1986-652 BUILDING PERMIT
TOWN OF, QUEENSBURY No. 86-652
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Allan Ferrie
OWNER of property located at Sunnyside East 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 m
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1-1
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1. OWNER'S Address is RD #1
Glens Falls, New York
2. CONTRACTOR or BUI LDER'S Name
C.H. Elms Construction, Inc.
3. CONTRACTOR or BUILDER'S Address
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Ridge Road c0.
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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)
( )Wood Frame ( ) Masonry ( I Steel ( I
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7. PLANS and Specifications 04
dist. box and 130 ft. leach field per plot and
No. application submitted.
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8. Proposed Use
Sewage system for dwellling o
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES Oct. 2 xxxx 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 2nd Day of October 19 86
SIGNED BY 77/ad t for the Town of Queensbury
Building and Zoning Inspector &r
•, * F3tJERY
Duin o f Q31ury APPLICATION FOR. SEPT : l `'S � ' ' 3 T
BUILDING end ZONING DEPARTMENT I • F B
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801 DATE / 86 SEP 6
LOCATION OF PROPERTY FOR INSTALLATION Sunnyside East 7181914.071 �1.11 ` ,
OWNER' S NAME Allan Ferrie
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ADDRESS Sunnyside East, Glens Falls, New York 12801 TEL 793-1810
INSTALLER' S NAME C.H. ELMS CONSTRUCTION, INC. TEL 792-4417 •
Number of bedrooms (r_esidential only) 3
Total daily flow(compute @ 150 gal per bedroom) - 450' gallons
Topography: 11111)
- Rolling .- Steep slope -(circle one) % of slope 0
Soil nature: Sand - Loam - Clay - Other Depth 50
Ground) water -At what depth? 50 ft.
Bed-rock or impervious material - At what depth? 50 ft.
Percolation test - Not required Required - -Rate min-inch. •
- Domestic water supply - Municipal 4eli)- Other •
Separation - Watersupply(if well) from Septic absorption 100 ft.
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Proposed System: Septic tank 1000 gal. ( Minimun size, 1000 gal. )- EXISTING
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 * 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 (5XX5
05/86 and/vl
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Section II Septic System Inspections: ..
A. All applicationd for septic system installation,
• alteration or repair, as reauired by the Town of
Queensbury Sanitary Sewage Ordinance, shall be •
• . submitted to the Buildina 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
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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 theiinstaller 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.
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_loiun o f QueenJbur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME pyr — 0G - Gf2
LOCAT ION e
DATE /25 / t PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length V3(C?
Length of each trench Ce<(
Depth of trenches
Size of gravel
SEEPAGE PITS{Number of) - t
Size- L( ft. X & ft.
Gravel size .4Lt3
PIPING: Size Type
Bldg. to tank
Tank to dist. box
Dist. box to field/ '
Openings sealed? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank ft:4-
Foundation to absorption 92ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION 0 YSTEM ON PROPERTY(circle one)
Front -/ Left side - Right side -
COMMENT
SYSTEM USE APPROVED ,YE NO
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/VI&J2.440
Building Inspector
01/86 and vl
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