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1987-167
BUILDING PERMIT TOWN OF QU EENSBU RY No. g,_167 WARREN COUNTY . NEW YOIRK peter partridge PERMISSION is hereby granted to i f2! _ Sweet Road Street, Reed or Ave. � L i.3 '� H OWNER of Property located at Sewage AlteraCion To Construct or place a w in the Town of Queenslaury, lot plans and other information hereto filed an a application together with p w at the above location in accordance to Building and Zoning Ordinance, m approved and in compliance with the Town of Queensburydd 1 . QW 55 Sweet Road NER'S Address is Quee,rtsbury , dy 12$01 tr same 2. COfiTRACTOR or BU1L13ER'S Namero v E rt r Y r 3. CONTRACTOR or BUILDER 'S Address same [ G S 4. ARCHITECT'S Name S. ARCHITECT'S Address 6, TYPE of Construction — (Please indicate by }[} ( I wood Frame [ } masonry [ I Steel [ I 128 ft . leach field per plot and application 7. PLANS and Specifiarrions No. S. Proposed Use Sewage system for dwelling ,April 16 19 89 $ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES sk be made to tfie Building and Zoning inspector of the (if a longer period is required an application for an extension mu town of Oueansburif before tfie expiration date.) 8 this 16th Day of April tip.-- -� Dated at the Town of Oueensbury eI' for the Town of [3ueensbury SIGNED BY Building and Zoning Inspector QWN OF QUE,Ei i oi 3ur Y Ul:! E APR 16 1987 / APPLICATION FOR SEPTIC DISPOSAL PERMIT f d � BUILDING a c:(DLj Ep-r D ATE LOCATION OF PROPERTY FOR INSTALLATION Owner's Name:: ,kf3 % � Telephone: Address: Installer's Name: _ Telephone: Number of bedrooms (residential only) Total daily- flow (compute @ 150 gal per bedroom) Topography_ circle one: Flat Rolling { Steep S� % of slope Soil Nattuex circle one: Sand Loam lay Other / Depth: feet Ground Water: At what depth? _ /d - /0� feet Bedrock or Impervious Materrial: At what depth? feet Percolation test: circle one: not require required f rate min. inch. Domestic water supply circle one: Municip 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.) / f TILE FIELD: Each Trench feet f Total system length feet SEEPAGE PIT(S) : Number of / Size each feet by feet Size of stone to be used # �' f Depth or Thickness os' '" feet cep I M P O R T A N T _..Plea.se.._LISST NEW EQUIPMENT TO BE INSTA1-T-KI3 (over) 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 structyres 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. Ce 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 vegxdations above and agree to abide by these and all requirements of the 'Town of Queenabury Sanitary Sewage Disposal O rdi: aance. Signature of responsible person: Date: - /'L 00W 7 Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HOME OF NATURAL BEAUTY A GOOD PLACE TO LIVE _lows nrceenyburF 13UILOING and ZONING DEPARTMENT Bay and Naviland Road, R.D. 1 50)( 98 aueensbury, New SEPTIC DISPOSAL SYSTEM INSPECTION ays NaME T"-c,r G1 r v 1 %I Q- LOCATION S DATE R Z /� 7 PERMIT NO . 0 "7i Jr C° �i SOIL TYPE Sand. - Loam - �ClaEs- �--- percolation Test Recce ax ed . - NO percolation rate - Min/Inch TYPE of SYSTEM= total gth AbSorp 3©n field r 100 Length of each trenchell Depth of trenches Size of gravel SEEpAGE pITS4Nu'mber £t) Size- If to x Gravel size Size Type pIPING -Bldg Im to tank Tank, to d i st _ box Dist, box to f ield/ Openings sealed? YES NO partial LOCATION/°SEFApATIONS s fto ,p•oundation to tank t3on If to foundation to absorp ' ft. 11 Absorption to lot line eft. Separation of pits ON pg SYSTEM ON PROPiRTY (circle one rant - Rear - Left side - z g t side cct4 I3TS /k4 /✓ � � I 1 SYSTEM USE App ID ES NO gui cling Inspector 01185 and vl 4xi/see 0Ti NOS i e ` I f lee f