1989-350 a
BUILDING PERMIT "
TOWN OF QUEENSBURY No 89_350 �
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to William Perry
OWNER of property located at 60 Helen Drive Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Sewage Al terati on
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
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2. CONTRACTOR or BUILDER'S Name
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Sanitary Sewer p,
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3. CONTRACTOR or BUILDER'S Address
Glens Falls , N . Y . 12801
d_ ARCHITECT'S Name
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5. ARCHITECT'S Address g
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6. TYPE of Construction — (Please indicate by X) �J
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f 1 Woad Frame { ) Masonry ( ) Steel ( 1
7. PLANS and Specifications
No. Existing 1000 gal . tank , 2 6 ' x 8 ' seepage pits as per plot plan
and application
8. Proposed Use
Sewage Alterations L
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$ MOO PERMIT FEE PAID — THIS PERMIT EXPIRES gX May 23 19 91 �
{lf a longer period is required an application for an extension must be rnade to t h a Building and Zoning inspector of the n
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 3rd Day of May 19 89 C
SIGNED BY �'�..... for the Town of Oueensbury
Building and Zoning 1 ctor
APPLICATION FOR4c
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f SEPTIC DISPOSAL PERMIT
TOWN OF QUEEIVSBURY
RECEIVED
DATE
�+�' _ aMAY 2 3 1989
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R.: n . BLDG. & CODE D,EP7-.
LOCATION OF PROPERTY FOR INSTALLATION e ,c_i br V(
Owner's Name: t(J [ j t IA&I Pk' JLP4,,&- Telephone :
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Address: U"' '
Installer's Name �r j l Tipfl 12 ` T c,�Lrt.� (' cTelephone:
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom ) j-
Topography: Circle one• lat Rolling Steep Slope 06 of Slope
Soil Nature: Circle on Sand Loam Clay Other /Depth : Feet
Ground Water : At what depth? ,W� Feet
Bedrock or Impervious Material: At what depth ? Feet
Percolation test ; Circle one; not required rate min. inch.
Domestic water supply: circle one; lunici Well Other
If domestic water supply is a well:
Separation : Water supply from septic absorption feet
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PROPOSED SYSTEM : Septic Tank } oOO gal. ( minimum size: 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 r- feet
I have read the regulation on the reverse a this sheet and r to abide by these
and all requirements of the Town of true ns ury 7Se Di posal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
]DATE :
OVER
Septic System Lnspections :
A . All applications for septic system installation , alteration or repairp
as required by the Town of Queensbury Sanitary Sewage Ordinance , shall
be submit-fed to the Building Department at least 24 hours before start
of construction arad skull include a plot plan stowing :
1 . ) tkLe proposed location of tile system
? . ) location and distance to loC lines
3 . ) location and distance to structures
4 . ) location and distance to any water supply
5 . ) size and dimensions of all tanks , distribution boxes ,
the fields :end / or drywells
B . No system shall be covcrod before inspection and approval by the
liuildia} b I ,} spector . Failure to comply with this requirement may
result in the uncoverin, 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 probl4ms during construction prevent proper Installa-
tion , alteration or repair of an approved systean , a new proposal must
2,e submitCud to the Queunsbury Building Department before further
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
�OWI7 D� �i4Lle'f:'1� 3 �LlI'!�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTI [DISPOSAL SYSTEM IN PECTION
NAME
LOCATION rll
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DATE � Z /� PERMIT NO.- !J q- c Z52
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/inch _
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TYPE of TEM:
Absorption jeld , total length
Length of e h trench
Depth of tre hes
Size of grave �-
SEEPAGE PITS4M�mber f)
51ze- ft. ? , _fir _Lt'•'
Gravel S zle
PIPING : i Size Type
Bldg . to tank. � (2C
Tank to dist. box 3� _
Dist, box to fiel nYES
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Openings sealed? / No Partial
LOCATION/SEPARATIONS : v,��j t
Foundation to 'tank. C YN •ft-
Foundation try+" absorption �) ft .
Absorption yo lot line ft -
Separation ;of pits ir,ft.
LCCILTION OF* SYSTEM ON PROPERTY (circle one)
le�W�on: F#tiear - Left side - Right slide
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SYSTEM USE APPROVED kYF: Nr
Bu ing Inspector
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TOWN OF +QUEENSBURY
� 742 Bay Road. Qrieenshury, NY. 12804-5902
16 March 2018
RE. Tax Map Number: 301 .8- 1 -3
Property Location. 60 Helen Drive, Lot 67
Town of Queensbury, NY
Prior to 2014 the Town of Queensbury did not issue certificates of compliance for
sewage alteration permits. However, as evident by the building permit document, a
building permit was applied for and the system was inspected and approved for us by
a Town of Queensbury Code Enforcement Officer (see enclosed inspection slip) .
In addition, a clear copy of the certificate of occupancy for the above-referenced
parcel is included .
I trust this will answer your concerns, based on the information provided by you.
Sincerely, ,/
' Y 4sotw�w
David Hatin, Director
Town of Queensbury
Building & Code Enforcement
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