1988-676 .S J
• BUILDING PERMIT
TOWN OF QUEENSBURY No �)3-��� 4
WARREN COUNTY, NEW YORK
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PERMISSION is herebyranted t� .
g Cornelius Sullivan •
OWNER of property located at (L ) Montray Rd_ Street, Road or Ave.
o0
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
2. CONTRACTOR or BUILDER'S Name
Chris Crandall
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name tt.3
4
O
5. ARCHITECT'S Address c-C
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( ) cn
co
7. PLANS and Specifications
O
• No. Existing 1000 gal tank, D Box, Tile field total 250' as per plot plan, drawing
and application.
8. Proposed Use
O
Sewage alteration
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 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 3th Day of Scp 19 88
/4_7
SIGNED BY - for the Town of Queensbury
Building and Zoning Insp ctor
.Jo urn. of atezade-ItrzG
1/\.\Y)C°
DAT
APPLICATION FORS • r C� ISPOSA1rPrRM .r•
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i 1,; _ .i•i 2GtiIHG J, B C cCS Dq'f.
Q . / lJ �. .. _ s 10hl Of UU t.,JUICY
SEP 8 18 .
DATE `ET / -
V BUILDING & CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION 57R- R1 , G .
Owner's Name: . \c\-Nkk1 V }9 n Telephone: vl 3 k 3 D
Address: 5(5z- II V lioirit " H\ ki) frot-A
Installer's Name: CAI'a,14 Qy�o2,y41(1.6ri I Telephone: -7 --
Li-
Number of bedrooms (residential only) L4 _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one Flat/ Rolling Steep Slope °u of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Ground Water: At. what depth? feet
Bedrock or ltupervious 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 Tank. ld 1; 0 . gal. (minimum size: 1 000 gal.)
TILE FIELD: Each Trench feet / Total system lengt ZS U fire'
• SEEPAGE PIT(S): Number of — / Size each — feet by feet
Size of stone to be used II 7— / Depth or Thickness 2 /?_ feet
* * * * * * * 4 * * * * * s * * * * * * * * 4 * * * * * * 4 44 4444444, 4
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * t * *" 4 * * i 4, 4 f * * i * * it 4 4 * * 4 4 * 4 * 4 * * * f * i
+oNe-
M P'e.a (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 subinitted 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
• •l.) 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: 4,,ya L ., 4/4�r)r.."+��
Date: ;7:4-7/ 71"
•
Town of Queensbury
Building and Code_Department
• Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
•
Jown of Queeniur1
. BUILDING and ZONING DEPARTMENT
on o I Bay and Haviland Road, R.D. 1 Box 98
•Queensbury, New York 12801
4
/ SEPTIC DISPOSAL SYSTE
M INSPECTION
NAME ,6I/C6- 41
LOCATION , // /O 1%Urw G
DATE_l- /� PERMIT NO. (JUC �(� /L,
CI
SOIL TYPE - Sand - Loam - Clay - •
Percolation Test Required? YES NO .
Percolation rate - Min/Inch :
TYPE of SYSTEM:
Absorption field, total length � �
Length of each trench ,s->
Depth of trenches ' y
Size of gravel . , ..
SEEPAGE PITS{Number of) J'
Size- ft. X ° ft./
Gravel size 4• 1
PIPING: i o- y
�'Sizp Type
Bldg.Bldg. to tank w
_ Sl
Tank to dist. box 'A� /'i-c'
Dist. box to field/pyt' Ii LI
Openings sealed? DES \ NO Partial
LOCATION/SEPARATIONS: / 4r '
Foundation to tank 0sl�� ft. '��
ic\ •
Foundation to absorption ft. •
Absorption to of line ft. .
Separation of p -its /./\ ft.
LOCATION OF YSTEM ON PROPERTY\(circle one) •
Front -/Rear- Left side - Right side -
COMMENTS_J .
I
•
•
/T-
SYSTEM USE APPROVE YESS NG
f
;y
Bui ding Inspector
01/86 and vl
•
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