1986-118 BUILDING PERMIT
TOWN OF QUEENSBURY No 86-118
�2 G WARREN COUNTY, NEW YORK
PER MISSION herebyg ntedlto William F. Billings
OWNER of property located at Sunnyside 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.
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1. OWNER'S Address is RD #1 Box 284
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Glens Falls, New York 9
1. CONTRACTOR or BUI LDEfl5 Name N•
Walt Stevenson
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3. CONTRACTOR or BUILDERS Address
RD #1
Glens Falls, New York
4. ARCHITECTS Name en
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5. ARCHITECTS Address
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6. TYPE of Construction—(Please indicate by X)
I Wood Frame 1 )Masonry I I Steel I I
7. PLANS and Specification m
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No. 8'x8' drywell only per plot and application submitted. sma
8. Proposed Use ft
Sewage system for dwelling re
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 15 19 88
(If a longer period is required en 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 Queensbury this 15th Day of {AApril 1986
SIGNED BY h O% . /✓ for the Town of Queensbury
Building and Zoning Inspector
'. Jown of QueenStury TOWNc? .._ _\^^^
BUILDING and ZONING DEPARTMENT rrIfffnLJ111���,/
Bay and Neviland Road. R.D. 1 Box 98 Y 4 �9 i� ��
Oueensbury, New York 12801 Vu i
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SEPTIC DISPOSAL PERMIT APPLICATION'=Ia'® r4
Owner 's Name 4,i;�.lM f /)i,ZZniys ;
Tel.2Y2 71
Address/ )A/ 130x 29`/ Su,✓.2' siL'e £-"
Person/Firm installing system lL/q,6J- -Sjcs/rtt,fo.. "--/
Number of bedrooms(residential only) 0:1
Total daily flow: (compute @ 150 eal.per bedroom per day) . j Z)' U
Topography: (t)- rolling - steep - (circle one) Decree of slope _%
Nature of soils: and+loam-clay- other- Depth ft.
Ground water-- at what depth? 0.0 ft.
Bedrock or impervious material--at what depth? A)6 ft.
Percolation Test - Not required / Required -Rate min/inch.
Domestic Water Supply - Municipal Well - Other
IMPORTANT !
On a separate piece of paper , submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, pond or wetlands. Include all
dimensions of the system itself. c
Description of proposed system: -Xist(fl Dent c fR,/g
B..p .. Lank.Li size idol. G
T . Otal rl d ft•
Size of stone I( 3 _.
Seepage Pit (s) Number / / Size g£tXaft. Size of stone$ ✓
Any contractor, corporation, individual , Etc. , engaged in the
construction of a Sanitary Sewage Disposal System, who covers the
same before inspection, does not have an approved Permit, or varies
from the approved application, will be subject to a Penalty of $250
as provided for in Section 6. 010 of the Town of Queensbury Sanitary
Sewage Ordinance.
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Signature of Applic nt Date
01/86 and/vl
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Septic System Inspections:
A. All applications for septic system installation,
alteration or repair, as required by the Town of
Oueensbury 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 he
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 Oueensbury Building
Department before further construction.
fouin o� Queenibury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSALDISPOSAL SYSTEM INSPECTION
NAME Y�
LOCATION ac 4t44.ty
DATE 0 Il}/ r PERMIT NO.
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SOIL TYPE Loam - Clay -
Percolation Test Required? YES -`
Percolation rate - Min/Inch - (9
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel_
SEEPAGE PITS{Number of)
Size- 8 ft. X a ft.
Gravel size - C4,9845 /N/X'
PIPING: Size Type
Bldg. to tank y PVC-
Tank to dist. box
Dist. box to field/•'
Openings sealed? disloNO Partial
LOCATION/SEPARATIONS:
Foundation to tank ZOtft.
Foundation to absorption j3-4-ft.
Absorption to lot line p0�ft.
dy Separation of pits , fj ft.
LO + ON OF SYSTEM ON PROP RTY(circle one)
Front Rear - Left side - Right side -
•i' TS:
SYSTEM USE APPROVEr11111, NO
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