1985-664 BUILDING PERMIT
TOWN OF +QUEENSBURY No
WARREN COUNTY, NEW PORK
SAgri ~ 2 �2) Richard and Carolyn Gallo
PERMISSION is hereby granted to
'i'D3csh3 re LJriv a Street, Road or Ave- xy
OWNER of property located at N.
Sewage Alteration 0
in the Town of Oueensbury, 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 0.ueensbury Building and Zoning Ordinance.
t . OWNER'S Address is 'RO # 1
Glens Fallsr New York. [�
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:CONTRACTOR or BUILDV3%jj�tejij_ ll Septi-c Tank Co .
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CONTRACTOR or BUILDER 'S Address 0
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North St .
Hudson Falls , New York 12839
r4. ARCHITECT'S Name F4
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ARCHITECTS Address
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TYPE of Construction — (Please indicate by X)
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( } Wood Frame ( I Masonry ( D Steel S }
PLANS and Specifications
1000 gallon septic tank , dist . box and
No- 2 -- S , xB ' drywells per plot and application
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8. Proposed Use
Sewage system for dwelling
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$ l0 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Nov . 14 19 87 ri
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date-)
17a of Npvember i9 $
Dated at the Town of C�ueensbury this
jl_d� ty/h_ Y
SIGNED BY ! f Y" -y---? for the Town of Oueensbury
Building and Zoning Inspect
`k TOWN OFF QUEFNSBURY r+c7WN QF QUEErrnsSe.. RY
BUILDING i CONING DEPP.RTMENT" LE 9 �]
1 SEWAGE DISPOSAL PEMIT APPLICATIflH U
C?wner * 8 Name rZ rC N4r21?1} l�lr i'� 11O
��QQ n # c . 7 fall. 11213141516
Address �t2I{ S4 &'i'2 e Z) Ertl 13 ff N. •
Telephone No .
2 . Property location
3 . Name of person or firm responsible for installing system
ail � �' '1rAxJKt� . - - Telephone Noe 7`f7-91`�`6
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Address +�-�o,�. 1 � T �' 1nd � cs►c) I �'
4 . Number of bedrooms ( residential buildings only) �
5 . Daily flow gallonsfday
6 . Septic tank capacity ? 000 R1, gallons
7 . Topography : flat , rolling , steep
$ of slope
8 . Nature of soil ,and depth_ Ve9A.AA % r'2A
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin` f t .
10 . Percolation test : A is required
B ✓" is not required
C Ii�requlred what is the rate minutes/inch
11 . Water supply : municipal , well , other
12 . Type of system proposed : dry�we31 , the field , other
Any contractor , corporation , individual , etca engaged in , th4 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 .
&L d
Date `7
s gna ure or applicant
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 , etca include all dimensions of
the system itself . ,r
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y 0 ( 5 7 a
Form 3- 62 4:;-
1IL7e 1
TOWN OF QUEENSBURY
Building Department
Nlnmpecbm* Repairt _ Dane 1 s''
Locatim
Pe.,eit No. s2 - <p G y4 Weather
Remarks
Sxca#atian
Footing Forms
pnotLina & Piers
Foundation
Cement Coat
water roofin
Backfill
Final Serve
Framing
Sheathing
Roof Felt
Roofin
Siding
M&Arozxry Veneer
Roe h P3
Relief valves
wall Board
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr . Tile
Concrete Floors
P22N70 Fixtures
Gar . Fireproofing
Door Closers
Chicane
water Meter Inst .
Septic Ajit
W Floors
Insulation Foundation
A'+al l s
Ceili
r
u ing Inspector
REMARKS
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