1988-881 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-881
WARREN COUNTY, NEW YORK
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PER SSION is hereby granted to Eric Reynolds
OWNER of property located at 3 Westmoore Avenue Street, Road or Ave. o
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
2. CONTRACTOR or BUILDER'S Name
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Condons Septic
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3. CONTRACTOR or BUILDER'S Address t7
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( 1 Masonry ( I Steel ( 1
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7. PLANS and Specifications
No.1000 gal tank, 200' tile field as per plot plan and application.
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8. Proposed Use
SEwage Alteration
$ 75.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 7 1990
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the o4
town of Queensbury before the expiration date.) a)
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Dated at the Town of Queensbury this 7th Day of November 1988
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SIGNED BY for the Town of Queensbury o'
Building and Zoning Inspector 0
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• APPLICATION FOR SEPTIC DISPOSAL PERMIT j(.;w•;:{ okay-`� '�;?,7 .f
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N 0 V 7 1988
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aiili.DING.& CODE DEFT.
LOCATION OF PROPERTY FOR INSTALLATION 3 0 ES-I Ma3'"E-AA. &o.e ,,,,s oky
Owner's Name: Mic,v
9'�O/�� Telephone: 4/8-5-
Address: a ssi!l'10!^p Ave (9,,,Fen/a r /U• y
Installer's Name: C 7iV1PTUI'tif 31G' - tC Telephone: g?'S'-`f 2_
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) -_ <C) •
Topography:. circle one: O Rolling Steep Slope % of slope
Soil Nature: circle one: San , Loam Clay Other • / Depth: feet
Ground Water: At what depth? /1./,4- feet
Bedrock or Impervious Material: At what depth? /1/A feet
Percolation test: circle one: not required required / rate PM min. inch.
Domestic water supply: circle one: Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /00 9 gal. (minimumsize: .1,000 gal.)
TILE FIELD:, Each Trench g'a feet / Total system length O0 feet
SEEPAGE PIT(S): Number of / Size each feet bsy feet
Size of stone to be. used IP 2.- / Depth or Thickness ` feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMI N'1"1'O BE INSTALLED
* * * * * * * * * * * * 4 * * * * * * * * * * * * * * x• * * s * * * * * *• •
(over) •
Section II . Septic System Inspections: • '
Al . • All applications for septic system installation, alteration or repair, as
required by the Town of Queensbur-y Sanitary Sewage Ordinance, shall
.. • be submitted to the Building Department at least 24 hours before start
ii, 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 installation, '
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
•
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I have read the regulations above and agree to abide by these-and. all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: g(-1-- •
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Date: /1 — 9 - g o
Town of Queensbury . •
Building and Code_Department '
Bay at Haviland Road
Queensbury, New York 12801
' (518) 792-5832 •.
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PO _Awn of Queensbur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 1
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SEPTIC DISPOSAL SYSTEM INSPECTION '
NAME P�,L�/ 1!eAt)'L./•"-( CJ
LOCATION 3
DATE //Ari 0 0 PERMIT NO. eFF
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -
TYPE of SYSTEM: /4:
-27
Absorption field, total length .
Length of each-trench ' 7 -
Depth of trenches „Li
Size of gravel' s—�
SEEPAGE PITS4Number of) '
Size- ft. X \ft.
Gravel size •
PIPING: `�Siz Type
Bldg. to tank ( ,l�L
Tank to dist. box/ 77
Dist. box to field.
Openings sealed? I YES ( NO 'Partial
LOCATION/SEPARATIONS: ,
Foundation to tank )Lift.
Foundation to absorption-,-- 'ft.
Absorption to lot line ft.
Separation of pits ft.
LOCATION SYSTEM ON• PROPERTY(circle one)
Front - Rear - Left side - 'Right side -
COMMENTS.
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SYSTEM USE APPROVED YE O
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