1985-569 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85- 569
WARREN COUNTY, NEW YORK
1XI - f _ 3 , 1
PERMISSION is hereby granted to Charles Harvey 0
OWNER of property located at `T D`71 West Mto Road at Sherman Ave * Street, Road or Ave,
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in the Town of Queensbury. To Construct or place a Sewage Alteration to
at the above location in accordance to application together with plot plans. and other information hereto filed and W
approved and in compliance with the "Gown of Queensbury Building and Zoning Ordinance. C
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t . OWNEROS Addressis RD# 2
Glens Falls , New York
P3. CONTRACTOR
TRACTOR or But LDE WS Name
same
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or BUILDER'S Address ,*
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0)4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Cormructlon — (Please indicate by Xl C'
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( ) Wood Frame { i Masonry f l Steel { ) SIB
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7- PLANS and Specifications
8 ' x8 ' drywell with stone per plot and application M
No. s �}� itied . r
8. Proposed Use
Sewage system for dwelling ua
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oct . 2 19 87 CD
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the F
town of Queensbury before the expiration date.)
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2nd October 149 5 w
Dated at the Town of Queensbury this pay of r I
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SIGNED BY ,, t�• for the Town of Queertsbury
Building Bred Zoning I
TOWN OF QUFENSBURY jp< jcosz 1"
BUILDING & ZONING DEPARTMENT TOWN OF QUE'ENSBURY
` SET&?AGF DISPOSAL PERMIT APPLICATION 0 IE ' [E I V F
1 . Owner ' s Name f C PA L
Address ( , _ IA A 11R. is7 �-" r L ' J�k lS . EM
A Telephone No . C��J
2 . Property location k) c-5 r2oA✓'1
3 . Name of person or firm responsible for installing system
Telephone No . !�-1
1 Sao 3
Address
4 . Number of bedrooms ( residential buildings only)
5 . Daily flow ' Jq 11.5 0 c►allons/day
6 . Septic tank capacity —gallons
7 . Topography : flat , rolling , steep
% of slope L /1
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Be Nature of soil and depth� .�
9 . If ground water , bedrock or i1A7
vious material is apparent at what
depth does it Obegin? /try ft .
10 . Percolation test : A is required
B x is not required
C If required what is the rate minutes/inch
11 . Water supply : municipal , well , ether G1AAc: PAL
12 . Type of system proposed : drywell , the field , other V u, �
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 .
I
Date IQ r �-
signature o apg .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 . r
14
Form 3 - 82
TC,]V11''N OF QUEEWSEURY
Building Department
�, Date /� z
P 47
at Na. - 4-6weathers
Remarks
NJ IN
Exaatra ti on
Footing Forms
Footing & Piers
Foundation
Cement Coat
Water roofin
BackT.J
Final Surve
Framin
Sheathin
Roof Felt
Roofin
sidinJtgr
1'tasonr Veneer
Rou h PZ
Relief valves
Wall Board
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railin Is
Cellar Dr . Tile
Concrete Floors
p FRIP Fixtures
Gar . Fireproofing
poor Closers
Chimne
liiiiiiiiiiiii'lli11
Water Meter Inst .
Se tia ApPrOval eui62n
Insulation inspector
REMARKS/
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