1986-638 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-638
9
WARREN COUNTY, NEW PORK
,--)q 1 N---k-D-L___ John Austin
PERMISSION is hereby granted to
OWNER of property located at/ 4 "7 Sunnyside East Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration o
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 RD #1 rtN.
Glens Falls, New York o
2. CONTRACTOR or BUILDER'S Name C. H. Elms Construction, Inc.
3. CONTRACTOR or BUILDER'S Address p
Ridge Road
Glens .Falls, New York N.
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4. ARCHITECT'S Name rxl
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( ) yr
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7. PLANS and Specifications M
dist. box and 1 4'x6' seepage pit per plot plan and ..-
No. application submitted. rt
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8. Proposed Use rt
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Sewage system for dwelling
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 26 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 26th Day of Sept. 19 86—
SIGNED BY -X I a Oc g0 for the Town of Queensbury '
Building and Zoning Inspector
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awn of
Queniury APPLICATION FOR , SEPTI , a '_11ihy
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 E 1-V E
Oueensbury, New York 12801
DATE / 5EP 1 '4I
9 �.
LOCATION OF PROPERTY, FOR INSTALLATION Sunnyside East jut 0 '
OWNER' S NAME JOhn Austin-
ADDRESS v ,
East Sunnyside, Glens Falls, New York 12801 TEL 793-3712
INSTALLER' S NAME C.H. ELMS CONSTRUCTION, INC. TEL 792-4417
Number of bedrooms (.residential only) 3
Total daily flow-(compute @ 150 gal per bedroom) 450 gallons
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Topography: Flat - Rolling .- Steep slope -(circle one) % of slope .
Soil nature:�and)- Loam - Clay - Other . Depth 50 ft.
Ground' water -At what/ depth? 30 ft.
Bed-rock or impervious material - At what depth? '30 ft.
Percolation test - Not required Required - -Rate min-inch.
Domestic water supply - Municipal Well - Other • •
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Separation - Watersupply(if well) from Septic absorption 125 ft.
Proposed System: Septic tank 1000 gal. ( Minimun size, 1000 gal. ) •
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Tile Field - Each trench 0 ft. Total system legnth 0 ft.
Seepage pit (s) Number of 1 . Size each 6 ft X 4 ft
Size of stone to be used 4 • 3 Depth or thickness • 2 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, streazn,pond or wet-lands. Include all dimensions of
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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 Ordinance.
Signature of responsible person
05/86 and/vl
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Section II Septic System Inspections: •
A. All applications for septic 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 drywells
B. No system shall be covered before inspection and '
approval by the Building Inspector. Failure to
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comply with this requirement may result in the
uncovering of the system by theiinstaller• 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..
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Jown o Queenturcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME _1 o hM Xu. 3T 17
LOCATION S(AVni si d Q 4 aS
DATE 714ri 'G PERMIT NO. - 6 3`3
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 0 'TflJ CO
Foundation to absorption '2a ft. .p_
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
1 %/) auk0e'Lftt/ -L
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SYSTEM USE APPROVED YES NO
!ram !/ '_,
Bui1 ing Inspect r
01/86 and vl
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