1987-283 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-289
WARREN COUNTY, NEW YOR K
PERMISSION is hereby granted to Robert LeFebvre o
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OWNER of property located at� Mountainview Lane Street, Road or Ave. 'o'
To Construct o place a Sewage Alteration
in the Town of Queensbury, p f0
at the above location in accordance to application together with plot plans and other information hereto filed and G
approved and in compliance with the Town of Clueensbury Building and Zoning Ordinance. m
i . OWNER'S Address is 9 Mountainview bane
Queensbury , New York 12801
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2. CONTRACTOR or BUILDER'S Name lay Sweet
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Queensbury Sewer N
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3. CONTRACTOR or BUILDER'S Address RD #1 CD'
Lake George , New York £
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4. ARCHITECT'S Name
5. ARCHITECT% Address
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6. TYPE of Construction — (Please indicate by X)
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I Y Wood Frame ( I Masonry 11 Steel ( I rf
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7. PLANS and 'Specifications
No- Dist . Box and 150 ft . leach field per plot and application
S. Proposed Use
Sewage system for dwelling
$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES May 27 t9 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 27th .__Day of May 19 87
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SIGNED BY `'"� ` for the Town of Queensbury
Building and Zoning Inspector
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BUILDING & ZONING DEPARTMENT 5FWAGF DISPOSAL PERMIT APPLICAT N MAY 2 1987
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Address
Telephone No .
2 , Property location
3 . Narnef person or firm responsible for installing system
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Telephone t3O "/l ��"
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Address
4 . Number of bedrooms ( residential buildings only )
5 . Daily flow' -j �" Z gallons,/day
45 Septic tank capacity " gallons
7 . Topography : flat] rolling , steep
$ of slope
Be Nature of soil and depth
9 . If around water , bedrock or impervious material is apparent at what
depth does it 'begin ? ft .
100 Percolation test : A is reauir,ed
B is not required
C if ` required what is the rate minutes/inch
11 . Water supply : it)aniciva , well , other -
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12 . Type of system proposed : drywell , etile field4 other
Any contractor , corporation , individual , etc . engaged Inv the construction
of a sanitary sewage disposal system who covers the same before inspection ,
does not have an approved pes- rnit , or varies from the approved application
will be subject to a penalty of $ 250 as provided for in Section 6 . 010 of the
Queensbury Sanitary Sewage Ordinance .
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Date
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-� sign ture�of applicant,
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions , including distance from any structure , distance from
property line and domestic water supply , etc . include all dimensions 0
the system itself *
Form 3 - 82
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flown o Qeeeen .31"ry y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D_ 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCAT I ON
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DATE SR P� ERMIT NO .
SOIL TYPE - 1 O -Requlired?
- Loam - ClaY -
Percolation YES - NO
percolation rate - Min/Inch ! (V
TYPE of SYSTE4:
Absorption field , total length
Length of each trench_, , nZ 5
Depth of trenches-,Zd 'O
Size of gravel 0a1 2.. _—
SEEPA+Cl1E 'E�ITS#Number of)
Size- 1c�=/ t. X ft .
Gravel size
PIPING : Size 'type
Bldg * to tank scitor
Tank to disc. box oo
Dista box to field/ * "v
Openings sealed? +� NO Partial
LOCATION/SEPARATIONS :
Foundation to tank _ft- � �
Foundation to absorption Z4:5> ft.-e
Absorption to lot line ft.f
Separation of pits 04eft.
LOCATION OF YSTEM ON P R'TY (circle one)
Front - ar - eft ide Right side
COMMENTS :
SYSTEM USE APPROVED NO
Bu ' ding Inspector
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