1985-649 BUILDING PERMIT
TOWN OF QUEENSBURY 85_ 64. 9
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Alberta Diefenbach
OWNER of property located at 39 ]Heinrick circle Street, Road or Ave.
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in the Town of 4ueenshury, To Construct or place a Sewage Alto r1m
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 Town of Queensbury Building and Zoning Ordinance. J
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1 . OWNER'SAddressis 39 Heinrick Circle '
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Glens Falls , New York
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2. CONTRACTOR or BUILDER'S Name
Condon ' s Septic and Drain Service
3. CONTRACTOR or BUILDER'S Address
17 Grant Ave _
Glens Falls , New York t^'
4_ ARCHITECT'S Name
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5, ARCHITECTSAddress Y+
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6. TYPE of Construction — (Please indicate by X) ~
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f ) Wood Frame ( ) masonry f 1 Steel ( !
7. PLANS and Specifications
2 6 ' x8 ' drywell with dirt . box per plot submitted.
No. and application ,
S. Proposed Use
Sewage system for dwelling M
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$ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES ��� ' � 1987
(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.) O
Dated at the Town of Queensbury this 6+_ ii Day of Nnvemb -t" 19 85
SIGNED BY In 4�d -' for the Town of Queensbury
Building and Zonirig Inspector
TOWN ap QU6EIu';; V° k
F TOWN OF QUEENSBURY
" BUILDING & ZONING DEPARTMENT
SFWAGF DISPOSAL PERMIT APPL CA ION��
1 . Owner s Name. {r y/� y,I ��// � (� (/^ /� //^ ]I e44i{�
Addresst_S f �/ 4 lIu L \ tc.._f ` `4 ( kc 1cc r, ?a CGfCI J~ r 4� Ir if 9
Telephone No . ? Fr J
2 , Property location
3 . Name of perso n or fir [.�m responsible for Xnstalling system 61V.Da li.! .�
J} Q I r,u Telephone No .
Address f_7 ,Zlk?AI7J __L AU F r� f C-Pu as:
4 . 'Number of bedrooms ( residential buildings only)
5 , Daily flow gallons/day
6 . Septic tank capacity ,/00 gallons
7 . Topography : flat , rolling , steep
of slope
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8 _ Nature of soil and depth s. JFO) , gd:z ( La V L
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? ft .
10 . Percolation test : A is required
B is not required.
C If required what is the rate minutes/inch
11 . Water supply : municip well. , other
12 . Type of system proposed : Q=ell the 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
Queensburry Sanitary Sewage Ordinance .
Date / // �j 16::- s
signature of applicant
On separate sheet of paper submit a d�.iaa�ra�m of the proposed septic system
with all dimensions , including distance r m any structure , distance from
property line and domestic water supply , etc . Include all dimensions of
the system itselfe
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Form 3 - 8 2 , _ C� }L �rt5 R u _. j 3 o k
TOWN OF QUEENSSURY
Building Department
Ins peebwe Report Dmte i G �V f
Name
Loartiaa cG
Permit Na Weather
Remarks
Excac}a tion
Footing Forms
Footin & Piers
Foundation
Cement Coat
Water roorin
Bacicfi.�3
Final Surve
Framin
Shea thin
Roof Felt
Roofi.n
Sidlag
Masonr veneer
Rou h PI
Relief valves
Wal' .I Doard
Ext . Porches
Finished Floor
Interior Trim
Stairs & Railings
Cellar Dr . Tile
Concrete Floors
P.Zbqo Fixtures
Gar . FireprooffinE.
Door Closers
Chimney
Water Meter Znst .
Se tic proval
Floo -S
FoUnda tiori
Insulation Walls
Ceiliri
Btii.2d.inq ].'nspector
REMARK'S
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