1986-247 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-247
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to King He ng da �fgteljC koa `- ci
OWNER of property located at east side Route 9 north Route 149- Street.Road or Ave.
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Sewage Alteration
in the Town of Queensbury,To Construct or place a w
at the above location in accordance to application together with plot plans and other information hereto filed and x
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNERS Address is RAHW
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Lake George, New York m
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2. CONTRACTOR or BUILDERS Name Bruce Williams
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
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6. ARCHITECT'S Address W
ID
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6. TYPE of Construction—(Pleaseindicate by X)
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11 Wood Frame I I Masonry ( )Steel I ) 0
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7. PLANS and Specifications 04
No 1000 gallon septic tank 2 - 4'x6' drywells with #3 stone per c
plot and application submitted. rr
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8. Proposed Use F
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Sewage system for office bath only per application
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 19 19 88 w
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(If a longer period is required an piYtbn for an extension must be made to the Building inspector and Zoningc[orrof the m
town of Oueeesbury before Ma a expiration date.) 9
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Dated at the Town of Queensbury this 19th Day of May 19 86 w
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a pe Queensburyfar the Town of 0
SIGNED BY -Thadp
Building and Zoning Inspector
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(L6 to ' awn
wn of Queenl1u/y TOWN OF QUEENSBUri
BUILDING and ZONING DEPARTMENT
Bay end Havilantl Road, R.D. 1 Boa 98
Oueensbury, New York 12801 MAY 1gk34 J
A.M. Ric /D
SEPTIC DISPOSAL PERMIT APPLICATION
Owner's Name King- NtN/)/Z/et /w 773/- Tel. -%, -0V/ir
Address 2 f ) /� Ac,,, (;cc.Y)c- / c/
Person/Firm installing system /),/'u Cr t-u,LL/'4149i'
Number of bedrooms (residential only) /1/4
Total daily flow: (comp>u @ 150 aal.per bedroom per day)_ f 5 17
Topography: flat - rolling steep - (circle one) Degree of slope ,2Z R
Nature of soils: sand-log clay- other- Depth ft.
Ground water-- at what depth? , ft.
Bedrock or impervious material--at what depth? ik.i/A- ft.
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Percolation Test - lot reguir / Re uired -Rate min/inch.
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Domestic Water Supply - Municipal Well Other
On a separate piece of paper, a =diteeten 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.
Description of proposed system:
Septic tank size 1000 gal.
Tile field- Length of each trench _ft. Total field ft.
Size of stone /
Seepage Pit(s) Nu— mEiF z / Size y ftX 6 ft. Size of stonet 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.
8 na r f Appl ' cant Date
1/66 m /vl
Septic System Inspections:
A. All applications for septic system installation,
alteration or repair, as required by the Town of -'
pueensbury Sanitary Sewage Ordinance, shall be
submitted to the Building Department at least
24 hours before start of construction and shall
include a plot plan shoving:
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. Na systei, 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 pueensbury Building
Department before further construction.
I
flown of Queendbury
BUILDING and ZONING DEPARTMENT
Bay and Newland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAMF KI,U(o /J bwDICLGLS jt ,r6-c—
LCCATION art 9 p
DATE 5)(6-/i* PERMIT NO. a6 - 2tie7
SOIL TYPE - and - Lo - Clay -
Percolation Tes eguired? YES -e0 2
Percolation rate - Min/Inch - �/
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel_ —
SEEPAGE PITS{Number of) _
Size- •/ft. X _ 6 ft.
Gravel size XX =
PIPING: Size Type
Bldg. to tank (/ Li
Tank to dist. box 'y i
Dist. box to field 0r
Openings sealed? NO Partial
LOCATION/SEPARATIONS:
Foundation to tank (aft.
Foundation to absorption ft.
Absorption to lot line ft.
Separation of pits af/ ft.
LOCATION YSTEM ON PROPERTY(circle one)
Front - Left side - Right side -
COMMEN
1 - Ipbtl 6ALSLAPT14- 1-ANIL-
- 2_ n1TS Fen_ O filch- 6i-
SYSTEM USE APPROVED NO
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