1988-793 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-793
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to��1' D & Q Nanageme�}t� Assoc. Inc.
OWNER of property located at' 1 Up.G-J,'1yli 1 Street L 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
16 Deer Run
Gansevoort, New York 12831
2. CONTRACTOR or BUILDER'S Name
Sid Timms sr
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3. CONTRACTOR or BUILDER'S Address phi
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4. ARCHITECT'S Name rt
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5. ARCHITECT'S Address H
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
In
No. 1000 gal tank, 2 5x8 Dry Wells and a D.Box
as per plot plan and application.
8. Proposed Use
Sewage Alteration
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$ 35.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 11 19 90
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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
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury t 's 11th Day of October 19 88
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SIGNED BY / d for the Town of Queensbury
Building and oning Inspector rt
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TOWN OF QUEENSBUR'Y
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,; /rz i 2� APPLICATION TOR l,�T �t, J iii
1988
,' �fi SEPTIC DISPOSAL.
.� al BUILDING CODE DEPT.
DATE /d -- /o / 8 0, .
. LOCATION OF PROPERTY FOR INSTALLATION L73-zi PpEiz 6-Cal A e-4- Or '
Owner's Name: . 'e Mee4/1 (G444 C ` Telephone: _5-/g —7 ((2—7 f7
Address: /6 FEE �J \( �RN EVo �.-7" N i-Y. tZ�_31 S/c�' �— 3�f6/
Installer's Nam -rSiD r C1 t 1S Telephone: lep 6 c ( c
Number of bedrooms (residential only) TWO
Total daily flow (compute @ 150 gal per bedroom) 36 C) I
Topography: circle one: Flat Rollin/g Steep slope % of slope
Soil Nature: circle one: Sand LoamClay Other / Depth: • feet
Ground Water: At what depth?. .Z feet A V- k
Bedrock or Impervious Material: At what depth? 3 6 feet • - A j 1-1•
• Percolation test: circle one: (not requir d
d required/rate min.inch.
Domestic water supply: circle one: M pal ` Well Other
If domestic water supply is a Well: N
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank ioba gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total:,system length feet .
SEEPAGE..PIT(S) : Number of 2_,/ Size each S feet by feet .
Size of stone to be used # 3 /Depth or Thickness //•-e) feet
****************************************************** .
. 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 Sanitirtip( COP v
Sewage Disposal Ordinance.
Signature of responsible person: u "`rfe V�"t1(
Date: Nb \ (1,04
(OVER)
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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: -
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awn ol Queenibury
: . BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
' Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /aw 1" o A Ri a d
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LOCATION / .p � /'c z G DATED// /157ePERMIT NO. 4---2
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SOIL T PE - Sand - Loam - Clay -
Percola ion Test Required? YES,.- NO
Percolatjon rate - Min/Inch / :
TYPE of SY. •TEM: •
Absorption Lield, total 1 gth
Length of ea. trench
Depth of tren es •
Size of gravel
SEEPAGE PjITS4N_ 171 • ) - '7.--:
Size- C/ ft. X £ ft.
Gravel size I. ''� /
PIPING: '' Size Type
Bldg. to tank \ Lf, /)' 1 �--
Tank to dist. .ox ' ; / 1,)G'C___
Dist. box to ?ield/,pit`, `1 /1/
Openings sea//ed? (7) \NO Partial
LOCATION/SEPARATIONS:/
Foundation/to tank fit:
Foundatio to absorption '3 " ft.
Absorpti n to lot line !eft.
Separat on of pits ft.
LOCATI OF SYSTEM ON. PROPERTY(\ircle one)
Front,—'Rear =, Left side - Right side -
COMMENTS: s / .
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) j71Yt) < <'
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SYSTEM USE APPROVED (AYES' NO
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Buiflding Inspector
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