1985-706 BUILDING PERMIT
TOWN OF QUEENSBURY No. 85- 706
Zqq } tct ^ \ .Q WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Edward Whiting m p
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OWNER of property located at r'�—''
�` 5unnyside East Street, Road or Ave. ri
in the Town of Oueensbury, To Construct or place a Sewage Alteration
at the above location in accordance to application together with plot plans and other information hereto filed andP.
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
t . OWNER'S Address is AD #1
{Glens Falls , New York
2. CONTRACTOR or BUI LQERS Name
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Sanitary Sewer Service
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3. CONTRACTOR or BUILDER 'S Address �O
P . 0 . Box 224 w"
Glens Falls , New York
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4. ARCHITECT'S Name
5_ ARCHITECT'S Address
6. TYPE of Construction — [Please indicateby X1
! 1 Wood Frame ( I Masonry i ) steel
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7. PLANS and Specifications 1000 gallon septic tank, dirt . box iA
1 7 ' xB ' drywell 24" #3 stone �
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per plot and application submitted m
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S. Proposed Use rt
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Sewage system for dwelling
$ 10 , 00 PERMIT FEE PAID — THIS PERMIT EXPIRES Nov . 26 19 87
Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queenslwry before the expiration date.)
Dated at the Town of Clueensbury this^y 26th Day of November 19 85
SIGNED BY
/f�f GC.r for the Town of Oueensbury
Building and Zoning inspector
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{ TOWN OF QUEENSBURY
4L - + -'L BUILDING i ZONING DEPARTMENT 6OWN OF Q1..TEENSS UR d
SFWAGF DISPOSAL PERMIT APPLICATIONR a V rry V E
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1 . Owner ' s Name �` L r .
Add r e s 8� � fS31 i AAL P.MF.
Telephone No . 4V
2 . Property location
3 . Name of person or firm responsible for installing system
re , i YZ6 Telephone No . ' � Z2 ,T _
Address .
4 . Number of bedrooms (residential buildings only)
5 . Daily flow ,F � �' : a--a, g'allons,/day
6 . Septic tank capacity gallons
7 , Topography : flat , rollin steep
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80 Nature of soi 1 and depth ,. 2 AL ( tI- 62zi
9 . If ground water , bedrock or impervious material is apparent at what
depth does it begin? f t .
10 . Percolation test : A is recmired
B - is not required
C If required what is the rate minutes/inch
ll . Water supply : municipal wel1 / other
12 . Type of system proposed : drywell 1tile field , other
Any contractor ,. corporation , individual , etc , engaged in ' thg 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 Ordinanc
Date_ U A �/ rf' i!
4( f 4 signature a p 2.. cant
on separate sheet of paper submit a diagram of the proposed septic system
with all dissensions , including distance from any structure , distance from
property line and domestic water supply , etc . Include all dimensions of
the system Itself * /
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Form 3 - 8 2 / "OK
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TOWN Orr QUEENSRU Ry
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Rexnarks
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FOntin Forms
Foots & Piers
Foundation
Cent coat
Water 2%040f-112
Sakakfill
Final Survrys
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yea th%n
Roof Felt
ROOF is:
Sidi
masonr veneer
Rau h 'PI
Relief Valves
Wall Boa
porches
gxt . Floor
Finis hed Trim
xnterio� rJL'" in
Stairs bile
Cellar Dr -
COncrete Floors
P., . Fixtures
Gar .
Fire roofin
poar Closers
Chimne
M�,ter znst
Water .
Se tic A royal
Floors
Foundation
insulation wa_ lls
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c33ng Tns.e for
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REMARKS
SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792 - 7257
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