1985-361 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85_361
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to ( Frank Lockhart.
OWNER of property located at � 1 Lockhart NFt . Road Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Sewage Al ;t rat ; on P
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- t7
7C•
s'
f_ OWNER"S Address is RD # 1 S]7
Lake George , New York r1
2. CONTRACTOR or BUI LDE R'S Name
same
3. CONTRACTOR or BUILDER 'S Address O
0
P'
Same w
4. ARCHITECT"S Name rf'
rt
S. ARCHITECT'S Address p
Pi
Lea
6. TYPE of Construction — (Please ind!cat& by Xi
{ ) Wood Frame { I Masonry { I Steel { y
7. PLANS and Specifications
new dist . box and 125 LF the field with 4 ft . rn
No, compacted sand/gravel per application and plot V4
plan submitted . su
B. Proposer! Use fp
Sewage system for dwelling y,
to
ri
$ 100 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 15 19 87 row
(if a longer period is required an application for an exterxsion 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 _-�1y�5th{ / Day
�yofJuly 19 8 5
SIGNED BY //ILEA lfl. /V for the Town of Queensbury
Building and Zoning I nape
TOWN of QLTE'FNSI3URY
BUILDING & ZONING DEPARTMENT TOWiV {Ol�r +QR]�EN58L3R�Y
SEV?AGF DISPOSAL PERMIT APPLICATIO I if 1w ./
- 19$5
1 . Owner ' s Name rc- .4 1 —cJ'= ! !c r JUL V , 5
Address LC}G-iC. ' iAde•i i� A A.M. d �
Telephone No .
2 . Property location
3 . Name of person or firm responsible for installing system
C? (,y,,4ffl -- Telephone No .
Address
4 . Number of bedrooms ( residential buildings only )
5 . Daily flownCi gallons/day
I r +
6 . Septic tank. capacity F X- L4 X 9 gallons
? . Topography : flat , rolling , steep
of slope
r
8 . Nature of soil and depth � �rs : vr �f r , '�� r � i r' r
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? ft .
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 , the 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 . r� f
Date } - �..• _ r`� r --- .•~"-•~- `'G
signature of applicant
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 .
.fit c>116 t3
Form 3 - $ 2
TOWN OF QUEENSSURY
Building DiepartIMOnt
Date
napec"S Raport
Name Az e'"-a_ . .tom
[.a�c+►fina Wreattivar
Penult Nea. "'
Remarks
SxcatSaIt on
Footin Forms
Footin & Piers
Foundation
Cement Coat
Water rooffln
ill
Final curve
Fram9n
Sheathin
Roof Pelt
Roofln
Siding
masonru veneer
Rory h PI
Relief Valves
WNWill
A1all Board
Ext .. porches
Finished Floor
Interior Trim
stairs Ral.lin s
,Cellar vr . Tile
Concrete Floors
P1I, . Fixtures
Gar . Fire roofin
Door Closers
Chimne
Water Meter Inst .
septic A roval
Floor's ----�'
Found,atiori ��-
Insulation falls
Ceilin
Build in inspector
REM"KS
TOWN OF QUEENSBURY
BuIlIdinr Department
Io�paaRaea Rapart Dsta 1 Z, �
Mamar'�EF�'
Pennfdt No. W cathas
(p Remarks
Exca0a t on
Footin Forms
Footing & Piers
Foundation
Cement Coat
Water roofin
,8ackfill .
Final survey
Framin
Sheathing
Roof Felt
Roofin
Siding
masonxv Veneer .
Rou h Plbgw
Relief Valves
Wall .Board
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railin s
C&.Ilar Dr . Tile
Concrete Floors
P1 . Fixtures
Gar . Fire roofin
Door Closers
Chimney
Water Meter Tnst .
Se tic A rova2
Foundation
Snsulation Walls
Celli
Hui ding XnsPector
REMARKS
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