1986-576 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-576
WARREN COUNTY, NEW YORK
PER MIS 10.1\ Y9
1 is hereby ranted to Guy Dunn
OWNER of property located at 11 Parkview Ave. Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alt.
• 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._
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1. OWNER'S Address is 11 Parkview Ave.
Glens. Falls, New York
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
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P.O. Box 224 • n
Glens' Falls, New York
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( 1 Steel ( ) m
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7. PLANS and Specifications prq
6 — 8'x4'- seepage pits per plot andapplication CD
No.
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8. Proposed Use
Sewage system for dwelling o'
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES . Sept. 15 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 15th Day of Sept. ,fig 86
SIGNED.BY for the Town of Queensbury
Building and Zoning Inspector
aeon of Qury APPLICATION FOR SEP�f" DI =PGsA-L ' RM
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BUILDING and ZONING DEPARTMENT 411
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Bay and Haviland Road, R.D. 1 Box 98 � ((� �, ,)
Oueensbury, New York 12801 DATE 9 / aar `p /667L rt ry��`�I
-i7i81911A1-112M-MMIOV‘
LOCATION OF PROPERTY FOR INSTALLATION I. ` 'P/2JiQ_ __Vt6.J 4 E
OWNER' S NAME u t J ) N
•
ADDRESS Palk told )C
LT E L7 9,3 r/ a J
—
INSTALLER' S NAME c „,
,Pe4(AJ ft f TEL76?)_ -7,),,,-2
Number of bedrooms (residential only)
, Total daily flow(compute @ 150 gal per bedroom)_ _. 9oz
Topography - Rolling .- Steep slope - (circle one) % of slope
Soil nature: and Loam - Clay - Other Depth ft.
Groundwater '-At what depth? 7 ft.
Bed-rock or impervious mat 'al - At what depth? ft.
Percolation test - of re u -- Required - -Rate min-inch.
Domestic water supply Munici ` - Well - Other
Separation - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank 9 O b(7 gal. ( .14Inimun size, 1000 gal. )
• Tile Field - Each trench . -- ft. Total system legnth ft.
Seepage pit(s) Number of . 61 . Size each /0 ft X .9 ft
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
the system, itself.
* * * * * * * * * * * * * * * * * * * * * * *. * * * * *. * * * * * * * * *
I have read the regulations on the reverse side of this sheet and agree
to abide by these and all requirements o The Town of Q bury
Sanitary Sewage Disposal Ordinance
Signature of responsible person •
Date ( -
05/86 d/vl
Section II Septic System Inspections:
A. ' All applications for septid system installation,
alteration or repair, as required 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 -drywell-s = — --
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.
_awn 'of Queen iur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME c,
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LOCATION 1 v (1/(,�.,
DATE qpi / i11 PERMIT NO. a6,_.5 6
SOIL TYPE San - Loam - Clay - �
Percolation t Required? YES N
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) _ CO
Size- ft. X ft. cu„j.11 4,l,1j
Gravel size
PIPING: Size Type
Bldg. to tank VV" Ye)
Tank to dist. box
Dist. box to field/:it
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank . ClO ft.
Foundation to absorption 750ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION •- STEM ON PROPERTY(circle one)
Front Left side - Right side -
ill
COMMEN '
SYSTEM USE APPROVED6---)
NO
61/7/43./1/V17:-Th
Building Inspector
01/86 and vl
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'A SANITARY SEWER SERVICE
LUZERNE RD. GLENS, FALLS N.Y. PHONE 792-7257
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