88-148 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-148
WARREN COUNTY, NEW YORK o
PERMISSION is hereby granted to R. S. Haviland
OWNER of property located at RD 1 Box 74 Ridge Rd. Street,Road or Ave.
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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.
1. OWNER'S Address is RD 1 Box 74 ,ti
Ridge Rd. �n
Glens Falls, N.Y. 12801
2. CONTRACTOR or BUILDER'S Name
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Same
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( 1 Masonry ( )Steel ( 1
7. PLANS and Specifications
No. Replacement of pipe from house to tank as per application.
8. Proposed Use m
Sewage Alteration
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 18, 19 90 et
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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 o
town of Queensbury before the expiration date.) p
Dated at the Town of Queensbury this 18th Day of April 19 88
SIGNED BY 7LIe�C L-1 , � /X for the Town of Queensbury
Building and Zoning Inspector "-d .
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l ' APPLICATION FOR SEPTIC DISPOSAL PERMIT APR 111988
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LOCATION OF PROPERTY FOR INSTALLATION/ 4/'irr per: rt_ --
Owner's Name: , 5 f 02_, t*cL Telephone: 297
Address: 'F I)
Installer's Name: 6,7,b , :/' _ Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope % of slope _
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other _
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank _gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
B. No system shall be covered before inspection and approval by the building
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may result
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
•
Signature of responsible person:
Date: , /,,A-Arr
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
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