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1986-414 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-414 WARREN COUNTY, NEW YORK PERMISSI N ie b ' ed to Jack Irion Y9 � OWNER of property located atGreenwood Lane 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 PO approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is 25 Greenwood Lane Glens Falls, New York H. 2. CONTRACTOR or BUILDER'S Name Sanitary Sewer Service 3. CONTRACTOR or BUILDER'S Address N P. 0. Box 224 `n Glens Falls, New York ro 4. ARCHITECT'S Name $ 0 5. ARCHITECT'S Address 0 m 6. TYPE of Construction—(Please indicate by X) ( 1 Wood Frame ( ) Masonry ( 1 Steel ( 1 7. PLANS and Specifications Cip 3 6'x8' seepage pits with #3 stone per plot and application CD No. oa 0 8. Proposed Use rt Sewage system for dwelling I. r� 0 0 $ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 18 1988 (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 18th Day of July 1g 86 SIGNED BY -'1 ',u C �..�� for the Town of Queensbury Building and Zoning Inspector ( • `Down of Queen31ury APPLICATION FOR ASEPTICAag 'JLTny —' 43UILDINGand ZONING DEPARTMENT �' Bay and Haviland Road, R.D. 1 Box 98 n EGEEIVIE Queensbury, New York 12801 ;,r+ r„ DATE :. / JUL 1 LOCATION OF PROPERTY FOR INSTALLATION SA4,1 A,�;�c., /D°a /(O{Y1e7etl1d1Ila� jp1k1�J� e.BF 0 �e r e r 6 6 32 ! e Y a �, 1 e �e OWNER'S. NAME V 1 • �'©.. ADDRESS r f 2elt/(.l,0 0 1i9/u�c TEL 7 93- o°2 INSTALLER' S NAME S/1 l .A./•-</ fet(0(t _ TEL7Q,)-77- 5-7 2/4 Number of bedrooms.(residential only) • Total daily flow(compute @ 150 gal' per bedroom) (IS Ov Topography: Flat - Rolling .- Steep slope - (circle one) % of slope Soil nature: Sand Loam - Clay - Other Depth /3 ft. Ground' water -At what depth? ft. Bed-rock or impervious material - At what depth? ft. Percolation test - of required ) Required - -Rate min-inch. Domestic water supply - Municipal Well - Other Separation - Watersupply(if well) from Septic absorption ft. Proposed System: Septic tank 16 .fi c7 gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench' ft. Total system legnth'" -- ' ft. Seepage pit(s) Number of • "3 : Size each C0 ft X ' 2- ft (BxP) Size of stone to be used# .J. - Depth or thickness' 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 - r the system, itself. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * have read the regulations on the reverse side of this sheet and agree to abide by these and all requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance Signature of , esponsible person •\ a V ' Date 05/86 and/vl • Section II Septic System Inspections: • • A. All applicationd 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 Queensbury Building �. Department before further construction. Jown of Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISSPOSALL SYSTEM INSPECTION` NAMED LOCATION titil ell-C... C<.r- --C 4-- C/l DATE / b(o PERMIT NO. . 2 - 9-/� SOIL TYPE - 0- Loam - Clay - Percolation -st 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 PITSfNumb,,ej of) 2r.` Size- . ep ft. X " ft. Gravel size 41-_3 PIPING: Size Type Bldg. to tank 4,0( f!a Tank to dist. box _ Dist. box to field/, . Openings sealed? NO Partial LOCATION/SEPARATIONS: Foundation to tank 6- ft. Foundation to absorption aft. Absorption to lot line rt,ft. Separation of pits ap ft. LOCATION" O YSTEM ON PROPERTY(circle one) - Front - Left side - Right side - COMMENT-. 410PSYSTEM USE APPROVED NO yJ C Building Inspector 01/86 and vl _._ • • SANITARY SEWER SERVICE - LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257 ri l ..3. r_____ . 0 1 . .4., 1 . •1 N- ‘ 71---) _ .-. J r;3,3 , 0. \1 ---2`', .,,. Cr_ / . ' .. • ''3 ' 6'cl. _ ' V . . - .C'\ 0 0 ___ ______-)---.---_ . NP\ 3 a — %,,,,. . :c\' . • , (o` a J • Cam. . . Mlytfotf441 . 1