1989-293 w
x
BUILDING PERMIT
-o
f
TOWN OF Q,UEENSBURY Na. s9- 293
WARREN COUNTY, NEW YORK c
PERMISSION is hereby granted to Ronald VanSl ooten a'
OWNER of property located at 7 Lower Warren 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 ether information hereto filed and
approved and in compliance with the Town of Queensbury Building and zoning Ordinance.
FAR
ress is
S o/o Bartholomew Realty- Mary Tony ,
0
M
R or BUILDERS Name
Sanitary Sewer o
a_
R or BUILDER S Address
NameS Address r
C
rC
6. TYPE of Construction — (Please indicate by X)
I ) Wood Frame I ] Masonry f ) Steel I I
e
FP :Se :P8ifica:10:na:s
00 :t:an:k3:, 3:j� 8 ' seepage pits as per plot plan andCl
application
osed use
Sewage Alteration
91
$ 9ro pQ _ PERMIT FEE PAID — THIS PERMIT EXPIRES May 10 fg
(if a longer period is required an application for an extension must be made to the Building and ,Zoning inspector of the
town of Oueansbury before the expiration date_)
Dated at the Town of Queensbury this t+l Day of May 1g
8n
for the Town of Queensbury
SIGNED BY
Building and Zoning n ctor
AVN OF QUE.ENSBURY
Ctip. APPLICATION FOR. r���'q�c �JtgjVSVE6 CRY
SEPTIC DISPOSAL PER.MI`i' fQ�r
l�/el 3 � y � �' Dept, �.�.---
D A T E
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name ,(J,g� -_ V&O—f A) 'Telephone:
Address:
Installer's Name: /AF1 0/UII�AT Telephone: +' �
Number of bedrooms (residential only)
Total daily flow (compute (d. 150 gal per bedroom) f600
Topography: Circle one Fla Rolling Steep Slope % of Slope
Soil Nature: Circle one San Loam Clay Other /Depth: Feel
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one- not require required rate min. inch.
Domestic water supply : circle one: unici al Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTENI : Septic Tank 100 0 gal. (minimum size: 1 , 00n gal.)
TILE FIELD : Each Trench feet/Total system length `~ —feet
[�
SEEPAGE PIT(S): Number of / Size each ' i feet by ,3 feet
Size of stone to be used # /Depth or Thickness 2.— feet
I have read the regulation on the reverse sid is sheet and agree to abide by these
and all requirements of the Town of Cluee y S nitary and
D posal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
DATE: J`7r/ Q $ 1
OVER,
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 crater supply
5 . ) size and dimensions of all tanks , distribution boxes ,
the fields and /or drywells
B . NO system shall be covered before inspection and approval by the
l:uilding 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 plat plan at time of inspection may
result in an immediate work stoppage ,
D . Should unforeseen problems during construction prevent proper installa--
tioes , alteration or repair of an approved system , a new proposal must.
be Submitted to the Queensbury Building Department before further
construction .
Town of Queensbury
BUILDTNC and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
ku ilia rks :
flow" of Queei" JI"ry
BUILDING and ZONING DEPARTMENT
Say and Haviland Road, M)- 1 Box 98
Queensbury, New York 12801
S PTIC DISPOSAL_ `SYSTEM INSPECTION
LOCATION I '�" '�` ':�•
DATE &,g PER, q F
SOIL TYPE - Sa Loam - Clay
percolation Test Required? YES -
PercdR ation rate - Alin/Inch
TYPE of SYSTEM:
Absorption f i_eld , totalength
Length of each trench_
Depth of trenche s
Size of gravel
SEEPAGE PITS4Nu of) __
Size_ Lca ftC X. ft.
Gravel size ,Y,_��
Bldg to tan
Tank to d box
i
Dist. box f o. field/-p t-\
Openings Aealed? ES Ito Partial
a
LOCATIC,f/SEPARATIONS : ' 1ft.
Foundation to tank. �£t .
Founcl�l.tion to absorption ft.
Abso tion to lot line
Separation of Pitsf t e)
LOC?LTION OF SYSTEM ON PRXJPE { circle
Fr nt - Rear - Left site '. Right side
C S :
3
t
SYSTEM USE APPROVED YES NO
416
Bui Bing In ector
01/86 Ind Vl
c�
' ,r✓ yrJ
as
r
J
1