1988-251 BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 88-251 '0
WARREN COUNTY, NEW YORK o
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PERMISSION is hereby granted to Lynette Goodrich
OWNER of property located at 1VP Pinello Road 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.
1. OWNER'S Address is
R.D.#4 — Pinello Rd. rt
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Glens Falls, N.Y. 12801 m
2. CONTRACTOR or BUILDER'S Name 0
Morning Star Excavating Fi•
3. CONTRACTOR or BUILDER'S Address
Route 32
Gansevoort, N.Y. 12831
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( ) (D
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7. PLANS and Specifications
No. existing 1000 gal. tank, 135' tile field as per plot plan
and application. 1-1
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8. Proposed Use N•
Sewage Alteration
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 90
(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 this 18th Day of May 19 88
SIGNED BY 7' 2 zz a. A 2 � for the Town of Queensbury
Building and Zoning Inspector /`-'
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`'��\ APPLICATION FOR SEPTIC DISPOSAL PERMIT 7 ,', " ` ,,^ r-' r.-,
\ . 7 ... -i : - ... IA
. MAY 1 1S .
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DATE y /6 / 7 6 BUILDING & CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ;,,Q Telephone: '79.2 '2y4- 2
�' yAddress:
Installer's Name: ,�� / ' Telephone: 7r 3 2 Z y' 0 . •
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) — c
Topography: circle one: eff, Rolling Steep Slope % of slope
Soil Nature: circle one: :. 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:411P 1 Well Other
IF domestic water supply is a Well:
'Separation: Watersupply from Septic absorption — feet
000
PROPOSED SYSTEM: Septic Tank ,c;.; . /— gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench y3-- feet / Total system length /9 f feet
SEEPAGE PIT(S): Number of / Size each feet by feet .
Size of stone to be used # _ / Depth or Thickness / feet
* * * ** * * * * 4: 4 * 4 * * * * * * * * * * * * * 4 * * 4444 * * * * * * * * -
IMPORTANT •
...Please...LIST NEW EQUIPMENT TO BE INSTALLLID
* * 4 * * * * * 44 * * * * * * * * * * * * * * * : : * * 44: * * 4 * * * 4 * * *
(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 7-. .",..�.
Date: 01 /( - Fa
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
own of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
7
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ) /71./,6(
LOCATION ! f /I,./ /e6
DATE (5=17/ d o PERMIT NO. T0;-eZ—i
SOIL TYPE - and Loam - Clay -
Percolation Test Required? YES - N j
Percolation rate - Min/Inch
TYPE of SYST
Absorption fie ., total leng /3 5
Length of each t ench
Depth of trenches 3
Size of gravel . ,2 _
SEEPAGE PITS-fNumber o•
Size- ft. X _
Gravel size
PIPING: size Type
Bldg. to tank
Tank to dist. cox A /WC,
Dist. box to Field/pit A 7C
Openings sea ed? ES2 0 Partial
LOCATION/S 'ARATIONS: ,,00
Foundation to tank 'C.,)el• ft.
Foundatio to absorption V .t.
Absorptio to lot line f .
Separation .f pits fg.
LOCATION OF SYSTEM ON PROPERTY(.ircle one)
Front e r Left side - Right side -
COMMENTS:
SYSTEM USE APPROVED 0
B i g Inspector
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