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1985-250 BUILDING PERMIT Z TOWN OF QUEENSBURY No. 85- 250 ! ` WARREN COUNTY, NEW YORK PE14MISSION is hereby granted to Conrad S . Kac zmarek rn OWNER of property located at 20 moorwood Drive Street, Road or Ave. C3 Sewage Alteration in the Town of Queensbury, To Construct or place a 0 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. [D t . OWNER'S Address is 20 Moorwood Dri-Ve Glens Fal1Sr New York 2, CONTRACTOR or BUl LDER'S Name Andy Scarpellino h , Q 3. CONTRACTOR or BUILDER'S Address 4 Seward Ave . 0 Glens Fallsr New York 0 0 4. ARCHITECT'S Name 0j CJ r-i C fD 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X1 ( ) Wood Frame S I Masonry ( 1 Steel S 1 ua fD 7_ PLANS and Specifications 1 6 ' xl0 ' x6 ' drywell with 42 stone- per plot plan and appli anon m No. st1bm :Lt.ted . 8. Proposed Use fD t'Y Sewage system for dwelling w rt 0 $ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES .Tune 3 19 87 (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 —7, d , ^Day of '3n 99 $ SIGNED BY _ 1/L Gt C L+r + for the Town of Queensbury Building and Zoning Inspector ej TOWN of QUFFNSBURY ! J BUILDING & ZONING DEPARTMENT 5.E-%JAGF DISPOSAL PERMIT APPLICATION 1 . Owner ' s Name 11 ,tea M I-g t:7 � G Z A- < xq /Z Address �G� / 1t* +a rr `�c r c3 c� Telephone No . 2 . Property location 3 . Name of person or firm responsible for installincr system Telephone No . :Z�Z7 Address rL 'p 4 . Number of bedrooms ( residential buildings only ) 5 . Daily flow gallons/day 6 . Septic tank capacity Z-!f:> c� C> �+ fx r 5 "; i gallons 7 . Topography : at rolling , steep $ of slope 86 Nature of soil and depth 5 .ram si 9 . If ground water , bedrock or impervious material is apparent at what- depth does it begin? /- ft . 10 . percolation test : A is recruired B is not required C if required what is the rate minutes/inch 11 . Water supply : municipal well , other 12 . Type of system proposed : drywell- tilt field , other Any contractor , corporation , individual , etca 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 provided for in Section 6 . 010 of the Queensbury Sanitary Sewage ordinance . r (� Date _ ) u v �- -3J .a *e 1 // sag tore o pp xcant 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 . 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