1989-053 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 89-53
WARREN COUNTY, NEW YORK z
PERMISSION is hereby granted to Robert McMillen w
OWNER of property located at Assembly Point 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
27 Moorwood Drive
Queensbury, New York 12804
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2. CONTRACTOR or BUILDER'S Name
W.A.Graham Excavating
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3. CONTRACTOR or BUILDER'S Address
301 Main Street
Hudson Falls, N.Y. 12839
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specifications
No. 1000 gal. tank, 200 feet tile field as per plot plan
and application.
8. Proposed Use
Sewage Alteration u,
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$ 79 _ 00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 15 19 89
(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.) rt
Dated at the Town of Queensbury this 15th Day of February 19 89 c¢r
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SIGNED BY s, for the Town of Queensbury
Building and Zon g Inspector
%YOWL of 01(arklifierp
TOWN OF QUEENSBURY �l
RECEIVED
APPLICATION FOR SEPTIC DISPOSAL MIT
FF B 1 - 1989
BLDG. & CODE DEPT.
DATE ,� / ` / Y`)
LOCATION OF PROPERTY FOR INSTALLATION Assewi bly Pt - lax Nat 7 / -2 3
Owner's Name: "Rvber4 S. Plcinnt„,.. Telephone: 793-5-9-47
Address: Mooruiued Dr if eC.vt4' 6 try N. /• l 2"POif;
Installer's Name: W. I} .. Graltawh &eai1a-hots Telephone: .747- 75-
Number of bedrooms (residential only) _ 3 _
Total daily flow (compute @ 150 gal per bedroom) 4 S0
Topography: circle one: da) Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: ' + feet
Ground Water: At what depth? None . feet
Bedrock or Impervious Material: At what depth? NO.t e feet
Percolation test: circle one: not require required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other La 1e
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /000 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 5-0 feet / Total system length .27O0 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # / Depth or Thickness / feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
Section II Septic System Inspections:
A. All applications tor 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 installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
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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: _� /
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
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.own of Queen34ury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTIONNAME ,1 ki TL //�/ c 17 -t;•L�i�c
LOCATION C -r nit //p)
DATE / PERMIT NO. 19- 5
SOIL TYPEH Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation':,rate - Min/Inch •
TYPE of SYSTEM:
Absorption field, total length 6741)
Length of each 'trench eSp
Depth of trenches '
Size of gravel y` _
SEEPAGE PITS{Nuinbe of)
Size- ft. X _ '° £_t.
Gravel size
PIPING: Size Type
Bldg. to tank 4( /‘7C
Tank to dist. box t/
Dist. box to field/pit
Openings sealed? '` ',NO Partial
LOCATION/SEPARATIONS:
Foundation to tank 36%,ft.
Foundation to absorption 30 t.
Absorption to lot line /a f
Separation of pits - ft.\
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front -cRear} Left side - Right side -
COMMENTS:
/e0r9
LEaGA P4
SYSTEM USE APPROVED YES NO
Buil ing nspector
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