1985-079 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85 - 79
,2,q , , i WARREN COUNTY, NEW YOR K
PERMISSION is {hereby granted to Martin Nelson
OWNER of property located at -3'� Montrasr Road Street, Road or Ave.
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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 z
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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t. OWNER'S Address is 37 Montray Road
Glens Falls , New York
2. CONTRACTOR or BUI LDE WS Name
Condon ' s Septic and Drain Service `tea
3. CONTRACTOR or BUILDERS Address 0
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17 Grant Ave . €i
Glens Pal _sj New 'York
4. ARCHITECT'S Name 0
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5. ARCHITECT'S Address
6_ TYPE of Construction — (Please indicate by X)
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( 1 Wood Frame [ ) Masonry I I Steel I Pj
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7. PLANS and Specifications
1000 gallon septic tank and 1 8 ' xg ' drywell per plot
No. plan and application subm ±tted .
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B. Proposed Use Ct
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Sewage system for dwelling O
$ 100 OO PERMIT FEE PAID — THIS PERMIT EXPIRES October 1 1965
(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 28t��h�� /Day of Mcizch 19 85
SIGNED BY for the Town of Queensbury
Building and Zoning Inspecto
TOWN OF QUFFNSBURY
TG+kI4rN QF QUEEN913'JRY
EUILL32NG & ZONING DEDEPARTMENTE
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SFVPAGF DISPOSAL PERMIT APPLICATION
1 . Owner ' s Name
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Address
Telephone No . 79 2, &J�
2 . Property location
s 3 . Name of person or firm responsible for installing system+ d (IlU
A /V t2 r'�+ /+'u �-' �I�. ,�'� Tel a phron e N o .
Address / 1 4 4a E - �= � c '�u<a f- 11I /fS /"(! ` / .L /r
4 . Number of bedrooms ( residential buildings only ) � -
5 . Daily flow gallons/day
6 . Septic tank capacity /4000 [�2 7��-s " gallons
7 . Topography : flat rolling , steep
% of slope
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of Nature of soil and depth / J
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? / C 4-*1 ft .
10 . Percolation test : A is required
g is not required
C if required what is the rate minutes/inch
ll . Water supply : municipal , well , other
12 ., Type of system proposed : rwelD -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 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage ordinance _
Date 3
signatuire or appl1cant
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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
TOWN OF QUEENSBURY
sU'llains nepartmen .
mmpoeuws Repmt oat
Nwme
Fsrnwit Nw
Rema rTcs
Excavation
Fvot%n Forms
Footin 6 Piers
Foundation
Cement Coat
Water roofing
Be
Final Surve
Frfxm%n
Sheathin
Roof Felt
Roofin
Sidin ------
Masonrw veneer
Rou h pl
Rel.i.ef Valves
Wall- Board
Ext , Porches
Finished Floor
interiox Trim
Stairs & Railin IsCellar I]r . Tile
Concrete Floors
pl . Fixtures
Gar . Fire roofin
Door Closers
Chimne
Water Meter Inst . T„
Se tic A royal
Floors
--
Foundatlon
Insulation Wa.I2$
Ceilin
Building InsPec Or
REMARKS
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