90-069 BUILDING PERMIT
1-3
TOWN OF QUEENSBURY
No. 90-69
WARREN COUNTY, NEW YORK
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PERMISSION is YBarrett Auto SalesIfereb granted to
OWNER of property located at ix Avenue 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
108 Lower Dix Avenue
Queensbury NY 12804
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2. CONTRACTOR or BUILDER'S Name PZI
Condon's Septic & Drain Service y
3. CONTRACTOR or BUILDER'S Address
12 2 Grant Avenue 1-3
Glens FAlls NY 12801 0
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4. ARCHITECT'S Name LI1
5. ARCHITECT'S Address
6. TYPE of Construction-(Please indicate by X)
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( I Wood Frame ( ) Masonry ( )Steel ( ) 00
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7. PLANS and Specifications •
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No. two 8' x 5 ' seepage pits including #3 stone to depth of 2 foot- ty
per plot plan and application.
8. Proposed Use
sewage alteration
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$ 35-00 PERMIT FEE PAID -THIS PERMIT EXPIRES MArch 19 19 99. ro
(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.) ,
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Dated at the Town of Queensbury this 1 , Day of 19 9p
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SIGNED BY GL� for the Town of Queensbury
Building and Zoning Inspe or
TOWN OF QUEENSUURY TOWN OF 1 0 ' NS Uh Y
BUIAPPLICATION FOR 1, , u :i ;:i .� DEPT.
v SEPTIC DISPOSAL PERMIT
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DATE (3 /i / )
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DATE / v� � ��
NEAR 15 1990
LOCATION OF PROPERTY FOR INSTALLATION .IO ko C(9 e/��� (/'E BLDG. & CODE DEPT.
Owner's Name: Nlr{? g%l ,4O fp Ji)/1S _ Telephone: 7Q3-S.Z.` 2--
Address: tog L cv g. I X 0()8 ,1),_c Rc 1 „
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Installer's Name:(Q/L9clpiu SSe f G4,7*1-//uSEl� Telephone: 728'"K5 !,,
Number of bedrooms (residential only) O 7,G c., eito`plc.gES
Total daily flow (compute (. 150 gal per bedroom) rf ye-6-( ®3 S CS-P. Z L S G.P ID-
Topography: Circle one: fp' Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam clay Other OPAOS( /Depth: �� Feet
Ground Water: At what depth? Q Feet
Bedrock or Impervious Material: At what depth? Q Feet
Percolation test: Circle one: not required required rate 44 min. inch.
Domestic water supply: circle one: Iunicipa Well Other
If domestic water supply is a well:
Separation: Water supply 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 2- / Size each feet by feet
Size of stone to be used # 3 /Depth or Thickness feet
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I have read the regulation on the reverse side of this sheet and agree to abide by these
and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE.PERSON: gdG�
DATE:
OVER
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 installa—
tion, alteration or repair, of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction.
•
Town of Queensbury .
BUILDING. and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks• • •
�(U6 awn of Qu cc n i u rty
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \/4 t1J Ia_t_uta
LOCATION Me ece.tze.(r (/
DAv4/ Q ) PERMIT NO. 97,—&CJ
SOIL TYPE _ Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length ;,
Length of each trench
Depth of trenches '
Size of gravel_
SEEPAGE P ITS-ENuinber of) '
Size- ft. X ft.
Gravel size .
PIPING: Size '' Type
Bldg. to tank
Tank to (list. box
Dist. bo): to field/pit
Openings sealed? YES j NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft.
Foundation to abscrption ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PRORERTY(circle one)
Front - Rear - Left side - Right side COMMENTS:
U� WW4o14 60A/D-n V.:.o/W1-164..tir C u
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SYSTEM USE APPROVED YES NO
Build ng In echor
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