1985-148 BUILDING PERMIT
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Mrs . Donald Sullivan �
PERMISSION is hereby granted to (In73 Boulevard
Street. Road or Ave. ,
OWNER of property located at 1111�;l
Sewage Alteration n
To Construct or place a W
in the Town of Queensbury lication together with plot plans and other information hereto filed and
at the above location in accordance to app uilding and Zoning Ordinance.
approved and in compliance with the Town of oueensbury B
G
Address is
73 Boulevard ~
t . t7WNE#i"S �
Glens Falls , N . Y .
W
2. CONTRACTOR or BUI LDE R'S Name and Drain S ery is e
Condon ' 's Septic
3. ( OoNTRACTW4 or BUlL[)FRS Address
17 Grant Avenue
York
New
Glens Fal1Sr
w
k. ARCHITECT'S 'Name �
F�
C
S1s
6. ARCHITECT'S Address S�
g. TYPE of Construction — (Please indicate by XI
i ) wood 'Frame ( S Masonry S ) Steel ( I
diet . box and 2 8 ' x$ ' drywells per application
7. PLANS and Speci#(cations i
No.
and plat plan submitted.
r
$. Proposed Use
Sewage system for dwelling
April 25 tig8'7
10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
$
(III 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 dared
Apr
$ 5
Dated at the Town of Queensbury this 25th Day of
for the Town of C2ueensbury
Id ALI
SIGNED BY r/Lt�.c
Building and Zonrng Inspectar„��,
TOWN OF GUFF NSBURY
"SC34N!'W OF QLJEEN5SL3RY
BUILDING & ZONING DEPARTMENT pa
Fm rV U �I
SEWAGF DISPOSAL PERMIT APPLICATION
1 JAI r k< J 198ti
1 . Owner ' s Name 1V t_� I C/ 12�
Address73 [f E G� R ' is �° 1121314 E
Telephone No . /' �•S
2 . Property location ,
3 . Name of person or firm responsible for installing' system_ �Q /" �� /"✓ S
TelepYyone No .
4 . Number of bedrooms ( residential buildings only ) -,R.
5 , Daily flow gallons/day
gallons
_ 6 . Septic tank capacity CfO o
7 . Topography : flat rolling , steep
of slope
S 8 . Nature of soil and depth��'r
g , If ground water , bedrock or impervious material is apparent at what
depth does it. begin*" a0 fte
Joe Percolation test : A IS required
g is not required
C S required what is the rate minutes/inch
lie Water supplyom ,emun1cipa� well , other
' 12 ,, Type of system proposed : rywell
-tile field , other
Any contractor , corporation , individual , etc . engaged in the construction
of a sanitary sewage disposal system who covers the same beforepiispatlon
does not have an approved permit , or varies from the approved n p
will be subject. to a penalty of $ 250 as provided for in Section 6 . O1C1 of the
Queensbury Sanitary Sewage Ordinance .
r
Date 1 �cant
sign ure o app
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions , including r staple fetc ,rom anlncludetallfdimensions distance fOfm
property line and domestic water su-ypcP y ,
the system itself . �i ,r ,a 4 L,0 C�
xi 7 CkAejees
Form 3- 82 ,R %�^
TOWN OF QUEENSBURY
Building DePurtment
Inep ecte" 'Rem _ Date
- Name � /h2-S ,.s �r'G�/,Gf° r • • �� . r :.�
73
Pest No. Weather
Remarks
' ExcatYa ti on
Footin Forms
Footin & Piers
Foundation
Cement Coat
Water roofin
Backfi.11
Final curve
Fran+in
Sheath!n
Roof Felt
Roofin
Sidin
Masonr veneer
Itou rh Plb
Relief valves
plall Board
Ext - Porches
Finished Flpor
Interior Trim
stairs & Railsn IS
Cellar Dr . file
Concrete Floors
P ra Fixtures
Car . Fire roofin
Door Closers
Chimne
Water Meter Test .
Septic A roval
Floors---
Insul.atlOn Walls
ceilin
U2 ding Tns actor
REMARKS
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