1989-259 BUILDING PERMIT
TOWN OF QUEENSBURY No. 89-259
o'`n WARREN COUNTY, NEW YORKlow
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PERMISSION is hereby granted to Paul in+ L Barne
Chi an Av_Ie - Street, Road or Ave.
OWNER of property located at -_— _- -----___ __---- ---- '�+
in the Town of Queensbury, To construct or place a SellllaZ �n
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.
F2, CONTR
NER'S:Address isBo94 Michigan AveQusbury, N . Y . 12804
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ACTOR or SUI LCIE R'S Name
C
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Sanitary Sewer
FARCHITECT'S
BUILDEWS Address
224
alls -N . Y . 128+D1
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6. TYPE of Construction — (Please indicate by X) S
f ) Wood Frame ! } Masonry 1 1 Steel
7. PLANS and Specifications
No. 1000 gal tank , 2 6 ' x 8 ' seepage pits as per plot plan and applicatio
8. Proposed Use
Sewage Alteration
$ 25 OO PERMIT FEE PAID -- THIS PERMIT EXPIRES _ May 2 19 91
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of 4]ueensbury before the expiration date.)
Dated at the Town of Queensb 2nd d'' i°f May 1 J89
SIGNED BY
for the Town of Queensbury
Building and Z ing Irrsla+actar
TOWN OF QUEENSBURY
APPLICATION FOR
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SEPTIC DISPOSAL PERMIT TOWN 4F QUEENSBURY
RECEIVED
MAY 2 _ 1989
DATE 6 '" 2--'�- d / BLDG. & CODE DEFT.
LOCATION OF PERTY FOR INST7�ALLATION /
Owner's Name: I�Aoe%� CAI- ; /ApfZ r Telephone: +7" 9 "
Address: Z30K C
Installer's Name:� #OU ( 'T`��LjTelephone: 2.
Number of bedrooms (residential only) 3
Total daily flow (compute (d 150 gal per bedroom)
Topography: Circle one4 <isi olling Steep Slope % of Slope
Soil Nature: Circle one: a d Loam Clay Other /Depth: Feet
Ground Water: At what depth ? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: <tot requir required rate min. inch.
Domestic water supply: circle one: unici Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM : Septic Tank / o 0 0gal. ( minimum site: 1 , 000 gal.)
TILE FIELD; Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # /Depth or Thickness -- feet
I have read the regulation on the reverse si of thi sheet and agr a to a 'de by these
and all requirements of the Town of 4�ue sb ry Sa itary Sewa s sal rdina ce.
SIGNATURE OF RESPONSIBLE PERSON:
DATE*
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Septic System Inspections ;
A * .111 applicati:ons 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 plat plan showing :
1 . ) the proposed location of the system
2 • ) location and distance to lot lines
• ) location and distance to structures
4 . ) location and distance to any water supply
5 . ) size and dimensions of all tanks , distribution boxes ,
file fields and /or drywalls
B . NO system shad be covered before inspection and approval by the
Juilding Inspector . Failure to comply with this requirement may
result in the uncovering of the system by the ut up to $ 250 . 001 installer and a fine
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 installa—
tion , alteration or repair of an approved system , a new proposal must
he submitted to the Quuunsbury Building Department before further
construction .
Town. of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York. 12804
huurarks
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RnDRIMand ZOf
98
BUILDING o%
Bay and Havill NaNYark 12BOI
QueensbL I S,YS}'EM INSPE.CTi(�
SEPTIC DISPOSAL �f
Lill
Jill
f; � --
�pCAT I ON r
PEPJAIT NC3 • -
1fATE _ Clay
TYP
Sand - Jill YES 140
SOIL £ TeS ReQ,�ixea7
percolation rate - Niinflnch
percolation
TYPE o� SYSTEM: total length
p l,sorp"I � le ll . 71
YLength of each enc'k►
ID
of trenches
size of! graved� — A~ ---.� -
SEE pP.GE ITS Ft3hex o7
f t.
Size- TI �e
Gravel size Size
PI7'114G =
to 4
slag - tan7c Jill
�7 1'
Tank to dist- boy` '
7]ist. box td field/P.J� t ,: No partial
YES
�PeT'ingsJill sealed?
TSCSNs
g+.*TT023 f gEFAR ift.
k o yaation to Ftan fabsozptxon + -
Foundation tos l
Absorption ts9 lot lineft.
pits one)
Separation CN FROpSRig t side
LOCp,TI013 OF SYS'r sine
Front - ReaX Left
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SYST19K CSSE APPR
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Inspectnz
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