1988-290 BUILDING PERMIT
TOWN OF • QUEENSBURY
No. 88-290
WARREN COUNTY, NEW YORK
IA 0
PERMISSION is hereby granted to Mark & Marcy Bombard c,
OWNER of property located 104'f Ridge Road 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
P.O. Box 130
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Kattskill Bay, N.Y. 12845 0
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2. CONTRACTOR or BUILDER'S Name
Russell Smith
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( I Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications �•
No. 1000 gal. tank, 200' tile field as per plot plan and
application.
8. Proposed Use
Sewage Alteration
10.00 May I 90
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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 his 26th Day of May 19 88
SIGNED BY �� for the Town of Queensbury
Building and Zoni g Inspector
i • '‘\-° of Qua ._'- 7 j
APPLICATION FOR SEPTIC DISPOSAL PERMIT • MAY° 251988
J ✓\� BUILDING & CODE DEPT.
A Pr
DATE Mat.1 25 / 19 85 DAT
[ONlt ODES DEPL
LOCATION OF PROPERTY FOR INSTALLATION TOWN OF QUEENSBURY
Owner's Name: i-iar(, ri Morey n rY;ba Telephone: _ (.0,5(,-A(073
Address: p, I,0 Ka-l-ts k;II Icy 12845
Installer's Name: 'RuSsn I1 S thLth Telephone: !per- 3575
Number of bedrooms (residential only) _ 3 _
Total daily flow (compute @ 150 gal per bedroom) 450
Topography: circle one: ® Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam. Clay Other / Depth: 5 feet t
Ground Water: At what depth? t 5 feet
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Bedrock or Impervious Material: At what depth? _ + � feet
Percolation test: circle one: not required required / ate 4 OCo min. inch.
Domestic water supply: circle one:. Municipal ell Other
IF domestic water supply is a Well: -�
Separation: Watersupply from Septic absorption //5 — feet
PROPOSED SYSTEM: Septic Tank /DoC gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 50 feet / Total system length 20c0. feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # a / Depth or Thickness _. feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * *. * *.** * * * * * * * * * * * * * *
(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 Disposal Ordinance.
Signature of responsible person:
Date: .5/25/gam
Town of Queensbury
Building and Code Department •
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
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A• �4 LAND
•CONSULTANTS• ��
Stone Schoolhouse Lane OASSOCUTIN
Lake George.N.Y.12845 i
Telephone:(518)668-4676
Dennis L.Dickinson.P.E./L.S.
PeEcdQhon Test
Town Qpcensbor y
Oaf 24, 1987
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Used Reference
fi14y Poi
Jern� R and Kez iQ W Howe
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Mar-f' W. a nd Marcy H. f�)ornkord
doled(: 16 J-o nu o ry I �88
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Map Reference
Map of o surv(f y o� lands cf'
S(frry and Kez(o Howe-
dafed *' I May CD87
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or Q surrey ok lands off'
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Town of�' Cueen,5bUrq C'ountc� c�' Warren
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wife o{'mQppin : 24 Met/ (egg
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LAKE: GEoR GE, �E W 1Nt6
DATE OF PRINTING 2 5 MAY 1988
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