1986-789 - BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-789
(2)(A (k WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Thomas Rabine
OWNER of property located at 8 Bullard Avenue = Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration 0
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 8 Bullard Ave.
Queensbury, NY 12801
2. CONTRACTOR or BUI LDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
P.O. Box 224 ao
Glens Falls, NY td
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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 ( )Steel ( )
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7. PLANS and Specifications S
No. 1000 gallon tank and 2 8'x8' seepage pits per plot and application
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8. Proposed Use rt
Sewage system for dwelling
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Noc. 10 1988
(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 10 th Day of Nov. 19 86
SIGNED BY G 4.4AtttALA, for the Town of Queensbury
Building and Zoni6g Inspecto
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. TJown o� QuQenilury APPLI +! 1N FOR SEPT.IT° ' ;
'BUieDING and ZONING DEPARTMENT • ' �„ I V L.
Bay and Haviland Road, R.D. 1 Box 98
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aueensbury, Npw York 12801 •-,!� • - r
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LOCATION OF PROPERTYFOR INSTALLATION - 4 I ] n � ?s�1°+ �IVIMj�19
B,} l�7 C a a a
OWNER'S NAME -I-4 /604,4 ...
ADDRESS x i)1 %T7f!_ L`
,J TEL
I72-4,-
NSTALLER' S NAME 4:41 ��] r -
�1 (nwic-c , TEL 77) -
Number of bedrooms (residential only) `D
41
Total daily flow(compute @ 150 gal per bedroom) 5- •
3
Topography: �lat)= Rolling - Steep slope - (circle one) % of slope
Soil nature: ' and' - Loam - Clay - Other Depth f t.
Ground' water -At what depth? .L— ft.
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Bed-rock or impervious material - At what depth? ft.
Percolation test Not required - Required - -Rate min-inch.
Domestic water supply -`Municipal - Well - Other
Separation T. Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank %O O Q gal. ( Minimun size, 10,00 gal. )
Tile Field - Each trench ft. Total system legnth ft.
Seepage pit(s) Number of , 2- . Size each (p ft X d- ft
(P) :)
Size of stone to be used # Depth or thickness ft.
* * * * * * * * * * * * * * * * '* * * * * * * * * * * * * * * * * i* * * *
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 siie t and agree
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to abide by these and all requirements ' of The Town of Queensbury
Sanitary Sewage Disposal Ordinance.
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Signature of responsible person I 2 1 17)
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05/86 and/vl c $ f left
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 Bui.ldina Department at least
24 hours before start of construction and shall
include a plot plan showing:
1) the proposed location Af 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.
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.
_Jouin of 2ueenJur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME p ._ y
LOCATION y py. , , ai.,,,
DATE ,94'a / PERMIT NO. y 4 - 7 8 9
SOIL TYPE Sa - Loam - Clay -
Percolation est Required? YES - NO
Percolation rate - Min/Inch _ Cr,) - 5-
TYPE of SYSTEM:
Absorption field, total length
Length of each trench ---
Depth of trenches
Size of gravel_
SEEPAGE PITS{Numb/g r of)
Size- (0 ft. X `b ft.
Gravel size it 3
PIPING: Size Type
Bldg. to tank t/e/' 4V
Tank to dist. box
Dist. box to field/ '
Openings sealed? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank �0 ft.
Foundation to absorption 3,cft.
Absorption to lot line ' ft.
Separation of pits ,eft.
LOCATIO • YSTEM ON PROPERTY(circle one)
Front - - Left side - Right side -
COMMENT- .
SYSTEM USE APPROVED YES
Building Inspector
01/86 and vl
SANITARY SEWER SERVICE
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LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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