1988-791 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-79177
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l,� WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Curtis Mayott
OWNER of property located at \ID 13 Dixon Road 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.
1. OWNER'S Address is
Same
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2. CONTRACTOR or BUILDER'S Name
Edward Ladd
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3. CONTRACTOR or BUILDER'S Address rt
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) 0
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( 1 Wood Frame ( ) Masonry ( )Steel ( 1
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7. PLANS and Specifications
No. 1000 gal tank, 1 8x8, Seepage pit as per plot plan
and application
8. Proposed Use
Sewage Alteration r„
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$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES October 11 1990 9
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 1 lth Day of October 19 88
SIGNED BY ?am/ �/ for the Town of Queensbury
Building and Zoning Inspector
TOWN OF QUEENSBURY •
APPLICATION FOR TOWN O c JEt TF'P.�t
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0(L), SEPTIC DISPOSAL PERMIT W
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DATE / / ?!% 4UDG & CODE DEP,.
LOCATION OF PROPERTY FOR INSTALLATION /34
Owner's Name: /. 4'Z4. "2�"� Telephone:
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Address: f j ��J �J RK-ArpQ
Installer's Name:4V Telephone: 77 Xy %7 5 )
Number of bedrooms (residential only) 4
Total daily flow (compute 4 150 gal per bedroom)
Topography: circle on- : Flat Rolling Steep slope % of slope �/
Soil Nature: circle one:; and oam 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 e: Municipal ell Other
If domestic water supply is a Well:
Separation: Watersupply from�om Septic absorption feet
PROPOSED SYSTEM: Septic Tank //I/5 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of / Size each eet by (feet
Size of stone to be used # £/jDepth or Thickness feet
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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 Sanitary
Sewage Disposal Ordinance.
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Signature of respon ible rson: ( ��o�a
Date: d / 7(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 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 installa-
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks: ti,
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• Down of Queeniurf/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
/�j Queensbury, New York 12801
SEPTICDISPOO-SAL SYSTEM INSPECTION
NAME (�LLv 7 O%T-
LOCATION / ?7 .../2)1 e- -- 4
:
DATE.//j%77/- PERMIT NO. 0 c(f- 7P/
SOIL TYPE - and - Loam - Clay -/
Percolation Test Required? YES/- NO
Percolation rite - Min/Inchj/ :
TYPE of SYSTEM /
•
Absorption fiel , total length
Length of each rench '
Depth of trench s . 7
Size of gravel _
SEEPAGE PITS{N a of) y!---- '
Size- qft. Xft. 4- 2,.
Gravel size
PIPING: Size Type,
Bldg. to tank `T; i/G
Tank to dist. b q' '/fi,L'6.
Dist. box to f' 1d 3 Li "I/G'[ ..-
Openings seale ? AYES ( NO 'Partial
LOCATION/SEP• RATIONS:
Foundation o tank / "—lift.
Foundation o absorption Y'=Tft.
Absorption} to lot line • "` ft.
Separation of pits .3. A"-'ft.,
LOCATION'/OF SYSTEM ON PROPERT (•gir_,cle one)
Front /Rear - Left side Rig t sided.
COMMENTS:
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SYSTEM USE APPROVED YES : NO
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