1987-837 BUILDING PERMIT I
t
TOWN OF QUEENSBURY No. 87-837 z
C>
WARREN COUNTY, NEW YORK
Neil TatarIIO �r
t
ERMISSIO is hereby granted to
15 Owen Ave . Street, Road or Ave_
OWNER of property located at ^'
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.
co
r•
r-'
[2*.:C7(03NTRACTO
ER'S Address is
r7
Same s"
rr
w
rt
R or BUILDER'S Name
Condon ' s Septic
3. CONTRACTOR or BUILDER'S Address 17 [;rant Ave .
In
Glens Falls , N . Y . 12801
ra
4. ARCHITECT'S Name
C
5. ARCHITECT'S Address
cn
m
B. TYF'E of Construction — (Please indicate by X) W
ca
to
( 1 Wood Frame C ) Masonry ( 3 steel ( ) a
N
rr
ra
7. PLANS and Specifications *i
!v
rt
No_ 1000 gal tank 200 ' trench as per plot plan and appllcatlon , a
0
B. Proposed use Sewage Alteration
10 . 00 Am Dec . 8 19 89
� PERMIT FEE PAID — THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueonsbury before the expiration date.)
$th Day of December 1987
Dated at the Town of Queensbury this 11��
SIGNED BY �• for the Town of Queensbury
Building and Zoning Inspector .�f'�
,��'�����,����// yy e�j y�//� L
1r/Own 74' � ���G� � m �J
U Q c 9$�
APPLICATION FOR SEPTIC DISPOSAL PERMIT
to
DATE
LOCATION of PROPERTY FOR INSTALLATION
owner's Name: I j + &'j �.+� E�{�_ Telephone:
Address* �^ Q// 1i� f2� ,� ,. ,n
Installer's Name*l_.( / lW S Telephone:
Number of bedrooms (residential only) i3 _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope ,+y °"o of /slope
Soil Nature: circle one: and Loam Clay Other 1� P Depth: 149 feet
Garound. Water* At what depth? C7 feet
Beds ck or Impervious Material* At what depth? ^ 4*.' feet
Percolation test% circle one: not required required / rate min. inch.
Domestic water supplyt circle one: Municipal) Well Other
IF domestic water supply is a Well*
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank did ., gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench u+ 0 feet / Total system length 2�0 0 feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # Depth or Thickness 400e feet
IMPORTANT
...Pleasie...L.IST NEW EQ[1'IPMENT 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
50) 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 EKSPosal Ordinance,
Signature of responsible person:
Date:
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
_Down o/ Queen shur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Sox 98
Queensbury, New York 12801
SEPTIC DISPOSAL. SYSTEM INSPECTION
NAME
L.00AT I ON '� �'"
DATE I�I PERMIT NO. ) '
SOIL TYPE - Sand - Loam - ClaY -
Percolation Test Required? YES - NO —
Percolation rate - Min/Inch _
TYPE of SYSTEM :
Absorption fiel total leng
Length of each ench
Depth of trenche '
Size of gravel
SEEPAGE PITS of _
Size- t. X _ f
el size _
PIPING : �._ Size Type
Bldg . to tank
Tank to dist . bo ..- --
Dist , box to fi Id i
Openings seale ? E NO Partial
LOCATION/SEP RATIONS :
Foundation o tank t "-
Foundation to absorption 70ft-4�-
Absorptio to lot line ft.
Separati of pits
LOCATION OF SYSTEM ON PROP TY (circle one)
Front - ear - Left side - ' ght side
COMMENT
C D C- it. � rrt
SYSTEM USE APPROVED ES NO
Bui ding Inspec r
01/86 and vl
NefL i H fU & r coPJD0Ns Sef4f*c -� ���9i►� SCR
7M8ri 37 I. bra•
ErOSEUR /V f )L-So�toI GW)sr /=,ills )vy at&ol
7�
� $4X
f-
� r
yo '50
loon A�
9L �� r
l