1987-773 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87-773 �
WARREN COUNTY, NEW YORK
QR 5 . 14 -
PERMISSION is hereby granted to Randall & Sherry Grippin �
w
I
Eldridge Lane '-
OWNER of property located at Street, Road or Ave. �!
w
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 Same
M
i1u
F�
2. CONTRACTOR or BUI LDE R'S Name xr„
Morning, Star Excavating �
Frank Shaw (°
n
n
3. CONTRACTOR or BUILDER'S Address
Rte 32 C)
Gansevoort , N . Y . 12831
W
b
r•
4. ARCHITECT'S Name
5. ARCHITECT'S Address
rt
r•
. a,
00
m
6. TYPE of Construction — (Please indicate by X)
W
Wood Frame I I Masonry I ) Steel { ) CDt>
7. PLANS and Specifications
No. 1000 mx*xx*rtgxxax gal . existing tank, tile field each trench 50 '
total system 250 '
u5
B. Proposed Use
Sewage alterationaq
M
M
r-r
fD
10 . 00 NOvember 18 89 "I
$ PERMIT FEE PAID - TH15 PERMIT EXPIRES 19
ff
life longer period is required an application for an extension must be made to the Building and Zoning inspector of the a
town of Queensbury before the expiration data_)
Dated at the Town of Queensbury this 18th Day of f November 19 87
SIGNED BY 2! 2a;� a - .0 G-c'2i�v for the Town of Queensbury
Building and Zoning Inspector
U .tiN OF QilrGcNraaURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT
NOV 181987
DATE
LOCATION OF PROPERTY FOR INSTALLATION r r"
Owner's Name: / { l� f/� _ Telephone:
r
Address: _ C1 Q 0
Installer's Name: '?e .� y�i + elephone:
Number of bedrooms (residential only) _ 7
Total daily flow (compute
�� @ 150 gal per bedroom)
Topography_ circle one: . Rolling Steep Slope % of slope _
Soil Natures circle one: th a Loam Clay Other / Depth: feet
Ground Water: At what depth? _�__ feet
Bedrock or Impervious Materials At what depth? iuf�— feet
Percolation test: circle one: n t required required / rate min. inch.
Domestic water supply: circle one: Municip� Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank 11d11gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench _ feet / Total system length 60 feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # _ / Depth or Thickness d #' feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(raver)
Section II Septic System Inspections:
A. All applications for septic system installation, alteration or repair, as
required by the Town of Queensbury Sanitary Sewage C]rdinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showings
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.
Do 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:
Dates fry" C G GT
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SE -rTLEO 1763 . . . HOME OF NATURAL BEAUTY A GOOD PLACE TO LIVE
Q" eens6ursy
pwn v�
SAJII. DING and ZONING DEPARTMENT
and Haviland 'Road, R. D- 1 Box 98
Queensbury. New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION .+r � -�•fr`
]7PER�MIT NO._ �
DATE2__�'" ����_S
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES NO
Percolation rate - Min/Inch _
TYPE of SYSTEM:
Absorption f field , total le th
Length of each trench
Depth., of trenches
Size 6f gravel
SEEPA E PITS4Number of)
Size- ft. X - f -
Gravel size T Pe
PIPING :
S
Bldgm to ankh
Tank to di t . box
r
Dist. box field pi d '-
openings se ed? O Partial
LOCATION/SEPA T ONS : 1W
Foundation to k
Foundation to a sorption ft .
Absorption to a line � £t.
Separation o£ it -" ft.
C" OF S S= CN PROPERTY (circle one)
Rear Left Ide - Right side
C co
iNTs :
r` I
SYSTEM USE APPROVED YES
Bui ding Inspector
41/86 'md vl
r
f
1
M�
f
n
I
J I
f
o
+J