1985-721 BUILDING PERMIT
TOWN OF +QUEENSBURY No. 85- 721
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Eva Granger w
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OWNER of property located at `O Crossover Lane , Assembly Point Street, Road or Ave. P6
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in the Town of Queensbury, To Construct or place a Sewage Alteration �
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 Queensbury Building and Zoning Ordinance.
f . OWNER'S Address is RD #1
Lake George , New York
2. CONTRACTOR or BUI LDER'S Name
Frank Shaw
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3. CONTRACTOR or BUILDER'S Address
128 Kabor Road a
Gansevoort , New York � s
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d. ARCHITECT'S Name
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S. A R CH lTE CT'S Address El
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6. TYPE of Construction — (Please indicate by X) �
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I ) Wood Frame ( ) Masonry l l 'Steel Q )
7. PLANS and Specifications
1000 gallon septic tank , list . box and 54 ft . tile
No. field per plot and application submitted .
8. Proposed Use
Sewage system for dwelling
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 9 19 87
(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.) rrto-
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Dated at the Town of Queensbury this 9th Day of December 19 85 w
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�.�'�.�' for the Town of Queensbury
SIGNED BY - 4_7Building and 'Zoning Inspector(
TOWN OF OUFFNSSURY 'e1r z e ./I ,�
BUILDING 6 ZONING DEPARTMENT TOWN OF <5uEENSeURY
SFWAGF DISPOSAL PERMIT APPLICATIOR F= a r g 1f
1 . Owner ' s Name V1t_ ;.; 51
Address Cj v, G 31415 d
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Telephone No .
2 . Property location /V1EE� .
3 . Name of person or firm responsible for installincr system
Eff, Telephone No . fir/ 3 , 11 C` — -�
Address 1 ` V es k3 n rs-, La � !r'4 , . ae� �! �,f'
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4 . Number of bedrooms ( residential buildings only) _ f1(/' /��
5 . Daily flow ,,+�,rrt; - rr'.�2�5�' s� F I� �5 go II ons/day -�
6 . Septic tank capacity _ 4,,__ � gallons
7 . Topography : flat , rolling , steep
% of slope
Be Nature of soil and depth
9 . If ground water , bedrock or impervious mater al is apparent at what
depth does it begin? y ft .
10 . Percolation test : A is required
H �'S'�.._._._is not required
q C If reurred what is the rate ,' minutes/inch
11 . Water supply : municipa �well__D other
12 . Type of system proposed : dryweljl .,~tile field , `s�ther '
Any contractor ,, corporation , individual , etc . 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
4ueensbury Sanitary Sewage Ordinance .
Date Jte - -��� - zrati e,- ~
—� l gnature of applicant
On separate sheet of paper submit a dia�gra�m 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
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TOWN OF QUEENSBURY
Building Department
Datean
Peron& NoNo. w7 z_.._ Wer th+er
,le d5trA!5;7z*" Remarks
Sxca*at on
Foot in Forms
Footi & Piers
Foundation
Cement Coe t
Water fin
pa.cJcfill
Final Surve
F ramin
Sheathin
Roof F0I t
RoOrl
S n
Masonr Veneer
Roca h PI
Relief Valves
wall .Hoard
Sxt . Porches
Fire i shed Floor
Interior Trim
Stairs & Railin s
Cellar Dr , Tile
Concrete Floors
Pl Fixtures
Gar . Fire roofin
poor Closers
Clsiume
Water Meter Inst .
-S otic A roval
Floors
Foundation
Insulation Walls
Cei3in9'
Hu Idi Inspector
REMARKS
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