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1989-280 w BUILDING PERMIT " TOWN OF QUEENSBURY No. 84_2s0 a WARREN COUNTY, NEW YORK ,Jt r PERMISSION is hereby granted o Anna Belle Lampson OWNER of property located at 61 Main Street 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 other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t . OWNER'S Address is SAME � x r 2. CONTRACTOR or BUILDER'S Name Action Septic ru ter+° 3. CONTRACTOR or BUILDERS Address. rb 4. ARCHITECTS Name ON 6. ARCHITECT'S Address # + W J. CA 6. TYPE of Construction -- (Please indicate by X) C+ I I wood Frame [ ? Masonry ( ) Steel { 1 e h 7. PLANS and Specifications No. 1000 gal _ septic , 135 ' the field as per plot plan and application _ 8. Proposed Use Sewage Alteration ro $ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES MEY 10 19 91 r.f (If a longer period is required an appiication for an extension must be made to the Building and 'Zoning inspector of the town of Queensbury before the expiration date.) W e'f J Dated at the Town of Queenshury this 10th Day of Play 1989 SIGNED BY r for the Town of Queensbury Building and Zoning Inspect n "-/'OWN OF QUEENSBI..lR Y TOWN OF QUEENSBURY APPLICATION FOR RECEIVED w � �. SEPTIC DISPOSAL PERMIT MAY 8 _ 1989 .3() 4 _ / BLOC. & CODE DEPT. DATE LOCATION OF PROPERTY�FOR 1��LLATION Owner's Name: Telephone: Address: E: I' YZ ;C/.s 4Ze rca5 f rd rvUUJ� �y Installer's Name: .�'?`�',�` • C�_-2_ - � ,�'7 s G Telephone: Number of bedrooms (residential only) 6�2 Total daily flow (compute (d 150 gal per bedroom) C_•- - ` Topography: Circle one: la Rolling Steep Slope of Slope (� Soil Nature: Circle one: and Loam Clay Other /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: lunicipal Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank gal. (minimum size: 1 , 000 gal.) TILE FIELD: Each Trench !2 feet/Total system length �fs� feet SEEPAGE PIT(S): Number of / Size each feet by feet Size of stone to be used # /Depth or Thickness^ }, Meet I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbury Sanitgry Sewage ispo . I Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE:� OVER ���� [ �_. [QPl1Slg CI1'1i1ISt / �St Sv- Utic Syst `rn Inspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall bu submitr= ed CO the Building Department at least 24 hours before start ut construction and shall include a plot Plan showing : 1 . ) Che proposed location of the system 2 . ) locution and distance to lot lines. 3 . ) location and distance to structures 4 . ) .location and distance Co any wafer supply 5 . ) Size and d "n� nsions of all tanks , distribution boxes , the .fields and /or drywells b • No System snail be covered before inspection and approval by the Ifuilding 11'spuctur . Failure Co comPly with this requirerruont may V sult it, the uncovering; of the system by the installer :.and a fine ui up to $ 250 . 00 . C . An approved copy of the Plot plan shall be available on rile construction sicu , failure to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseen problums during construction prevent proper installa— tion , alteration or rupair of an approved system , a new proposal must f,e submitced to the Queunsbury Building Department before further L' UEa.; trUCC li7n . Town of Queensbury BUILDING and CUDES DEPARTMENT Bay and flaviland roads Queensbury , New Yorlc 12804 1ti.4 F77.:i C1,: :i �./oWn ©� �eeeen36urt� BUILDING and ZONING DEPARTMENT Say and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION LOCATION / PERMIT NO* HATE s " r C / and : Loam - clay P - - -- erc TYPEolation `$esst '�4u 'Y iced?iy,, ES - NO Percolation Percolatio rate - Min/Ii6h - . �. TYPE of SYS = Absorption f eld tonal lgth �!1 Length of ea tr pep _h of tren es Size of gravel SEEPAGE PITS-(N ter of) Size_ ft_ ' _ft. Gravel size Si e T PIPING = Bldg . to to ; Tank to di box List, box o field/ Openings Baled? E NO Partial L OCAT3:ON SEPARATIONS : I 6;) f t. Foundat on to tank tion f t . 'Founda on to absorp Absorp ion to lot line Separ ion of pitsLOCA pgpPETcle one) ron ON YSTEM ON Y (cir Fron - ear - Left side - Flight side - cpS TS f i SYSTEM 1ISE APPROVE YES NO Building Ins a tar 03-/86 and vl "7©�' A"rFR Action Septic Service - w , Shaw 's Septic ,Service P60o Box 1430 Saratoga Road South Glens Paps, N.Y. 12803 zjl jet fll�ll Aeij OV 793-2115 - 7934949 5874444 7'rcralbIcsjjoutbrg Our Specialty