1987-448 BUILDING PERMIT �
TOWN OF QUEENSBURY $ 7-448 �
No.
WARREN COUNTY, NEW YORK
Sue Doyle c,
PERMISSION is hereby granted to 1
! it iC or .
OWNER of property located at 45 -Myn*r4"&. �`: Street, Road or Ave.
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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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
t. OWNER'S Address is Cn
45 Hendricks Dr . p
Queensbury , N . Y , 12801 ry
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2. CONTRACTOR or gUl LDE R'S Name
m
Morning Star Excavating
3. CONTRACTOR or BUILDER 'S Address
Frank Shaw
Route 32
Gansevoort , N . Y . 12831
4. ARCHITECT'S Name
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5. ARCHITECT'S Address fD
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G. TYPE of Construction — (Please indicate by X) t7
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i 1 Wood Frame ( 1 Masonry ( I 'Steel
T. PLANS and Specifications
No. Seepage pits ( 2) each 6 ' x 8 ' per plot plan and application .
S. Proposed Use
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Sewage alteration M
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40
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10000 July 14 , 89
THIS PERMIT EXPIRES 19 m
(If a longer is required an a h
ng period q application for an extension must be made to the Building and Toning inspector of the �
town of Gueensbury before the expiration date.) '*
O
Dated at the Town of Queensbury this 14th Day of���j July 19 87
SIGNED BY Q� 4<, for the Town of Queensbury
Building and Zoning Inspector lfir/�'
�� if aesw&oy
APPLICATION FOR SEPTIC DISPOSAL PERMIT TOWN OF
� � D J , W! € P
b JUL 14 7981
DATE / BUILDING & Cu. ir. oE:p ^
LOCATION OF PROPERT�-Y^� FOR INSTALLATION
Owner's Name. _, Telephone:
Address: ,
Installer's Name: � � Telephone:
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: i `` Rolling Steep Slope �'u of slope
Soil Nature: circle one: an 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: uniccipa1 Well Other
IF domestic water supply is a �Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank V�D_ gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of ��_ / Size each 6 feet by feet
Size of stone to be used # 3 / Depth or Thickness ' feet
IMPORTANT
...Plea se...LIST NEW EQUIPMENT TO BE INSTALLED
(over)
4 _./ourn of Quee" Jiury
i BL,IILDING and ZONING DEPARTMENT
` � Bay and Haviland 'Road. R.D. 1 'Box 98
csl'�' Oueensbury, New York 12801
I `
SEPTIC DISPOSAL SYST INSPECTION
r� LOCAATI �
/rJ �rALf PERMIT NO.
SOIL TYPE a Lcaam - clay
Percolation est Required? YES
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total length
Length of each trench
,. Depth of... trenches.'
Size of gravel Of
SEEPAGE PITS4Numbe ft&
size.. t x
Gravel size Size Type
PIPING :
Bldg , to tank
Tank to dirt- box Open box ea fiels7E
Partial
Openings sealed?
IMAT2ON/SEPARATIONS : f t.
Foundation to tank
Foundation to absorPtion 4f
f
Absorption to lot line ft.
Separation of Pits
Cp,.p= YSTEM ON FROPERTY (circle one)
Front Re - Left side - Right side -
CC7MMENT
V
SYSTEM USE AppgOVED YE NO
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Building Inspector
01/86 and VI
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