1985-378 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 8 5- 3 7 8
< ,� yi � r 1 w 1
PERMISSION[ WARREN COUNTY, NEW Y�RK
_' "S! ON is hereby granted to Daniel Lambert
l�
OWNER of property located at 4S Twin Channels Road Street, Road or Ave_ �.
m
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 p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance_
tt)
1 . OWNER'S Address is �
Twin Channels Road rr
Glens Falls , New York
2. CONTRACTOR or SUI LDE R'S Name
Roger Jones
H
3. CONTRACTOR er BUILDER'S Address F+-
Johnsburg , New York
tj
4. ARCHITECT'S Nam&
CG
an
5. ARCHITECT'S Address 0
0)
6. TYPE of Construction — (Please indicate by X)
1 Wood Frame { ) Masonry ( ) steel I }
7. PLANS and Specifications
1000 gallon tank, dist . box 4 61 stacked drywells
No. per plot and application submitted .
w
8. Proposed Use M
Sewage system far dwelling
rr.
(o
rc
rt
$ 1 0 w) PERMIT FEE PAID — THIS PERMIT EXPIRES — July 23 19 87 0'
(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 23rd Day of „ July _79 85
SIGNED BY � 4 for the Town of Queensbury
8uildirig anCl Zoning Inspectof
TOWN OF QUEENSBURY "TOWN OF QUEENSSURY
BUILDING & ZONING DEPARTMENT
SFWAGF DISPOSAL PERMIT APPLICATION = III
f_ j l l L
1 . Owner ' s Name �rrr �i• ' y 71
] fe o� � - Q �PM
Address .f ->-
Telephone No . ;'7
2 . Property location
3 , Name of person or firm responsible for installing system
Telephone No . /' _ - �f
Address
4 . Number of bedroom ( residential buildings only) 2_---
5 . Daily flaw = ', /9 gallons/day
6 . Septic tank capacity f C L" C' gallons
7 . Topography : ffla rolling , steep
of slope
s . Nature of soil and depth_ �f— ry
9 . If ground water , bedrock or impervious material is apparent at what-
depth does it begin? f t .
10 , Percolation test : A is required
B� is not required
C If required what is the rate minutes/ inch
ll . Water supply : municipal ] well , other
12 . Type of system proposed : . drywell tile field , ether
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 .
Data
f slgna re applicant
On separate sheet -,f 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 CVJEENSSURY
suildim!
RJR Date_.. Z-
Pam No.
Remarks
' Sxaatrat�-on
Footin Forms
Footin & piers
Foundation
Cement Coat
water roofin
Back f ill
Final Surve F
Frami.n
Sheathin
Roof Felt
Roof-In
sa.di.n
I Pnr veneer
Rou h Pl
Relief valves --
Wall Board
Sxt . Porches
Finished Floor
interior Trim
,Stairs & Ra lin S
Cellar Dr .
Concrete Floors �_�
Pl Fixtures
Gar . Fire roofin
por.r Closers
Chimne -_
Water Meter Inst .
5e tie A roval Floors
Foundation — --
Insulation walls
Ceilin
Bu Id ` g Inspector
RFMARKS
r
- — DAN I.._Arc\ BE Rr
�r
.Srs.� ❑ BAsa+z. �� T'h/iN 'C� hNu� LS �.p .
C u �ENst3uR`{ W .y .
II
.Tp Mix
RF-S io osm IJL E
1 DOL7 eaA L
SF.Vrf,L -r" K
E
�"KQPcs� ED �EPTr.0 S `lsTrM
t '' - .z 40