1988-123 BUILDING PERMIT
TOWN OF QUEENSBURY No. 88-123
WARREN COUNTY, NEW YORK
(30")\ • \ 59
PERMISSION is hereby granted to John Howland
OWNER of property located at 112 Coolidge 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.
1. OWNER'S Address is Same
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2. CONTRACTOR or BUILDER'S Name 0
Rollin Graves
a.
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address O
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a.
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( 1
7. PLANS and Specifications
No. Existing 1000 gal septic tank, new distribution box, 2 8' x 10'
cn
seepage pit.
8. Proposed Use sv
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Sewage Alteration
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 8 19 90 H.
(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 8th Day of April 19 88
SIGNED BY 7 2 - - 2. � /�— for the Town of Queensbury
Building and Zoning Inspector A
TOWN OF QUEENE3
alien- Of Clitteakektilv/
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APPLICATION FOR SEPTIC DISPOSAL PERMIT
I APR 5 1988
BUILDING & CODE DEPT.
d I 0 9 rL-t �.4 I D
aDATE L� es
LOCATION OF PROPERTY FOR INSTALLATION I I C DOL r dG e Aki- •
Owner's Name: JD I1,i !-I ) Lj,4c1 Telephone: -2 c 3 - 3 (,-7 5
Address: / f p2_ (.D()Li ci 'e live • 0 v•2 S i it .
Installer's Name: f?O f(1/.1 (ri VPS Telephone: (039 7�(0
Number of bedrooms (residential only) _ T
1
Total daily flow (compute @ 150 gal per bedroom) _ 6 d C7 3J Ai S,
Topography: circle one: Flat Collin;)Steep Slope % of slope
Soil Nature: circle one: and Loam Clay Other / Depth: feet
Ground Water: At what depth? 13 Plus feet
Bedrock or Impervious Material: At what depth? hN f A feet
Percolation test: circle one: not required required / rates S min. inch.
Domestic water supply: circle one: Municipal Well Other 1-6 {r, r
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank ! 000_ gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length _ feet
SEEPAGE PIT(S): Number of / Size each /0 feet by SI feet
Size of stone to be used # 7 / Depth or Thickness feet
* * * * * * * * x ; * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please.®.LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * *
Ek( --i v6 - 1000 1P7--1z-TA ,
l�( -r. Igo K
9-- X io PJ46 4 )9,r�
(over)
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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.
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. 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 Disposal Ordinance.
Signature of responsible person: a � ,�..�-'6
Date: `/ q- „Ci
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
`) 176" '-'QME OF NATURAL. -r%,UTY . r-PLAr- -
J.) 1/2 awn of Queenitury •
�30 BUILDING and ZONING DEPARTMENT
tom° Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSALL SYSTEM INSPECTION
NAME 94-4/ 50-6c.-- —e.
LOCATION //
DATE y-// /Oa PERMIT NO. iif--/g3 /
SOIL TYPE - an - Loam - Clay -
Percolation Test Required? YES NO
Percolation rate - Min/Inch
TYPE of SYST: : •
Absorption field, total 1: gth
Length of eac, trench
Depth of tren es
Size of gravel
SEEPAGE PITS-(N •er v.f)
Size- g ft. X eft.
Gravel size . . 3
PIPING: Size Type
Bldg. to tank
Tank to dist. b•x •
Dist. box to f. eld/p,t X-C 4!3
Openings sealvd? Y ' NO Partial
LOCATION/SE•ARATIONS:
Foundation o tank ft.
Foundation to absorption ft.
Absorptio.: to lot line ft.
Separati• of pits ft.
•
LOCATION OF SYSTEM ON PROPER (circle one)
ront -ear - Left side - Ri• t side -
COMMENT .:
SYSTEM USE APPROVE YES NO
Building Inspector
01/86 and vl
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