1985-572 BUILDING PERMIT
TOWN OF QUEENSBURY No 85- 572
WARREN GCIUNTY, NEW YORK
P/E+R M 1 SSI iO N is hereby granted to
Street, Road or Ave_ C4
OWNER of property located at O
in the Town of Queensbury, To Construct or place a S wa e Alteration
at the above location in accordance to application together with plot plans and other information hereto filed and 0
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1 . OWNER'S Address is 21 Carlton Drive
Glens Falls , New York.
r2. CONTRACTOR or 13UILDE8"S Name
Condon ' s Septic and Drain Service
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3. CONTRACTOR or BUILDERS Address
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17 Grant Ave . ¢'
Glens Falls . New York
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4_ ARCHITECT'S Name ti
U
F'(
F'•
C
5=ARCHITECT*SAddran
6. TYPE of Construction — (Please indicate bV X)
( y Wood Frame 1 1 Masonry i ) steel i y
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7. PLANS and Specifications 2 6 ' x8 t �
1000 gallon septic tank, disc . box per plot and
No. drywells and 300 gallon grease trap p
application submitted .
8. Proposed Use ~
Sewage system for dwelling (D
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$ 7 O
PERMIT FEE PAID — THIS PERMIT EXPIRES Oct- 3 19 �
$ (if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of QueensburV before the expiration date_)
Dated at the Town of Queensbury this- -�y.y �C,d� Day of (7ctober
1$8 5
An
SIGNED BY J // for the Town of Queensbury
Building and Zoning I nspector
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TOWN OF QUFFNSBURY TOWN OF OUSE 'dSIBURN,
BUILDING & ZONING DEPARTMENT OLD
E 0 [E D
SEWAGE DISPOSAL PERMIT APPLICATION OCT 3'11, +1
►a.M: t� L .4. . 4P.tla
1 . Owner ' s Name '`�
dr . . . . . . .
Address D �
Telephone No .
2 . Property location
3 . Name of person or f irm responsible for install !na system
t f 4j C JE Telephone No . ' � , " S' y�
Address 19S �
4 . Number of bedrooms ( residential buildings only )''
5 . Daily flow Gallons/day
6 . Septic tank capacity 00 e; &I' P-) '00 gallons
7 . Topography : epllat roll ±ng , steep
$ of slope
86 Nature of soil and depth /
9 . If ground water , bedrock or impervious material i,s apparent at what
depth does it begin? ft -
10 . Percolation test : A is required
g K. 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 e tC4.S
Any contractor ,. corporation , individualr 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 o
p J — sIgnatu Vo ppllcant
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 - 82a {
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TO'rla►N OF QUEENSBURY
Building Department
Name
kj CAQ. C � P4
Permit No. „7 -Z Weather
Remarks
TixcaiYa tiara
Footing Farms
Footing & Piers
Foundation
cement coat
Wa ter roofi n
Backfill
Final surve
mq
Framing
Sheathing
Root Fel t
Rodin
S.id.ingr
Masonry Veneer
Rough PI
Relief Valves
walI ,Board
ext . Porches
Finished Floor
Interr.ior Trim
Stairs & Railings
Cellar Dr . Tile
Concrete Floors
P2 . Fixtures
Gar . Fire roofln
Door closers
chimne
Water Meter-Inst .
Se tic A royalwjo
Floors
Xnsulation Foundation
Walls
coiil iin��
Build ng Xnspector
REMARKS
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