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1987-885 BUILDING PERMIT � TOWN OF QUEENSBURY � No. 87-$85 � WARREN COUNTY, NEW YORK o Joann Serotta � PERMISSION is hereby granted to I ra 16 Reservoir Dr . t� OWNER of property located at Street, Road or Ave. o+ 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. ti 1 . OWNER'S Address is Same w to ro ry 2. CONTRACTOR or BUILDER'S Name rrt r-r Same 3. CONTRACTOR or BUILDER'S Address Condon ' s Septic 4. ARCHITECT'S Name c eo W f9 rt 5. ARCHITECT'S Address D �-S t7 6_ TYPE of Construction — (Please Indicate by X) I ) Wood Frame I ) Masonry ( ) Steel i I 7_ PLANS and Specifications G] No. Existing 1000 Tank New D Sox 2- 6x8 seepage Fmtg pits as per plot plan and application . OQ S. Proposed Use °1 Sewage Alteration rq c r't W $ 10 t oo PERMIT FEE PAID — THIS PERMIT EXPIRES December 24 18 89 � Uf a longar 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 data.) Dated at the Town of Queensbury this �.-� 24th 'yDay of December tg 87 SIGNED BY / r/ 6 - 4 a" for the Town of Queensbury Building and Zoning Inspector %A00 1i f APPLICATION FOR SEPTIC DISPOSAL PERMIT OEI L:OL ham? . DATE 12 LOCATION OF PROPERTY FOR INSTALLATION _A5�56A Vol Owner's Name: Telephone: _�'/ ! " 3 Address: �iy Installer's Name: Q I'tl1�i 6/Vs 13 A,0 -�' r G Telephone: T Number of bedrooms {residential only} Total daily flow {compute @ 150 gal per bedroom} Topography: circle one: Fla# Roiling; Steep Slope %n of slope Soil Nature: circle one: an Loam Clay Other / Depth: feet Ground Water: At what depth? [a feet Bedrock or Impervious Material: At what depth? _ feet Percolation test: circle one: not required required / rate min. inch. Domestic water supply: circle one: Municipal Well Other _ IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tankrvoo gal. r (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE PITS) : Number of -- / Size each E3 _ feet b %L< feet Size: of stone to be used # _ 3 / Depth or Thickness feet IMPORTANT ...Please...LIST NEW EQUIPMENT TO BE INSTALLED �j57o '5ir# .t. � 1 ©d90 FAA*'11P (over) t Section 11 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: 25c �dJ^YL 1 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 oe �2 1'T )J�qo 0r . 7.'" O/ �iEIr�FIt3Er�lr� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Dueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME #I( LOCATION, �rkrs �' & tlpi DATE /-1-, 7 PERMIT NO. SOIL TYPE - and _ Loam - Clay - Percolation Test Required ? YES - Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total Length of each tr �-- Depth of tr es �~ Size rave -- SEEPAGE PITS4 �smber Size- �ft- Gravel size _ PIPING : Size Type Bldg . to tank y. Tank to di.st . b Dist_ box toIt Z OPenings seal ? ES NO Partial LOCATXON/SEP RATIONS : Foundation o tank LO ft.+f Foundation to absorptio ft . Absorpt10 to lot line - ft- Separat.1 of pits ft. LOCATION OF SYSTEM ON PROP TY (circle one) ron - ear - Left side - ght side - NT �-+ d5T- SYSTEM USE APPROVED : YE N Buf ing Inspector 01/86 and vl n3i a jug 4 f � I � sr�v�rruo '