1987-112 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-112
WARREN COUNTY, NEW YORK E
Edward Baertschi PL
PERMISSION is hereby granted to
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OWNER of property Located at Route 9 Street, Road or Ave.
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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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1 . OWNER'S Address is RD #5
Lake George Road
Queensbury , New York 12801
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2. CONTRACTOR or BUILDER 'S Name Chris Crandall rt
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3_ CONTRACTOR or BUILDER'S Address
RR #1
Lake George , New 'York
4. ARCHMCT'S Name
5, ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
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( ) Wood Frame i ) Masonry f 1 Steel f ? fe
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i. PLANS and Specifications
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4 ' x6 ' seepage pit to replace one damaged by construction r-
per plot and application .
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8, Proposed use
Sewage alt .
$ 10400 PERMIT FEE PAID — THIS PERMIT EXPIRES April 3 19 89 --
(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 3rd Day ooff / April 19 87
SIGNED BY
f ` f ^—` ` for the Town of Queensbury
Building and Zoning Inspector
TOWN
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APPLICATION FOR SEPTIC DISPOSAL PERMIT APR 1 1987
BUILDING BccfG ICE DEFT.
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LOCATION OF PROPERTY FOR INSTALI.ATIC7N .. �
Owner's Name : �7 ,r ,�U�C^pt"/ekz� 11 Telephone
✓:
Address:
Installer's Name: a'�r1 +� L � ` �" Telephone:
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope % of slope _
Soil Nature: circle one* Sand Loam Clay Other / Depth* feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank , gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
EEPAGE PIT(S) : Number of /� / Size each feet by feet
`f Size of stone to be used # / Depth or Thickness feet
IMPORTANT
...Please...LI'SIr NEW EQU PMENT TO BE INSTALLED
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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, the 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 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.
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal ll Ordinance.
Signature of responsible person:Gj�-
Date:
Town of Queensbury
Building and {Code Department
Bay at Haviland Road
Queensbury, New York IZ801
(518) 79Z-583Z
SETTLED 1763 HOME OF NATURAL BEAUTY A GOOD PLACE TO LIVE
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