1982-465 BUILDING PERMIT
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Lewis DeAngelis
OWNER of property located at
32 Fort Amherst Road Street, Road or Ave.
Sewage Alteration r'
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 F,.
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. M
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1 . OWNEROS Address is 32 Fort Amherst Road.
Glens Falls , New 'York CD
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rCO:NT:RAOR or BUILDER S Name
Sanitary Sewer Service
CONTRACTOR or BUILDERS Address
s.a
53 Fourth St . n3
Glens Falls , New York
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4. ARCHITECT'S Name Or
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5. A R ON ITECT'S Address
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6. TYPE of Construction — (Please indicate by X) ¢,
( } Wood Frame ( ) Masonry ( } Steel i }
7. PLANS and Specifications
1 7 ' x8 ' drywell # 3 stone for washing machine system .
No.
S. Proposed Use
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Sewage system for dwelling w
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August 23
$10 . 00 PERMIT 'FEE PAID — THIS PERMIT EXPIRES 19 87 cfi
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Of a longer period is required an application for an extension must be made to the Building and Zoning inspector of the H
town of Queensbury before the expiration date) 03
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Dated at the Town of Queensbury this 2 3rd Day of
August 19 85
SIGNED BY CL _ for the Town of C].ueensbury
Building and Zoning Inspector
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TOWN OF C)UFENSBURY V V
2- BUILDING & ZONING DEPARTMENT
SFWAGF DISPOSAL PERMIT APPLICATION /0
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1 . owner ' s Name C� ? � Igi .° 10 ��i l $ i 16
Addr e s cPt ►
Telephone No .
2 . Property location
3 . Nam f person or firm responsible for installing system
Telephone No . ' 7 9 .l - `? . S"
Address
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow gallons/day
6 . Septic tank capacity o 6 LL7 gallons
7 . Topography : flat , rolling , steep
% of slope
8 . Nature of soil and depth_ Ali
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? ft .
10 . Percolation test : A is required
}3 � is not required
C if mired what is the rate minutes/inch
11 . water supply : municipal , we other
12 . Type of system proposed • dryw+ell the field , other
Any contractor ,. corporation , sdual , 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
ignature apfrricfant
on separate sheet of paper submit a d Iram 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 f
4
TOWN OF C�EENSBI�IRY
$nilaing Department
Ingpecters Report .
Name aG+�
Lro�uN►twe 0,, �- Weer
P,eeeeit No. �---
'Remarks
Excat7a tion
Footinct Forms
Footin a Piers
Foundation
Cerr{ent Goat
Water roof-in
8ackfill
rinal Surve
Fx'aA+I n
5heathin
Roof Felt
Ftoofin
Siding
Masonr Veneer
Rou In Pl
Relief Valves
wallBoard
Ext . ,porches
Finished Floor
Interior Trim
gtairs & Rilin IS 11111111111111111111111
Tile
Cellar pr .
Concrete Floors
P1 . Fixtures
Gar . Fire roofin
poor Closers
Ch ione
Water Meter Inst .
Se tic roval
Floors
Fou�ion
Insulation Walls --�-
Ilin
Build g Inspector
REMARKS
Moo ATA4,I
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