1985-354 BUILDING PERMIT
TOWN OF CtUEENSBURY Y
No, 8 5 -354
WARREN COUNTY, NEW YOR K 0
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PERMISSION is hereby granted to Veer rn
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OWNER of property located at 3 Bueria Vista Avenue Street, Road or Ave.
in the Town of Queertsbury, 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
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
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t . OWNERS Address is 3 Buena Vista Avenue
Glens Falls , New York
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2. CONTRACTOR or BUILDERS Name C
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Walter A . Graham �
3. CONTRACTOR or BUILDER S Address C
301 Main Ste @
Hudson Fallsr New York
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4, ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X) A
( ) Wood Frame [ ) Masonry ( I steel I 1
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7. PLANS and Specifications !I?
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Na. 2 '" 6 r x8 l drywells - d ist . box and # 3 stone per
plot and application submitted . rt
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B. Proposed Use
Sewage for dwelling
$ 10000 PERMIT FEE PAID - THIS PERMIT EXPIRES July 11 - 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 Clueensbury before the axpi rat ion data.)
Dated at the Town of Queensbury this l 'i f-h Day of July 1985
SIGNED BY 1,4 �'i _ + t�-°,_nM for the Town of C2ueensbury
Building and Zoning Inspect
TOWN OF QUEFNSBURY
4 . y BUILDING & ZONING DEPARTMENT 'TOWN lOF QUEENSBUFZ�Y
J SET*+?.AGF DISPOSAL PERMIT APPLICATI F. �8 1 E � V
1 . Owner ' s Name 6 „` C' rT T t__4t_�� c •--
Address R — p L> `' ��
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Tel ephond' o : S- ! c3
2 . Property location s
3 . Name of person or firm responsible for installing system
Coe, J Telephone No * �7 Ll7 � 7S"` P
Address 01
4 . Number of bedrooms ( residential buildings only )
5 . Daily f low. L-1 J`- 4 -gallons/day
6o septic tank capacity gallons
7 . Topography : flat rolling steep
& of slope _
$ . Nature of soil and depth
9 . If around water , bedrock or impervious material is apparent at what
depth does it begin? ft .
10 . Percolation test : A is required
g is not required
C if required what is the rate minutes/inch
Ilm Water supply : municipal well , other
12 . Type of system proposed : drywel 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 . olo of the
Queensbury sanitary Sewage Ordinance .
Date
�T signature of app scant
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 _
Form 3 - 82
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TOWN OF QUEENSBURY
B"Olding DOPeortment
blpaetairs Report bate 7 / r
Permit No. S _ Wasthcr
Remarks
Excatra ti on -
Footin Forms
Footinq & Piers
Founda ti.on
Cement Coat "
Water roofin
Back.fi l l
Final Surve
Framing
Sheathin
Roof Fel t
Roofin -
Si d.i n -
Masonr veneer
Rough Plbg . -
Relief valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs & Railin s
Cellar Dr . Tile -
Concrete Floors
Pl . Fixtures
Gar . Fire raofin
Door Closers
chimne
Water Meter Sns t .
Se tic Appzoyal
oors
Insulation Poundation
Walls
Ceilin
Buxlding Inspector �—
f REMARKS
-47
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