1987-425 BUILDING PERMIT
TOWN OF QUEEWSBURY No. 87-425 �
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Ora Bard# *+ I
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CAS .ri�W. Mtn . Rd . N
OWNER of property located at Street, Road or Ave.
in the Town of Queensbury, To Construct or place a �Sewage Alt-o-rntion
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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t. OWNER'S Address is rt
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86 Daton Rd .
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Lake Worth , Fla 33467 w
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2. CONTRACTOR or BUI LDER''S Name
Pro Craft Inc .
3. CONTRACTOR or BUILDER'S Address
t�7
11 Pheasant Walk
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Queensbury , N . Y . 12801
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4. ARCHITECT`S Name
K
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5. A R CH ITE CT'S Address
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6. TYPE of Construction — (Please indicate by X)
( I Wood Frame ( ) Masonry i ) steel 1 1
7. PLANS and Specifications
No_ 1000 gal . tank , seepage pit per plot plan and application .
S. Proposed Use
Sewage alteration cn
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$ 10 . 00
PERMIT FEE PAID — THIS PERMIT EXPIRES
July 8 , 19 89 r~t
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the pot
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town of Queensbury before the expiration data.l rrt
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Dated at the Town of Queensbury this Sth / Day of jJuly _ ,+ 19 87
SIGNED BY �'� - .. .CJ� �/T� ' for the Town of Queensbury
Building and Zoning I nspector
LhlAPPLICATION FOR SEPTIC DISPOSAL PERMIT JUN 2 91987
- f l� '�" o � � BliiLG & 17EPT�-
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LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name,0 ()r a` a c . •• Telephones.�tDS - !
Address: — �1 c. � vim'`+ - c� �`` -� a � \ F,- s a
Installer's Name: l A- Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) -
Topography: circle one: Flat{ Rolling' Steep Slope % of slope _
Soil Nature: circle one:4SandLoam Clay Other / Depth: feet
Ground Water: At what depth? ! feet
Bedrock or Impervious Material: At what depth? _ ' feet
Percolation test: circle one: not required required / rate min, inch.
Domestic water supply: circle one 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
r SEEPAGE PIT(S): Number of �_ / Size each �` _ feet by ZQf feet , �
Size of stone to be used '# '�'� / Depth or Thickness _ feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
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(over)
�� 1 _ fawn o/ Queenitursy
�IY �' F' BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
I• ' J SEPTIC DISPOSAL SYSTEM INSPECTION
NAME C3 rr c13 Ok
LOCATION cis v� r 1+ �. _rL
DATE PERMIT NO
_�_. +�L- -
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -
TYPE of SYSTEM:
Absorption field , total length�l~""�
Length of each -trench �~
Depth of tre
Size of grave]_ —
SEEPAGE PITS4Number
Size- _ 6__ft . X ft-
Gravel size -
PIPING : Size Type
Bldg . to tankcw,� Tv P%J*�
Tank to c3ist . box IpV' r`"' -
twist. box to field/
openings sealed-? YES NO Partial
I.oCATIoN/SEPARATIONS :
Foundation to tank ft.
Foundation to absorption f
Absorption to lot line ft
Separation of pits
LOCATION -€.`_SYSTEM t� PROPERTY (cjrcle one)
Front � Left side - Right side
COMMENTS :
SYSTEM USE APPROVED !18
NOBui ing No
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