1986-482 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 86-482
DOAQ r /I � WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Jade Palace (Philip Lau)
OWNER of property located at Route 9 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 p
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. m
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1. OWNER'S Address is Route 9
Glens Falls, New York
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( ) CD
7. PLANS and Specifications r'
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1250 gallon tank, dist.box and 2 8'x10' seepage pits per plot and
No. application submitted. 2 more 8'x8' drywells to be installed N
by .Time •0, 1 487_
8. Proposed Use
Sewage system for restaurant
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 12 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 12th Day of August 19 86
SIGNED BY /7kui1�+ Q. Aze v for the Town of Queensbury
Building and Zoning Inspector
awn o� Queenituri APPLICATION, FOR SEPTIC pJ, J oNg4 t,
i BUILDING and ZONING DEPARTMENT I
Bay and Haviland Road, R.D. 1 Box 98 P t U EE l
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Queensbury, New York 12801 Rk
DATE /
UG 71986 -
LOCATION OF PROPERTY FOR INSTALLATION d� M (Q���e P ri,
c1 J./ /� O R f f • • e Ca c
OWNER' S NAME s kLL.� l . - F_ - /4 c4
ADDRESS R.,
0 L 9 TEL
INSTALLER' S NAME 'v i'm,,,,, ) .,(A 11d (-`r TEL —2C14) — /4,2J2
Number of bedrooms (residential only) —
Total daily flow(compute @ 150 gal per bedroom) .—
T
Topography- Rolling - Steep slope - (circle one) % of slope
Soil nature: Sand - Loam - Clay - Other Depth ft.
Groundwater -At what depth? ' ft.
Bed-rock or impervious it.-terial - At what depth? • ft.
Percolation test - Not required ' Required - -Rate min-inch.
Domestic water supply - Municipal Well - Other •
Separation - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank jay 0 gal. ( Minimun size, 1000 gal. )
? -/O v 3 Cl fg'c- £,e(d yvd-
Tile Field - Each trench ft. Total system legnth ft.
Seepage pit(s) Number of 2 :. Size each ! Oft. X P-ft
Size of stone to be used # . Depth or thickness ' ' ,� ft.
IMPORTANT ! '. P�/.�L - N,� S' D C—P egg 14- 677 S�6-e s,
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, streazn,pond br 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 all requirements of The Town of Queensbury
Sanitary Sewage Disposal Ordinan e . 7(7 '
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Si nature of responsible person /L�
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Date ?- UDC
05/86 and/vl
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Section II ,- Septic System Inspections:
' A. All applicationd for septid system installation,
alteration or repair, as required by the Town of
Queensbury Sanitary Sewage Ordinance, shall be
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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.
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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.
_own of Queen iur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbur , New York 12801
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SEPTIC DISPOSAL SYYYST INSPECTION
NAME yd ? ,,e ;4o e
LOCATION Ab /
DATE // ERMIT NO. ' --6 11
SOIL TYPE - Sand - Loam - Clay -
Percolation Test 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 P S{Numbe of) _ 2 140/'i
Size- Oft. X ft. - Z,
Gravel size
PIPING: Size- Type
Bldg. to tank �--
Tank to dist. box
Dist. box to field/:,'t - t/
Openings sealed? ali, , O Partial
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: `/ ,
dlitik/ U ele / /1 /-(V el f c-
P 7 7
SYSTEM USE APPROV D Y NO
g/----- "
B,ilding Inspector
01/86 and vl
(,4 ii / '%/x6 ( -=!
gown 01 Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
Il15)7. bIw- 1 30 /Z cm /-hf J., /2 / 6/1
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 1544 f l� 1 0 _ -
LOCATION fl o t. f GJ
DATE p /L /;16, PERMIT NO./-)._0, zr ri r
SOIL TYPE - Sand - Loam - Clay -
Percolation Test 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*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 Partial
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 -
COMMEN '„itS:
/� #,,,,,,
,,,,, --
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SYSTEM USE APPROVED Y NO
Building I.-•spector
01/86 and vl
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SANITARY SEWER SERVICE .. .
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LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7.2.57
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