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88-851 • BUILDING PERMIT TOWN OF QUEENSBURY • No. 88-851 WARREN COUNTY, NEW YORK Slut U 30 PERMISSION is hereby granted to Fitzgerald Realty OWNER of property located at 3(Q 3),.26--Big Boom Road 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. 1. OWNER'S Address is Glen Street • Glnes Falls,New York 1280117. . _ 2. CONTRACTOR or BUILDER'S Name • [~� C tr Condon's Septic _ - c 3. CONTRACTOR or BUILDER'S Address - x r K 4. ARCHITECT'S Name • 5. ARCHITECT'S Address - n C. - tz r . C 6. TYPE of Construction—(Please indicate by-X) C C (• )Wood Frame ( ) Masonry (. )Steel ( ) _ 7. PLANS and Specifications No. 1000 XX gal tank, 2,00' tile field as per plot plan and application 8. Proposed Use • Sewage Alteration " tr. z $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 28 • 19 XX 90 tr. (If 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 Queerisbur this 28th y Day of October . 19 88 • C . . SIGNED BY •, for the Town of Queensbury Building and Zoning nspector • (004 of atatu141 1 l APPLICATION FOR SEPTIC DISPOSAL PERMIT ZDNZ &DLDG CODES DEFY. 4) 1 P Of QUEENSOUItY LOCATION OF PROPERTY FOR INSTALLATION .(I / ; ,OC/yD ,�Ld Owner's Name: i-2,a Em-`b kea1-ty Telephone: 7 3 ` 6 to 1-6 Address: Lt) `gi'V s f. G P- 1v S F a/0 fvf 7 B P Installer's Name: enini7(►rtl S Sec C, 'Telephone: 7pss"-4)'.5't/'2, Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) _ LKO , Topography: circle one:. Rolling Steep Slope % of slope ' Soil Nature: circle one: Sand Loam Clay Other / Depth: - feet • Ground Water: At what depth? /VA feet Bedrock or Impervious Material: At what depth? /4_ feet Percolation test: circle one: not required required / rate NA 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 WOO' bal. (minimumsize: 1,000 gal.) TILE FIELD: Each Trench 540 feet / Total system length D,..d O " feet SEEPAGE PIT(S): Number of / Size each feet By feet Size of stone to be used It / Depth or Thickness / feet * * * * * * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * IMPORTANT ...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: l.). the.proposed location of the system. 2.) location and distance to lot lines • • 3:) location•and distance to structures._ . -- . 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: eeitYliterY"\-- • Date: � ` L - • Town of Queensbury . Building and Code_Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 • t•i , 1.. _ T 1 f':." n r // c%t // . cc77 Jown of Queen4'ur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTICDISPOSA SYSTEM ,747INSPECTION NAME 1�//i/<:7-t- ec' 7 . ir LOCATION / f'l //,,,,-_,- /// DATE/ l % W'ERMIT NO. bf'S i SOIL TYPE - Sand - Loam - Clay - / Percolation Test Required? YES - NO;/ Percolation rate - Min/Inch s" Y TYPE of STEM: ,,,. -, , , __,,,A, Absorptio- field, total length,;?'----- Length of ach trench 5''.., ' Depth of t nches Size of gra eT ( 17 SEEPAGE PITS Number of) , Size- ft. X ft. ��° Gravel size %. "' t. PIPING: iz Type Bldg. to tank 1 ��--.-- Tank to dist. bo' I 1/; ' 7,L-'---- Dist. box to field/pi , U/ V r'"/ Openings sealed? YES ( NO jPartial LOCATION/SEPARA rON i" Foundation to ank \ J S tt. Foundation to 4absorptiQn 'y,.'J ft. Absorption toflot line '' T- ft. Separation o pits _t. OPiE LOCATION OF SYSTEM ON PRRTY(circle one) Front - Re - Left side - Right side - COMMENTS: A f V --4-a/ \\, SYSTEM USE APPROVED YES NO/ .�1 - - Build. ng Inspector 01/86 and vl Avn&5(113?0 e 1©y L000 2 Dj j 9 -t9 Fe, 7 , .A. 0-r...-c --- c., '?. J � et\A .. w `.. 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