1986-343 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-343
WARREN COUNTY, NEW YORK
(a00 \
PERMISSION is hereby granted to Dale Granger
OWNER of property located at Lot 49 Meadow Drive Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage System
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
43 W. Notre Dame St. �
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Same
3. CONTRACTOR or BUILDER'S Address
Same
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
CD
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
1000 tank, dist. box and 187 ft. leach field per plot and
No. application submitted.
8. Proposed Use
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Sewage System
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 24th 19 88
(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.)
Dated at the Town of Queensbury this 24th Day of June 19 86
SIGNED BY 0=- a . /" for the Town of Queensbury
Building and Zoning Inspector
Jown of kr
,' Lw�,' ��� UFZYQueen3tury APPLIII0 , FOR SEPTIC C EBUILDING and ZONING DEPARTMENT D .
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 ' � �
DATE l /Z3 sitm.ue. jja
LOCATION OF PROPERTY FOR INSTALLATION ►o A )�i� e. ITIVI s� `` � . 19
OWNER'S NAME nT1 �1.0 ()Ang ✓'
ADDRESS 43 Lo a Nn � ek, 6 TEL- W2-1:-D0 7
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INSTALLER' S NAME TEL
C
Number of bedrooms(residential only) 3
Total daily flow(compute @ 150 gal per bedroom) .4„cb
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Topography: Flat - Rolling - Steep slope - (circle one) % of slope / 1K 2.
Soil nature: .Sand - Loam - Clay - Other gyau,,l Depth G,l ft.
Ground' water -At what depth? (p • ft.
I
Bed-rock or impervious material - At what depth? (fl ft. .
. Percolation test - Not required - Required - -Rate A..-,C m.0eN min-inch.
Domestic water supply Municipal -. Well - Other .
Separation. - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank leveyD gal. ( Minimun size, 1000 gal. )
/
Tile Field - Each trench ( 2, a ft. Total system legnth 1 2?" ft.
Seepage pit(s) Number of - . Size each ' • ft X ' ft
/
Size of stone to be used # 77; Depth or thickness 'j ft. •
IMPORTANT! '. •
On a separate piece of paper, submit a diagram of the proposed system .
with all dimensions shown; including distance from any structure,
distance' from property lines and from ANY DOMESTIC WATER SUPPLY or
shore-line of lake, stream,pond or wet-lands. Include all dimensions of
the system, itself.
* * * * * * * * * * * * * * * * * * * * * * * * * * . * * * * * * * * * * *
I .have read the regulations on the reverse side of this sheet and agree
to abide by these and aZZ requirements of The Town of .Queensbury
Sanitary Sewage Disposal Ordinance.
Signature of responsible person I ji !ram
:lj
Date 6 24r (p
05/86 and/vl
Section II Septic System Inspections:
A. All applications for septid system installation,
alteration or repair, as" reauired 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.
Jown of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ' ,-,r-(1�y.._
LOCATION L‘.64 149
DATE �/ /-1 PERMIT NO. NI —3 4
SOIL TYPE Sand . Loam - Clay - ,,,m,
Percolation "-st Required? YES -"NO
Percolation rate - Min/Inch
TYPE of SYSTEM: /
Absorption field, total length
Length of each trench
.j)
Depth of trenches
Size of gravel 2tP 2_- c^` I.�lyt A--
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box _
Dist. box to field/pit
Openings sealed? YES NO artial
LOCATION/SEPARATIONS:
Foundation to tank ft.
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 -
COMMENTS: /,„4
SYSTEM USE APPROVED NO 0
Building Inspector
01/86 and vl
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