1987-282 BUILDING PERMIT
TOWN OF QUEENSBURY
No. $?-2$2 WARREN COUNTY, NEW �rar� K - -
PERMISSION is hereby granted to Ben Faggiano
OWNER of property located at 1 Leo St • Street, Roar! 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.
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OWNER'S Address is Ih
Leo St .
Queensbury , New York 12801
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CONTRACTOR or BUI LVER'S Name
Sanitary Sewer Service
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3. CONTRACTOR or BUILDER 'S Address T
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P . 0 . Box 224 .*
Glens Falls , New York
4. ARCHITECT'S Name
S. ARCHITECT'S Address
S. TYPE of Construction — (Please indicate by XI
l wood Frame i ) Masonry ( ) Steal { J
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7. PLANS and Specifications
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6 hole dist . box and 2 6 ' x8 ' seepage its {D
No, g ` per Blot and applicatio
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B. Proposed Use rn
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Sewage system for dwelling
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES May 27 yg 89
(If a longer period is required an application for an extension must be made to the Suilding 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
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
TOWN OF
APPI IGATION FOR SEPTIC DISPOSAL PERMIT L i Lt MAY 1 A 1,4,8.E 'J
,r .sEPT.
DATE f 3 `Sf
LOCATION OF PROPERTY FOR INSTALLAT10N
Owner's Name : Be ry a1z Zrh''iI+ VW Telephone: 73 ye/0 --
Address:
Installer's Name* �L�L � L �- Telephone:
Number of bedrooms (residential only) _
Total daily flow (compute C& 150 gal per bedroom)
Topography: circle one Fla Rolling Steep Slope % of slope _
Soil Nature: circle one San Loam Clay Other / Depth: feet
Ground 'Water: At what depth? feet
Bedrock or Impervious Material: At what depth? i � - feet
Percolation test: circle one not require required / rate min. inch.
Domestic water supply: circle on< unicipal 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
SEEPAGE PIT(S) : Plumber of Size each feet by feet
Size of stone to be used # _ / Depth or Thickness �_ feet
IMPORTANT
_..Please...XAST NEW EQUIPMENT TO BE INSTAIX4E l
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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, 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.
Co 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 Msposal Ordinance.
Signature of responsible person: r'"`
Date: F
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
c3u.n of
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Sax 96
Queensbury. New York 12801
SEPTIC DISPOSAL. SYSTEM INSPECTION
LOCATION
DATE J#/
1EIzMIT
is?tRequired?
Loam - Clay - -
Perc TYPE
Percolation
YES I3t]
Percolation rate - Min/Inch -
TYPE of SYSTEM: total length
Absorption f field ,
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS-(Numb f)
Size- ^ft. 'X _ .
Gravel size Size TYPe
PIPING
Bldg * to tank [1e [
Tank to dist. box -- +---�
Dist. box to field/ i` Partia al
openings sealed? E
NO
LOCATION/SEPARATIONS f t.
Foundation to tank ��ft .
Foundation to absorption
Absorption to lot line Wft.
Separation of pits rcle one)
LOCATION OF SYSTEM ON PROPERTY (ci
Front - Rear - Left side -- Right side -
CpEy1KENTSa4l
fruz,
SYSTEM USE APPROVED ES NO
Building Inspector
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