1985-196 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85 - 196
Mn IkD WARREN COUNTY, NEW YORK
PERMISSION its hereby granted to Carl DSVidson ----
OWNER of property located at L Sheraton Land Irl - - a Street, Road or Ave. �
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in the Town of Queensbury, To Construct or place a sewage A ra I Or+ ~
at the above location in accordance to application together with plot plans and other information hereto filed and C]
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approved and in compliance with the Town of Queensbury Building and 'Zoning Ordinance. C
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1 . OWNER'S Address is Rolling .Ridge
Glens Falls, New 'York
2. CONTRACTOR or BUI LDE R'S Name
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Sanitary Sewer Service ]I
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3_ CONTRACTOR or BUILDER'S Address
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P . O . Box 224 D
Glens Falls, New York 12801 �
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address y`
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6. TYPE of Construction — (Please indicate by XI
{ I Wood Frame { I Masonry { I Steel { I
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7_ PLANS and Specifications
1 dist . box and 250 ' leach field per plot plan
No. and application submitted .
8, Proposed Use co
Sewage system for dwelling g
$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES May 15 19 87
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 1CD5
town of fueenshury before the expiration date} P)
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Dated at the Town of Queensbury this
,15th Day of May 19 � 5 0
SIGNED BY I✓' 6c for the Town of Queensbury
Building and Zoning Inspector ®f,l
TOWN OF QUEENSSURY
TOWN OF QUEENSBURY
BUILDING & ZONING 'DEPARTMENT
S MAGF DISPJOSAL PERMIT APPLICATION 1� MAY 1 4 1%5 ,h
] . owner ' s Name Q) � 14 �4A. L 1 I IKIA. ti
Address 11 4
P "" r vF'[--•
5 h e yG cs h L 2 , an, Telephone No .
2 . Property location
3 . Navkaof person or firm responsible for installing system
� ot Telephone No .
Address C� f
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow. gallons,/day
6 . Septic tank capacity ( gallons
7 . Topography . flat , rolling , steep
% of slope
8 . Nature of soil and depth A L
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? fto
low Percolation test : A is required
B^ is not required
C If required what is the rate .4/W minutes/inch
11 . Water supply : unicipa well , other
12 . Type of system proposed : drywell file fi le d 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 pr ed for in Sectl 6 . 010 of the
Queensbury Sanitary Sewage Ordinance .
Date
�r s gnature 'o'T a pI nt
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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A?Form 3 - 82 /`�
TOWN OF QUEENSSURY
Building Department
inspectors Reipmt Date�'4.5.rz
Name
Pmmft No.
�j �Q I►i r im I� Y' �j' rrd s 4 J? �i . Rema rk,
Excavation
Footin Forms
Foot in & Piers
Foundation
Cement Coat
Water roofin
Backfill
Final Surve
Framin
3heathin
Roof Felt
Roofin
Sid.Ing
Masonry Veneer
Rowa7h Pi
Relief Valves
Wail, Board
Ext , Porches
Finished Floor
.Interior Trim
Stairs & Railin s
Cellar Dr . Tile
concrete Floors
P1 Fixtures
Gar . Fire roofin ---
Door Closers
Chimne
Water Meter In
se tic A royal
Floors
Foundation
Insulation wails _
CeI l in �.
Building Inspector
REMARKS
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r ; SANITARY SEWER ER SERVICE
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Division of G. P. Drellos, Inc.
53 FOURTH STREET GLENS PALLS, N . Y. 12.801
TELEPHONE 792-7257
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