1987-838 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87_838 0
WARREN COUNTYr NEW YORK
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PERMISSION is hereby granted to Lou Varney i
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OWNER of property faceted at
8 Moorwood Dr . 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.
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r4. ARCHITECTOS
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RACTOR or BUILDER 'S Name r`
Sanitary Sewer Service
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RACTOR or BUILDER S Address N
P . O . Sox 224 +c
Glens Falls , N . Y . 12801
NameHITECTS Address �
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r7- PLANS
=Constructio,,,inease indicate by X)
I 1 Masonry { ) Steel { 1
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and Specifications
04
No. Existing 1000 Gal Tank , Distribution box 2 6 ' x 8 ' dry wells as per a
plot plan , and application .
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8_ Proposed Use Sewage Alteration H
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$ 10000 21 December S 79 89
PERMIT FEE PAIL? — THIS PERMIT EXPIRES ,
(11 a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ousensbury before the expiration date.)
8th December 19 87
Dated at the Town of Queensbury this yyDay of
SIGNED SY / / 'e_e � , A4 e--� for the Town of Queensbury
Building and Zoning Inspactor
APPLICATION FOR SEPTIC DISPOSAL PERMIT ? � i
S 1 i
BATE
LOCATION OF PROPERTY FOR INSTALLATION r p y
Owner's Name: o u � Telephone:
Address: �r
Installer's Name: `J A /V/ TAB Telephone:
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom) y " �
Topography: circle one: Flat Rolling Steep Sloge % of slope
Soil Nature: circle one: f8andY Loam Clay Other f Depth: feet
Ground 'Water: At what depth? '! feet
Bedrock or Impervious Material: At what depth? _ �" feet
Percolation test: circle one r t require required / rate min. inch.
Domestic water supply: circle one<icipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM4 Septic Tank (200 gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet f Total system length feet
SEEPAGE PIT(S) : Number of '"' f Size each _e feet by - feet
Size of stone to be used # ' f Depth or Thickness feet
IMPORTANT
...Please_..IdST NEW E[2XlIII WENT TO BE INSTALLED
(over)
Section II Septic System Inspections;
A. All applications for septic system installation, alteration or repair, as
required by the Towns. of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least Z4 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
So) 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 $ZSO.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 Queensbuuy Sanit Sewage Dispcwal OrdinaIIce.
Signature of responsible person:
Date: /�/ 07
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
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
41 .STATE STREET. ALBANY, NEW YORK 12207
Date $ppiiCurian . Va- QrLfile . . . . . .
e
THIS: CERTIFIES THAT
only the electrical equipment Es described below and introduced by the applicant named an the above application number in the premises of
in the foltawing tocation; ❑ Basement 1i lot Ft. 2n4 FT. '.Section stock Lot
xaae esamirsed on - t 11 1 } - and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES ICOOKING DECKS I OPENS DISH WASHERS EXHAUST FANS
OUTLETS MCIPTACUISJ SWLTCHRS NCANDESCEM FUXMSCEHT OTHER AMT, K. W- AMT. K- W. AMT. K.W. AMT. K. W. AMT. H, /.
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECYAI 110C'PT TIME CLOCKS LslLll UNIT HEATERS MAXTt.pYiLET pliM/WERS,
AMT. K- W- OIL H- P. GAS H. P. AMT. NO. A. W. G. AMT. AMP, AMT_ AMP$_ TRANS. AMT. y, F. SYSTEMS AMT. WATTS
No_ OF "M
SERVICE DISCf7NHECT NO. OF S E R G V I G- METER E
AMT_ AMP. TYPE LIt�I,IRr. 1 ,e' riv 1 X avY 3 X ry 3 X 4W ' O►ER�CGIND. OF CC. CaND. . 4f HIAEG OF WtEG NCI. C7P NLLITRALS Of r,&WA t
OTHER APPARATUS:
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BRANCH MANAGER
M+d . i . T ._
,Per•
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by theit credantiais.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MIDST NOT BE ALTERED IN ANY MANNER.
r �rfiQueen iltdry
E1111LD1NG and xpfJllVG DEPARTMENT
9$
Bay and Havifand Road, R.O
Queensbury. New York 12501
SEPTIC DISPO SYSTEIA INSP TION
NAME_
LOCATION r
DATE
7- / PERMIT NO . � �
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SOIL TYPE - Sand - Loam - Clay
Percolation Test 'Required? YES - NO
percolation rate - Min/'Inch _
Ty,V E Of SY STEM=
Absorption fi Id , total length
Length of each trench
Depth of trench s
size of gravel
SEEPAGE P ITS413umb r of)
f t. X
Site- - s
Gravel size _ S: ye Type
PIPING :
Bldg to tank
Tank to list. box
Dist. box to field/p t partial
Openings sealed? ES 'NO
t,OCP.TXON/SEPA'RATIk S : ft.
Foundation to t soxption ft ,
Foundation to ft ,
Absorption to of line
ft.
Separation Of pits PER (circle one)
LpCATION STEM . t side -
Front Rea 3.eft side
CCKMEN r
SYSTEM 235E APPROVED YE
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