88-820 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-820
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Frank Arnold
OWNER of property located at Ridge Road Street, Road or Ave. `O
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
Box 41
Glens Falls, New York 12801
2. CONTRACTOR or BUILDER'S Name
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Jon Senecal
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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)
( 1 Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications
No. Replacement of existing 1000 gal tank, as per plot plan,
and application.
8. Proposed Use
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Sewage Alteration
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$ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES 10/21X 19 90 r
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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
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 21st Day of October 19 88
SIGNED BY .91 / for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY {��
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APPLICATION FOR C ' _tu
SEPTIC DISPOSAL PERMl
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JL 1.DINc & CODE ®EST.
DATE ./, ' / � � ���
LOCATION OF PROPERTY FOR INSTALLATION 8/ /9/ y�GL- 7�d73
Owner's Name: yj,?, /L Ay44/UL-2) Telephone: .7 3- 5-- J
Address: A'x <I/ h oc..J /e4-,0 — (ideeluS/5✓/�y
Installer's Name: _____ke 4/1? LTelep/phone: _7 — 7Zo g
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) gC
Topography: circle. one: Rolling Steep slope % of slope
Soil Nature: circle one: and Loam Clay Other / Depth: feet
Ground Water: At what depth? .'"'Y) feet
Bedrock or Impervious Material: At what depth? feet
Percolation test: circle one: of required )required/rate min.inch.
Domestic water supply: circle one: Municipal - Other
If domestic water supply is a Well: 465'
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /07�' gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 570 feet / Total system length .-CU feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # � /Depth or Thickness feet
******************************************************
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:
Date: )C:— [[-(— q'
y -11 ;/ (OVER)
rii," / 4/ 7/ �\
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:
awn of Queen.i4ury 6619
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM IINSPECTION
NAME '/��/��� .i�Gfia I1
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LOCATION P! ,/% ' TyV `fax ci/
DATE /0/ /a o PERM IT NO. S'Es'
SOIL TYPE - Cana Loam - Clay -
Percolation -Test Required? YES - 1O
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length r°, a trO"
Length of each trelch
Depth of trenches =+
Size of gravel
SEEPAGE PITS{Number •f)
Size- ft. X f. .
Gravel size
PIPING: .ze T„ p
Bldg. to tank <r
Tank to dist. box P
Dist. box to field/p t
Apre
Openings sealed? ES •O Partial
LOCATION/SEFARATI'' S: •
Foundation to t- ,k ft.
Foundation to a•sorption/ '\ft.
Absorption to of line "__ fit.
Separation of pits f
LOCATION OF .YSTEM ONFPROPERTY(�cle one)
Front - Re-• eft ide Right side -
COMMENTS:
SYSTEM USE APPROVED - YES O
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