.BUILDING 6 ZONING DEPARTMENT R
SEV7AGF DISPOSAL PWWRMIT APPLICATI AVR I rJ 41�3bb
ode" Fer"f .
] . Owner ' s Name A-Ma 6
Address
Telephone Nov
2 . ' Property location
3 . Name of person or firm responsible for installing systemcPA --err
[V f �e � P �Z F' LJr' C t Telephone Nov ,/ 6?2 'fie)
Address - Q' C'J ,�d 4V
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow #ts5 () gallons/day
6 . Septic tank capacity G C�> gallons
7 . Topography : flat rolling , steep
of slope
8 . Nature of soil and depth El 4ou 1 Q f
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? s fto
10 . Percolation test : A� is required
B is not required
C if required what is the rate d -'S� minutes/inch
11 . Water supply : municipal well , other
12 . Type of system proposed : drywall -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 a ovided for in Section 6 . 010 of the
Queensbury Sanitary pSewage ordinance .
Date _ IS> 3
ignature o(\ i )
pl cant
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 .
j` ' �`
Form 3 - 82
'7 `�'
TOWN OF C14JEENSBURY
Building DePirtment
meta" RAPOIt Date -5
L.ocatipm ! „.► ►'L C] n rZ[ ,mac �'] ' L .�---
Pe No._72.5��1 2 �?-- Weather `
Remarks
Excavation
Foot in Or
Footing & Piers
Foundation
Cement Coat
waterproofing..
Bacicfi l l
Final Se�xve
Framrin
Srjea thi n
Roof Felt
Roof_i.n
Siding
masonru veneer
Ron h Pl
Relief Valves
A7all Eoard
Ext . Porches
Finished Floor
interior Trim
Stairs & Railin s
Cellsr Dr . Tile
,Concrete Floors
Pl , Fixtures
Gar , Fire roofin
Door Closers
Chimne
Water Meter Snst .
Sept c A roval
Floors
Foundatlon
Insulation Walls
Cellin
Building inspector
REMARKS
SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS FALLS, N . Y. 12801
TELEPHONE 792-7257
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