1986-158 BUILDING PERMIT
TOWN OF QUEENSBURY No 8e_158
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/ ' ' O WARREN COUNTY, NEW PORK
PERMISSION is hereby granted to Ernest LaVine
OWNER of property located at 24 Lupine Lane Street,Road or Ave.
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in the Town of Queensbury,To Construct or place a Sew 0
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at the above location in accordance to application together with plot plans and other information hereto filed and n
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t..
1. OWNERS Andress is 24 Lupine Lane
Glens Falls, New York m
2. CONTRACTOR or BUILDERS Name Sanitary Sewer Service
3. CONTRACTOR or BUILDERS Address
P. 0. Box 224 ,dc'
Glens Falls, New York H.
4. ARCHITECTS Name
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6. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
1 1 Wood Frame ( )Masonry ( )Steel ( 1
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7. PLANS and Specifications w
6 hole dist. box, 2 61x81 drywalls 24" #3 stone 0°
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No. per plot and application submitted.
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B. Proposed Use
Sewage system for dwellingrt
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 23 1988
Of 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 Queensbury this 23rd Day of April 1986
SIGNED BY )/1 a' for the Town of Queensbury
Building and Zoning Inspector a
Jown of Queenllurtj TOWN c'::-' CJC ENE"'-
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; BUILDING aria �jtl ZONING DEPARTMENT k ii v L I11 �'i
Bay and Haviland Road, R.D. 1 Box 98 L'
Oueensbury, New York 12801 APR 'A 1986 o K ../�
A.M.��.. /O P.fvl/12AJ
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SEPTIC DISPOSAL PERMIT APPLICATION
Owner's Name C 2 N I C G A V iN& Tel. '/93- SAY{,
Address c?Lt L✓pi.vt- L✓a/v(
Person/F irm installing system tiF)A/ ;rAi2 deWtw, reedit
Number of bedrooms(residential only) 3
Total daily flow: (compute @ 150 aal.per bedroom per day)_ fco
Topography: - rolling - steep - (circle one) Degree of slope 8
Nature of soils: g'%loam-clay- other- Depth /0, ft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? ft.
Percolation Test -(11ot reguire f Required -Rate min/inch.
Domestic Water Supply -*unicipa - 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, ponder wetlands. Include all
dimensions of the system itself.
Description of proposed system:
Septic tank size /OoO gal.
Tile field- Length of each trench_ft. Total field_ ft.
Size of stone R
Seepage Pit(s) Numb e1 / Size (, ftX_ 8' ft. Size of stone#3
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. /_ 6 hdte V/ Sal 6✓ re Jrl SO..,
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gnature c Applicant Date
01/86 and/vl
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 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 Oueensbury Building
Department before further construction.
_/owu of Queenshury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801 ,
SEPTIC DISPOSAL� SYSTEM INSPECTIONGi NAME 42,0 tto - I. 4,:n L
LOCATION ,(2Y Zc.A.r o -,.e
DATE 1,744 / yG PERMIT NO. ire - /.S5
SOIL TYPE - Loam - Clay -
Percolation 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 PITS{Numbe of) ,„
Size- 4 ft. X ft.
Gravel size �� 40„‘.. c CE—
PIPING: Size Type
Bldg. to tank
Tank to dist. box PP
Dist. box to field/pit _
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank Nft.
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits )< ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
CcMMENTS:
SYSTEM USE APPROVED ® NO
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Building Inspecor
01/86 and vl
SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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