1987-556 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87-556 �
WARREN COUNTY, NEW YORK
William Lavery � +
PERMISSION is hereby granted to 1
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OWNER of property located at 1 Kendrick Rd . Street, Road or Ave_
in the Town of Queensbury, Sewage Alteration
To Construct or place a
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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1 . OWNE R'S Address is
1 Kendrick. Rd .
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Queensbury , N . Y . 12801 �
2_ CONTRACTOR or BUILDER 'S Name
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Condon ' s Septic
3. CONTRACTOR or SUI LDER'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)
[ ) wood Frame ( ) Masonry I ) Steel I I
7. PLANS andSpecifications
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No. Existing 1000 Existing tank Tile field each trench 50 feet /
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total system length 200 feet m
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S. Proposed Use
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Sewage Alteration ro
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES August _20 ' 1989
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queansbury before the expiration d ate.i
Dated at the Town of Queensbury this 20th Day of August 19 87
SIGNED BY ;e � � �-�'`� for the Town of Queensbury
Building and Zoning Inspector
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APPLICATION FOR SEPTIC IILSPOSAL PERMIT AUG 17 1Jti1
1 BUILDING f3c CODE ,DEPT
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DATE t� `f / f j !
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LOCATION OF PROPERTY FOR INSTALLATION 4Arle/f l" .
Owner's Name: J'lydu J. 3Vmy Telephoner
Address. Lbw L`]!2 f C F f HJ g CS CJ f v_____ /U !ir $
Installer`s Name* t+J � � ;r l �C . Telephoner '1/ ' —t 2 .
Number of bedrooms (residential only) .._T__
Total daily flow (compute @ 150 gal per bedroom) i ��
Topuf raapphye circle one: rFlat I Rolling Steep Slope % of slope _
Soil 'Nature: circle one: and Loam Clay Other / Depth: _ feet
Ground Water: At what depth? 6 feet
1edn3pk or Impervious Material: At what depth? _ [� feet
Percolation test: circle one: not require required / rate min. inch.
Domestic water supply: circle one: Eunicipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank b1 OJ gal. (minimum. size: 1 ,000 gal.)
TILE FIELD: Each Trench 'Cr-_'� feet / Total system length 0 feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # '. / Depth or Thickness _ /" feet
I M P O R T A N T
_..Please._-LIST NEW EQUIPMENT TO BE INSTALLED
(over)
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
50 size and dimensions of all tanks, distribution
boxes, tile fields and/or drywells
Be 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 aWee to abide by these and all requirements
of the Town of Queensbury Sanitarry Sewage Disposal Ordinance,
Signature of responsible person:
Date:
Town of Queensbury
Building and. Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY A GOOD PLACE TO LIVE
_.rocun o/ Queensbury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Sox 98
Clueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME_ � �—
LOCAT I ON I AID rL +Cgf+s:
DATE PERMIT NO .
SOIL TYPE - Sand - Loam - Clay -
percolation Test Required? YES - NO
Percolation rate - Min/inch _
TYPE of SYSTEM :
Absorption field , total length f "
Length of each trench� r
Depth of trenches
size of gravel
SEEPAGE PITS4Nimnber of) _
Size- ft. X
Gravel size -
PIPING : Sizeye
Bldg . to tank
Tank to dist _ box
Dist . box to field/
openings sealed? YES NO Partial
LOCATION/SEPARATIONS : r
Foundation to tank
Foundation to absorption
Absorption to lot line ft-
Separation of pits ft.
LOCATIO S STEM ON PROPERTY (circle one)
Front ear Left side - Right side -
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SYSTEM USE APPROVED ES N
ding Inspector
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