1987-385 BUILDING PERMIT y
TOWN OF QUEENSBURY No. 87 385 "o
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Joe Cardinale a
OWNER of property located at CD 0�> Sherman Ave . 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.
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1. OWNER'S Address is n
Box 151 s
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Upper Sherman. Ave . w
Queensbury , N . Y . 12801 0
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2. CONTRACTOR or BUILDER'S Name ro
Sanitary Sewer Service
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3. CONTRACTOR or BUILDERS Address o
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p . a . 224
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Glens Falls , N . Y . 12801
4_ ARCHITECT'S Name 'IC$
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S. ARCHITECT'S Address H
6. TYPE of Construction — (Please indicate by X)
( Woad Frame I ) Masonry I I Steel l }
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7_ PLANS and Specifications ro
No. Distribution Box and 160 ' leach field per plot plan
and application n
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a. Proposed Use r*
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Sewage alteration
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10 . 00 June 23 , 19 89
$ PERMIT FEE PAID — THIS PERMIT EXPIRES ,
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration dateJ
23rd June 19 87
Dater! at the Town of Queensbury this Day of
SIGNED BY ��/a" for the Town of Queensbury
'' Buis Id on�ng lnspee'tor
TOWN 0 _ .
BUILDING anO ZONING DEPARTMENT � �[. ; � I I
Bay 9nd Haviland Road. R.D. 1 Box 98 1
Queensbury, New York 12801 ,J UN 6 1987
{� BUiLEAN604 c C OQL)E. DEPT.
f J SFPTIC DISPOSAL, PERMIT APPLICATION
Owner ' s Name 0 iSJTe1V ■
Address A 42 .44J
Person,/Firm installing seaysterr �
Number of bedrooms ( residential only)
Total daily f low : ( compute @ 150 ual . per bedroom per day) _
Topography : lit - rolling - steels - ( circle one ) Decree of slope
Nature of soils : sand loam-clay- other- Depth ft .
Ground water - at what depth? --- ft .
Bedrock or impervious material- -at what depth? """ ft .
Percolation Test - Nat r +eauirc!d Required -Rate min/'inch .
Domestic Water Supply Well - Other
IMPORTANT !
On a separate piece of paper , submit a diagram of the proposed septic
system with all dimensions ; including . distance from any structure ,
distance from property lines and distances from any domestic water
supply or shore - line of lake , stream , pond or wetlands . Include all
dimensions of the system itself .
Description of proposed system :
Septic tank size GOO gal * I�)C €
Tile field- Lengt0each trench40 ft . Total field /� ka ft .
Size of stone #
Seepage Pit ( s ) Number Size ftX_ ft . Size of stone#
Any contractor , corporation , individual , Etc . , engaged in the
construction of a Sanitary sewage Disposal System , who covers the
same before inspection , does not have an approved Permit , or varies
from the approved application , will be subject to a Penalty of $ 250
as provided for in Section 6 . 010 of the Town of Queensbury Sanitary
ge Ordinance . 1 /� � �1 a
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Signa ure of Applica t Date
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Septic System Inspections :
A . All applicationse for septic systems installation ,
alteration or repair , as required by the Town of
gueensbury Sanitary Sewage . C) rdinance * shall be
submitted to the Buildina Department at least
24 hours before start of construction and ,shall
include a plot plan shoring :
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 , the fields and/or drywell s
Be r:o systems, 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 $ 25 €1 . 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 pr6blems during construction
prevent proper .installation , alteration or
repair of an approved system , a new proposal
must be submitted to the pueensbury Buildina ;
Department before further construction .
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BUiLDiNG and ZONING DEPARTMENT
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Bay and Haviland Road, R. D_ 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME L-'c � C`lY s�'Q�p, c�oc ;r
LOCATION � d? f' /" • C/'hu
DATEC' 7 /.2KI PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total length 11. 0
Length of each trench 40
Depth of trenches - . 3
Size of gravel_
SEEPAGE PITS#Number of )
Size- ft. X _ ft_
Gravel size
PIPING : Size Type
Type
Bldg . to tank A/ ;4
Tank to dist_ box
Dist. box to field/
Openings sealed? Y S NO Partial
LOCATION/SEPARATIONS : ^�
Foundation to tank
Foundation to absorption 7...5 ft .
Absorption to lot line -or fto
Separati f pits ft .
LOCATION YSTEM ON PROPERTY (circle one)
Front - ear Left side - Right side -
COMMENT
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SYSTEM USE APPROVE YES NO
Building Inspec'
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