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1987-559 BUILDING PERMIT
TOWN OF QUEENSBURY No 87-559 �
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Louise & Agustus McKasty ,J
w
�J Reardon Rd , r!,
OWNER of property located at [3 Street, Road or Ave. N
in the Town of Queensbury, To Construct or place a Sewage Al terat ion
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_
i. OWNER'S Address is
Reardon Road
Queensbury , N . Y . 12801 r
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2. CONTRACTOR or BUI LDER'S Name ri
a.
Frank Shaw
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3. CONTRACTOR or BUILDER 'S Address r*
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4. ARCHITECT'S Name
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5. ARCHITECTS Address
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6. TYPE of Construction — (Please indicate by X) Iv
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11 Wood Frame 1 ) masonry ( 1 steel 1 1 0
Pd
7. PLANS and Specifications
No Existing septic tank - 1 seepage pit $ r x 81
8. Proposed Use cn
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Sewage alteration to camp �
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10000 August 24 89 ro
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fIf 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 , y2,4tth,, Day of August .Ig 87
SIGNED BY / _ze 4.0::�e2 X far the Town of Queensbury
Building and Zoning Inspector �,,!
%AYOUFM J(QeZW&t0P
APPLICATION FOR SEPTIC DISPOSAL FERMI
y8UIL DING & coo DE PT
�C%',
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ass �C.Ve o + 5 �S l�Yy1,� 1�F1ST '�/� Telephone:
Address: � .qrL D D +� t� +"�+�1 i1 - a�+u grm f-,05 M61..U�
Tele hone:
Installers Name. 2q t�3 1L Cs e-'y .q #.i -1 P
Number of bedrooms (residential only) _ 7L
Total daily flow (compute @ 150 gal per bedroom) "3Qe
Topography: circle one: Flat as Steep Slope % of slope
Soil Nature: circle onee. an Loam Clay Other / 'Depth: feet
Ground Water: At what depth? `gym feet
Bedrsock or Impervious Material: At what depth? _ 4 feet
Percolation test: circle one not require required / rate min. {inch.
Domestic Water supply: circle one: unicipal ei Other Fzp t - jns V%A o t-) �*-y
IF domestic water supply is a Well: '1
Separation: Watersupply from Septic absorption _ ( p 4c� feet
PROPOSED SYSTEM: Septic Tank E*1 Sc gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
f
SEEPAGE PIT(S) : Number of _ _ / Size each � feet by jf2 feet
Size of stone to be used #� / Depth or Thickness _ � feet
I M P O R T A N T
...Please...LIST NEW EQUIPMENT TO BE INSTAL11
(over)
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 Chrd rta ce.
Signature of responsible perso
Dater
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE
E own 01 Queer i "rsy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road. R .D. I Box 98
Queensbury, New York 12801
SEPTI
C
D I SP SAL SYSTEM INSPECTION
NW�M1E � l
DA'3C_ J�7 +�_� PERMJT NO ., I
SCILT�' _
TY
PE 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
SEEPAGES4Numlkf of)
Size- L.
ft. x ��� ftl-
Gravel size _ IPIja�r t
PIPING : Size TYIHe
Bldg . to tank
Tank to disc , box
Dist. box to field/ L
Openings sealed? YES NO Partial
LOCATION/SEP�AFATI -S I Vto
Foundation to tank t-
Foundation to absorption
Absorption to lot line : ft ,
Separation of pits ft.
LOCATI(7i3 ySTEM ON PROPERTY (circle one)
Front - Rear - Left side - Right side -
CCHMENT
Pp
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SYSTEM USE AI'PR()VED EIS NO
Ins pecBui i g tor
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