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1987-265 BUILDING PERMIT TOWN OF QUEENSBURY Na. 87- z6s WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Mark Sager x OWNER of property located at ` ' Naey Road , Glen Lake Street, Road or Ave. m in the Town of Oueensbury, To Construct or place a Sewage Alteration �t 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. t . OWNER'S Address is RD #1 Lake George , New York 12845 2. CONTRACTOR or 8UI LDE R'S Name n Rick McGuire �y 0 w r1. 3. CONTRACTOR or BUILDER"S Address RD #1 Glens falls , New York 4. ARCHITECT'S Name 5. ARCHITECT'S Address trx f0 6, TYPE of Construction — (Please indicate by X) W ( 1 Wood Frame I } Masonry I 1 Steel ( i m a w rr 7. PLANS and Specifications f0 �t 1000 gallon tank, pump chamber , 1 / 2 horse pump alarm systemrt No. and 1 8 ' xlO ' seepage pit per plot and application H. d 8. Proposed Use Sewage system for dwelling $ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES May 18th 19 89 (If a longer period is required an application for an extertrion 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 18th Day ofp May 19 87 SIGNED BY ' " for the Town of Queensbury Building and Zoning Inspector APPLICATION FOR SEPTIC DISPOSAL FERMI � U 7 MAR 2 3 1987 eufLC]�1NG a a C, C7D� �DEypT.� DATE ^ LOCATION OF PROPERTY FOR INSTALLATION _E[_ Owner's Name: Telephone: U * Address: Installer's Name: IC t c �C /Y C 6 Ve , Q < < Telephone: S� �i /� Number of bedrooms (residential only) c7{ Total daily flow (compute @ 150 gal per bedroom) �Q TopogXraphy: circle one: Flat Rolling Steep Slo ems:- %n of slope Soil Nature: circle one: Sand Loam Clay Other / Depth: feet �.� /f Cwound Water: At what depth? feet ,.-� �'" rr Bedrock or Impervious Material: At what depth? _ feet Percolation test: circle one: no=requir::e:d ) required / rate min. inch. Domestic water supply: circle one: Municipal Weil Other _ IF domestic water supply is a Well: r 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) : Number of _ / / Size each feet by feet Size of stone to be used # / Depth or Thickness " feet IMPORTANIT ...PIease***ISST NEW EQUIPMENT TO BE INSTALLED goo (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 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. Sbouid 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 regiurexnents of the Town of Queensbury Sanitary Sewragee D—is—posal. Ordinance. Signature of responsible person: ]/ --- ' "t Date. L�3 " Town of Queensbury* Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLED 1763 . . . HOME 0F NATURAL BEAUTY . . A GOOD. PLACE TO LIVE suyp� reyeRr� BIItLC3ifi1G andG�yi{.jCa gox 98 Bay and Ha�iland Road, Rfl� G2ueensburY , New YorK 128d SEP-IIC DISPOSAL- Sy5TFM INSPECTiGIS`1 SAGSE Eoaae Glen S'2lce I3 acy Co LQGAT IOty Cl aY Sana - -Laoasn 130 SOSL 'i'YPE Test Re ixed� YES rcolation tAin/Xnch Fercolati-O rate PE of SY STEM d e al 3, TY .�- pbso t'n eac encb 9i�h t CbeS De of ze of ravel er of) onk= _ ._-- TS-(Igluvb - SEEP AGE l f ' y, g�f t' — Size- I two YP Gravel 5rze . -�� - -- S g3,K%" 41% pvo P-LP IIIG to tanK -- - s--- alue �t7 [i7L5t • box Tanvu DiSt� o 'box e % 7g /F'Y �p part opening s sealed-' E ls DpCs,+T7t7L1IsEP'ATC5135 1-0 _f t - bus to lr. t . Fousarlat3-on to abso won ��Q- +- . ]C1 �t- pouxlaation of ine ---�-� t- ti on 4to 1 (cir a one? AbsoxP of lei 51, °+ d ` e Separation ?CIPLTrx013 �ee�i C e -Front _ have access for seise C�E13TS � �,ust RUM p Gba ,her ass'l - ire d- of pip/fJoa+. yication - r �'be filed tin aI'p Electrical ings of System inclu LrL . pump Specs - incl'}3� n9 `` all ,�r,its of system. lacatio lift, e c cti arX'i n�3 to Y't owner is ca ©ned pdert suxface hei�3 Proper't raain9 (soil exosion a+n final `3 off - water xun D E NO SYSTEM usvE ppPR� 7E Bui1+3 in9 n ector olJsrC> ma vl - �u f7olR+It a t30ILDING and 7'0"NG DE o . 113ox 98 Bay and Ha. Road, . and Ha. b�rY New York 12801 SEPTIC f7I5P0l'SAL SYSTUA It4SP'E.CT ION t,1Ps"1E_ LOCRT I ON -�, PERMIT _-- " PEIT pAT£ •�-' `_ � clay E - Sand - Loam YES _ 140 SOxL TYP Test R,equrxed - percolation rate - Min/Inch percolation TYPE of SYSTEMS iength� f field , SPIRd AbsoxPt3LOn each tYr pf each Len9 ches Depth of grayed:_ ---' 5iz PSTS (114 er of) SEEPAGEft. Xf' 4 - Size- T pe Gravel size Size Bldg . to tat . bolt t4 rj.15 Tank boX to field/P1t Partial Dist . YES NO �1eni.ngs Sealed . LOCPTION/SEPARATI[3L35 = foundation to tanK t/ Lion to absorptia -- Founds to lot line Absorption one) Separation of STE2 CO PROPER {circle LOCp.TIOt3 OF 5Y5'TEM side Right side Front - Rear - Lef t CCMMEN'TSi =� Wo PV A4 Y NO SYSTEM USE APPRQVELI L.., wL ng TnspeC or O1/$ r' mcl vl �w _lawn a� �espens� ure� BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISP©SSAAL` SYSTEM INSPECTION NAME LOCAT I DATE ;&f/ `t'} PERMIT NO 62 SOIL TYPE - Sand - Loam - Clay _ Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM.: Absorption field , total length Length of each trench Depth of trenches Size of gravel_ SEEPAGE PITS-(Number of) Size- ftw X ft. Gravel size # PIPING : Size Type Bldg . to to�F __� E y c Tank to c93 .ut?p�triWa�Iiq'y13&X A 4p [J C Distw box to f /pit 2: a� PVG Openings sealed? ES NO Partial LOCATION/SEP^ARATIONS : Foundation to tank ��fto+ - Foundation to absorption __ oft .-+ - Absorption to lot line c7 ft-~1r Separation of pits --� f--�--^ LOCATION OF SYSTEM ON PROPERTY (circle one) ron - Rear - Left side - Right side rCt4MENT :57 fc !"� f laoli;- � � rzC CeaV � u'Lc � oo • AJO w I Jl3 - /*C C S S T''co Pu +, .t Ia ;c►;� R N S e 6c-"O AJ'- SYSTEM USE APPROVED YEg, NO Bulding Tns i pe tar 01/86 and vl ?__c3 lot' .r bv 11 ► D c.� � €� _ - - - - - f C3]b fS._aF_ QLJF-E.s UT 1 � - uu_ 1987 MAR 2 :� - BUILDING & cODE