1986-791 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-791
,A\. 1 \ ARRENCOUNTYINEWYORK
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PERMISSION is hereby granted to Paul Krihak ,tiy
1 Spruce Court
OWNER of property located at p 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is 1 Spruce Court
Queensbury, NY 12801
2. CONTRACTOR or BUILDER'S Name Sanitary Sewer Service b
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3. CONTRACTOR or BUILDER'S Address
P. 0. Box 224
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Glens Falls, NY
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
No. 1000 gallon tank, 150 ft. leach field for washing machine only
per plot and application.
8. Proposed Use
Sewage system for dwelling
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES Nov. 10 1g 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 `10th Day of November 19 86
SIGNED BY for the Town of Queensbury •
hG)l Bunumg"and Zoning I spector igj
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own of Qur ti
� APPLI C T OR SEPT ��;,D ,": ('
BUILDING and ZONING DEPARTMENT 1_. M• -t I
Bay and Haviland Road, R:D. 1 Box 98 '` l
Queensbury; New York 128p1 . - - ;t
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LOCATION OF PROPERTY FOR INSTALLATION o1g60�a a: 1;114161
OWNER'S NAME - �� K, R,.i ii k
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ADDRESS • v ��.��, ( OTT �9,'77''�
/� TEL
INSTALLER' S NAME C\ ilfj / 'ylc ����� . .
��� (/'fir=�. T E L`7C,, ` 70�-
Number of -bedrooms(residential only) - •
/,�
Total daily flow(compute @ 150 gal per bedroom) �i� =f�, //L/C) , 44411/lc.C- 0- -
Topography: Flat Rolling - Steep slope -.(circle one) % of sge
Soil nature Sand - Loam - Clay - Other Depth _ ft.
Ground' water -At what depth? ft.
Bed-rock or impervious material - At what depth? ft.
Percolation test - Not required - Required - -Rate min-inch.
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Domestic water supply - unicipal Well - Other
Separation - Watersupply(if well) from Septic absorption ft.
Proposed System: Septic tank -"NO gal. ( •Minimun size, .1000 gal. )
Tile Field - Each trench <5-0 ft. Total system legnth (S U ft.
Seepage pit( s) Number of . Size each — ft X ' ft
Size of stone to be used r " L'L 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,pon.d or wet-lands . I,nclude all dimensions of
the system, itself. -
• * * * * * .* * * * * * * *• * *- * * * * * * * * * * * * * * * * * * * * * *
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
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Signature of responsible person ' Oj AAL /1/kj/6Z
/ 0U6 1.64 • (-or G)ash( ) Yn
05/86 and/vl ��(j �� l '(•� . U S /y
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Section :II Septic System Inspectionsz
A. All applications for septid system installation,
alteration or repair, as required by the Town of
Oueensbury 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
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 ,lnstaller 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 Oueensbury Building
Department before further construction.
51((r,1--C /02 ,l'O°
_Down of Queen.i ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPIC DISPOSSAL SYSTEM INSPECTION
NAME il ' -1L
LOCATION / ..Cp(Li�'e Loc�r /—
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DATE i(//7T ��p !PERMIT NO. ? C. - 1 i I
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length /O
Length of each trench ,S 0'
Depth of trenches
Size of gravel 'F
SEEPAGE PITS-Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank tO't ^ � p
Tank to dist. box
Dist. box to field • '
Openings sealed? NO Partial
LOCATION/SEPARATIONS:
Foundation to tank /3 ft.
Foundation to absorption " j ft.
Absorption to lot line is ft,.
Separation of pits ft.
LOCATION ! YSTEM ON PROPERTY(circle one)
Front 0
Left side - Right side -
COMMENT
SYSTEM USE APPROVED YES NO
‘0113
Building Inspector
01/86 and vl
SANITARY SEWER SERVICE -
• UZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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