1986-189 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-189
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Michael Gazzillo
OWNER of property located at ' / '.Clark St.
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
5 Clark St.
Glens Falls, New York r°
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2. CONTRACTOR or BUILDERS Name m
Sanitary Sewer Service N.
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3. CONTRACTOR or BUILDER'S Address
P. 0. Box 224
Glens Falls, New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X1
1 I Wood Frame ( I Masonry 1 )Steel I I
2. PLANS and Specifications 1 — 6 hole dist. box
No. 3 — 6'x8' drywells with 24" #3 stone per plot and
application submitted. 0b
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e. Proposed Use
Sewage alteration for dwelling n
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 5 9 88
(If a longer period is required an application for en 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 �57t�h, - / Day
of /� May 1g 86
SIGNED BY 2I aCG ) . /JJ..���.--w for the Town of Queensbury
Building and Zoning Inspector /y�
awn of Queenitury TOWN OF QUEENSEllr
• BUILDING and ZONING DEPARTMENT �r��7� I[,
Bay and Heviland Road, R.D. 1 Box 98 ��(
Queensbury, New York 12801 ���J���yyy A;..f! Y; Q
SEPTIC181911-011111221
I DISPOSAL PERMIT APPLICATION
Owner's Name Mt ( �I f� QR -22 i 110 rel. Q34P/0
Address 3 C. tA/c4C s%,< e T n
Person/Firm installing system (S)4tiJ 074112/� jFcw (,&_ ffi1zuicc
Number of bedrooms (residential only)
Total daily flow: (compute @ 150 gal.per bedroom per day) (p64D
Topography: lot rolling - steep - (circle one) Degree of slope _%
Nature of soils: 'loam-clay- other- Depth 7 Oft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? 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.
Description of proposed system:
Septic tank sizele)DO> gal.
Tile field- Length of each trench ft. Total field ft.
Size of stone %
Seepage Pit(s) Number 3 / Size ftX- kft. Size of stone:Li?
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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Signatur of Applicant Date �.A
I- 6 h'ic ys, , RT'x
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 Buildina 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.
TOWN OF QUEENSBURY
Building Department
DateInspocton peon
Location
Permit
No.
way+
Remarks
ExcaOation
FOOti • Forms
Footin• & Piers
Foundation
Cement Coat
Water•roofin•
Backfill
Final Survey
Framin•
Sheathin•
Roof Felt
Roofin•
siding
Mason Veneer
Baud] Pl.. .Relief Valves
Interior
Stairs & Railin•s --
Cellar Dr. Tile --
Concrete Floors --
pl.. . Fixtures
Car.
Fire•roofin•Door Closers
Chimne
Water Meter Inst.
Se.tic A..roval war
Foundation
Insulation WaIIs
Ceilin
Building Inspector
REMARKS
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SANITARY SEWER SERVICE
LUZ RNE RD. GLENS FALLS N.Y. PHONE 792-7257
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