1987-481 BUILDING PERMIT
TOWN OF QUEENSBUR''Y' No. 87_481 �
f� Q WARREN COUNTY, NEW YOrR K o
318
PERMISSION is hereby granted to A . Brad Frank Q,
OWNER of property located at Olen Lake & Birch Road if &r-G� " ' Street, Road or Ave. w
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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 Lin
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
RR # 1 Sox 1783
Lake George , N . Y . 12845 ]°
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2_ CONTRACTOR or SUI LOE R S Name PA
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3. CONTRACTOR or SUI LDER"5 Address
4. ARCHITECT'S Name
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5_ ARCHITECT'S Address t-
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6. TYPE of Construction — (Please indicate by x}
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( } Wood Frame f I Masonry i } Steel 1 I ::r
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7. PLANS and Specifications
No. Repairs to septic system per application .
B. Proposed Use
Sewage alteration
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$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES July 24 yg 89 ti
{If a longer period is required an application for an extension must be made to the B u i Wing and Zoning inspector of the
town of Queensbury before the expiration date.}
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Dated at the Town of Queensbury this 24th^ pay ofr'� f my 19 87
SIGNED BY G- or the Town of Queensbury
Building and Zoning I nspector
� �'IF�/6► TOWN OF tij 'Gt_iY�L _.
*20ft 6f
r MAY I U 1981
APPLICATION FOR SEPTIC DISPOSAL PERMIT BUILDING $r CODE DEFT.
"I DATE
LOCATION OF PROPERTY FOR INSTALLATION G 1 e r1 L 4 k F $` I. 0- 11
Owner's Name:: — ji - 1 CA � E /�� Telephone: � �� � � Gj 23
Address:
Installer's Name: Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Roiling Steep Slope % of slope
Soil Naturee, circle one: Sand Loam 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: Municipal 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.) !'r
TILE FIELD: Each Trench feet / Total system length fee I I P I
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SEEPAGE PIT(S) : Number of / Size each feet by feet Rp�
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Size of stone to be used # / Depth or Thickness feet V
I M P O R T A N T
...Please...LIST NEW EQUIPMENT TO BE IN57ALI
(over)
_lawn ofu �,ens � seray
DEPARTIJSENT
BUtLOING and ZONING
Bay and kiavilanci Road . R .G. 1 Sox 98
►.few York 12901
()ueensburY .
SEPTI DIS OSAL
YST INSPECTION
y�r
LOCATION
PERMIT NO .
DATE _
- Sand - Loam - Clay -yO
SOIL TYPE fired? yE5
Percolation Test Required?
inch
Percolation rate - Min/ -
TYPE of SYSTEM total length
Absorption field ,
Length of each tx'encl'
Depth of trenches
Size of gravel
SEEPAGE PITS-(Numbe7r of)
ft. x ft .
Size- --- Type
Gravel size Size
PIPING;
Bldg * to tank
Tank to d1st • box _-------
DistIII, box to field/pit KO partial
Openings sealed? YES
LOCATION/SEPA'RATION5 = ft.
Foundation to tank
Foundation to absorption t .
Absorption to lot line
ON PROPERTY (circle one
Separatican of ATE
LOCATION OF SYSTEM side - Right side -
Front - Rear Left
CCMMENTS
SYSTF14 USE APPROZ* YES
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Building ns
ector
Ol /BE' and vl
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, FI, D. 1 Box 98
t Queensbury, New 'York 12801
SEPTI DISPO L YSTEM INSPECTION
NAME b �
L.00AT I ON r G .^
DATE Z I PERMIT NO .
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 PIT'S4Number of)
Size- ft. X _ ft-
Gravel size -
PIPING : Size Type
Bldg . to tank - --
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS :
Foundation to tank f't *
Foundation to absorption ft .
Absorption to lot line ft .
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front - Rear -- Left side - Right side -
CCMMEN T S
CU� �
SYSTEM USE APPROVED YE NO
BuilSingg Spector
01/86 and vl