1987-398 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87-398
WARREN COUNTY, NEW YORK t4� `�
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PERMISSION is hereby granted to Lewis Cutter
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OWNER of property located at � � Street, Road or Ave.
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.
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7 . OWNER'S Address is
79 Lower Dix Ave . co
Queensbury , N . Y . 12801
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2. CONTRACTOR or BUILDERS Name to
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Walter Stevenson
3. CONTRACTOR or BUILDERS Address
Rana # 1Queensbury . N . Y . 12901
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4. ARCHITECT'S Name n'
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5, ARCHITECTS Address Ip
6. TYPE of Construction — (Please indicate by X)
[ ) Wood Frame i ) Masonry 1 ) steel 1 1
7. PLANS and Specifications
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No. 10 x 8 ' Seepage Pit per plot plan and application OQ
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S. Proposed Use } '
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Septic system for dwelling m
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES June 25 , 1989
1}f 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.)
Dated at the Town of Queensbury this 25th Day of June 19 87
SIGNED BY /?!� for the Town of Queensbury
Building and Zoning Inspector 40rC0 ,
TOWN Or= Qu -iEc'NSBI
APPLICATION FOR SEPTIC DISPOSAL PER �r Ujj
{ JUN 23 1987
DATE BUILa[fUG 8c CODE L7EP'� .
LOCATION OF PROPERTY FOR (INSTALLATION 792 4`04
Owner's Name* [Js f� ,T 'Telephone:
Address: ? Z L,r _ Z s G f / {�✓ _ 6' Ic- c —
Installer's Name: s� ] � ,f/� e� Telephone.
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one Fla Rolling Steep Slope Ora' of slope
Soil Nature: circle one San Loam Clay Other / Depth: _ feet
Ground Water: At what depth? ' feet
Bedrock or Impervious Material: At what depth? , �� feet
Percolation test: circle one Eot required equired / rate min. inch.
Domestic water supply: circle one Munic' Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank Kj3?rljdr gal. (minimum size: 1 ,000 gal.)
TILE FIELD : Each Trench feet / Total system length feet n-
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SEEPAGE PIT(S) : Number of / Size each _ � feet by feet ( of `b
Size of stone to be used # G �L/ Depth or Thickness feet
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I M P O R T A N T
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
(over)
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