1985-485 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85 _ 485
WARREN COUNTY, NEW YDRK
PERMISSION is hereby granted to. Rand a 7 I R rhimr F "
OWNER of property located at 3 Brookwood Drive Street, Road or Ave. v
Sewage Alteration
in the Town of Queensbury, To Construct or place a
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.
1 . CIWNE WS Address is 3 Brookwood Drive
Glens Falls , New York
2. CONTRACTOR or BUII_dERIS Name
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3. CONTRACTOR or BUILDER'S Address O
same 0
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4_ ARCHITECT'S Name b
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5. ARCHITEcri Address
6. TYPE of Construction — (Please indicate by X)
S I Wood Frame ( ) masonry ( ) steel ( Y
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7. PLANS and Specifications
add - 6 ' xS ' drywell per plot and application
No. submitted . (Dro
S. Proposed Use
Sewage system for dwelling (p
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$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES Auctust 3 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 Ca sonsbury before the expirsdan date,)
Dated at the Town of Queensbury this 3 0 th Ray of August 19 85
SIGNED BY f� ___ "� for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEFNSBURY
BUILDING S ZONING DEPARTMENT
SEWAGE DISPOSAL PERMIT APPLICATION4' ►�`'Y or �p� `'' � RU
Y
1 . Ownes ' s Name ra'.a/.ewL des- p
Address :3 .'-
A.M. P.
Telephone No4Sra
2 . Property location
3 . Name of person or firm responsible for installing system 5i; -VIE�
Telephone No .
Address
4 . Number of bedrooms ( residential buildings only )
5 . Daily flow gallons/day
6 . Septic tank capacity /�` �d gallons
7 . Topography : flat , rolling , steep
% of slope � r�
so Nature of soil and depth
•9 . if ground water , bedrock or impervious material is apparent at what
depth does it begin? A y f t .
10 . Percolation test : A is required
B is not required
C if required what is the rate. minutes/ inch
11 . Water supply : municipal , well , othevf4r4? G.�'
12 . Type of system proposed : drywell. , tile
re 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 .
Date 9 / �?,c'> 494. .
signature c>t app scant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions , including distances from any structure , distance from
property line and domestic water supply , etc * include all dimensions of
the system. itself .
Farm 3 - 82
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TOWN OF QUEENSSURY
Suil+diax- DepartmOut, /
b"peedEe u
Name ?�
Weather
Pereant NOW
Remar)cs
INN IN INN
E'xcaoa tion
P40DO , Forms
Foot.in & Piers
Foundation
Cement Coat
Water roofin
BackfilZ
Final Surve
Fraxu
Sheathin
Roof Felt
Roofin
Sidin
Masonr Veneer
Rou h PI IN
Relief Valves
Wall .board
xt . Porches
Finished Floor
Inter.for Trim
Stairs & Railin Is
Cellar rir . Tile
Concrete Floors
PI Fixtures
Gar . Fire roofin
,L7oor Closers
Chione
Water Meter NI
Se tic A royal
Floors
Foundation
Insulation Wa
ell!
kk
Huil ing Inspector
,REM"KS
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