Loading...
1989-373 r•� �r BUILDING PERMIT �1 TOWN OF QUEENSBURY No. $9-373 � WARREN COUNTY, NEW YORK PERMISSION is hereby granted to _ ark Sherlock w OWNER of property located at 21 ai xon Court Street, Road or Ave_ in the Town of Queensbury, To Construct or place a _ Sewage Al tera i:i on 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. L'7 1 _ OWNER'S Address is ran Tl Same ,7C Y 2. CONTRACTOR or BUILDERS Name X Sanitary Sewer -� 7� S. CONTRACTOR or BUILDER 'S Address Glens Fallss New York 12WI 4. ARCHITECT'S Name Q 5. ARCHITECT'S Address C� C C e'r 6. TYPE of Construction — (Please indicate by X) { ) Wood Frame ( ) Masonry I ) Steel f } 7. PLANS and Specifications No. 1000 gal _ tank , 1 61 x Sr seepage pit as per plot plan and applicati r. rp S. Proposed Use Sewage Alteration n x rt $ 75 pp PERMIT FEE PAID — THIS PERMIT EXPIRES May 19 $ e ilf a longer period is require l an application for an extension must be made to the Building and Zoning inspector of the C town of Queensbury before the expiration date.l Dated at the Town of Queensbury this_ h Day o ' may 1989 SIGNED BY {/ for the Town of Queensbury Bu lding and Zoni nspector fOILW GF QUE• ENSBUrY 7� "400r,,r -- APPLICATION FOR SEPTIC DISPOSAL PERMIT 7 ©tvv or DATE C O'L.,00( 198,9 LOCATION OF PROPERTY FOR INSTALLATION 6::,2 / ! .'�A c) /C-.$ Owner's Name. Cl \S) lr' X Lr-C�C,/C_ Telephone: Address :y6 =�— Installer's Name: + ,/ti' (% V -/� Telephone : 7 9 Number of bedrooms (residential only) e "ZIA Total daily flow (compute Cd 150 gal per bedroom ) �/ /7 Topography: Circle one:gand Rolling Steep Slope % of Slope Soil Nature: Circle one: Loam Clay Other. /Depth : Feet Ground Water: At what depth ? Feet Bedrock or Impervious Material: At what depth ? Feet Percolation test: Circle one: of require required rate min . inch. Domestic water supply : circle one lunicipa Well Other If domestic water supply is a we : Separation : Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank gal. ( minimum size: 1 . 00n gal. ) TILE FIELD : Each Trench --- fleet/Total system length feet SEEPAGE PIT(S): Number of 1 / Size each feet by '� feet Size of stone to be used # /Depth or Thickness 2� feet I have read the regulation on the reverse sid his sheet and a ree to abide by these and all requirements of the Town of fluee y anitary Se a e Di posal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: c� DATE : t l — J Cf OVER Vj o *Xi o , r- septic Syscem Inspections : A * All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall be submit-fad to the Building Department at least 24 hours before start of construction and shall include a Blot plan showing : 1 . ) the proposed location of chc system location and distance to lot lines 3 . ) location and distance to structures 4 . ) location and distance to any water supply 5 . ) size and diRoensions of all tanks , distribution boxes , the fields Lnd /or drywells B . Nu system shall be covered before inspection and approval by the lsuilding l ,ispuctor . Failure to comply with this requirement may result in the uncovering of tFh4 system by the installer and a fine uf 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 irnmudiate work stoppage . D . Should unforeseen problems during construction prevent proper installa- tion . alteration or repair of an approved system , a new proposal must l, L� submitted to the Queunsbury Building Department before further L011struction . Town of Queensbury BUILDING and CODES DEPARTMENT Flay :and Haviland Roads Queunsbury , New York 12804 kumarks : _.J'vwr: o� �ueen3besr� ffd o BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R,D, 1 BOX 98 Queensbury, New 'York 12801 SEPTIC DISPOSAL 'SYSTEM INSPECTION LOCAT I; riA'1'E f PERMIT NJO . s0iL TYPE - Sand - Loam - Clay' - HO Percolation Test Required? YES Inch Percolation rate - Min/ TYPE of 'Sy+,, TEM: ,'A'bsorpt3oTJ field , total length Length of ach trench Depth of tr nche s Size of gran l �m14 �---` SEEPAGE PITS fcbft� �--�— Size_ �ft. Gravel size ' PIP Bdg . to tank r Tank to disc . t_ Dist. box to fld Y ` S NO l Partial Openings sealed? Y LC7CPTxOId/SEPAllATIObIs ; I ft. Foundation t tank + f to Foundation t absorption �s f t. Absorption o lot li t ne �f . Sep ration f pits CH3 Cxf` SYSTEM ON PROFE$;TY (circle one) Front Rer - Left side - R3ght side - So SYSTEM USE APPROVED YES NO !; Building Inspector Ol/ s6 and vl or kAs Ste `lo St III C�' Y co/w