1988-921 H
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 88-921
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Kenneth Collier "'
OWNER of property located at 13 5 Bonner Drive 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.
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1. OWNER'S Address is r
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SAME
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2. CONTRACTOR or BUILDER'S Name p
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Condon's Septic 0
3. CONTRACTOR or BUILDER'S Address
12i Grant Avenue
Glens Falls,New York 12801
4. ARCHITECT'S Name
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5. ARCHITECT'S Address m
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6. TYPE of Construction—(Please indicate by X) m
( )Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specifications
No. existing 1000 gal tank; 200' tile field as per plot plan and
application.
8. Proposed Use
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Sewage Alteration m
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 25 . 19 90 1—'
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(If a longerperiod is required an application for an extension must be made to the Buildingand Zoningm
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town of Queensbury before the expiration date.) W
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Dated at the Town of Queensbury this 25th Day of November 1g 88 0
SIGNED BY az-kW /l for the Ton of Queensbury
Building and Zoning Inspector's w
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0Jrilrit of Oue4L4 dtl • DAT !/ S
APPLICATION FOR SEPTIC DISPOSAL PERMIT ZONING&DLDO CO ES DEFT.
TOWN OF QUEENSDURY
DATE/I ` 2- 5 i o r
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LOCATION OF PROPERTY FOR INSTALLATION / S� 8ori'rvpiQ. D
Owner's Name: /VufV e / 160/1j Telephone: 79 f' ,-
Address: l5--f30iliii) F C9 €kosRovy /'?1_/°
Installer's Name:CO/l,F)0a S 6 Frt../G Telephone: /7p8f- es 47
Number of bedrooms (residential only) _✓ _
Total daily flow (compute @ 150 gal per bedroom) _ 1/
Topography: circle one: Flat Rolling Steep Slope % of slope _
Soil Nature: circle one: e. Loam' Clay Other �`/� / Depth: feet
Ground Water: At what depth? N/A feet
Bedrock ex-Impervious Material: At what depth? 04✓1� : feet
.Percolation test: circle one: not required required / rate /j/, min: inch.
Domestic water supply:. circle one: MOM Well Other
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IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank C/ice-fir , a1. (minimum(minimum size: -1,000 gal.)
TILE FIELD: Each Trench 50 feet / Total system length -aO feet
SEEPAGE PIT(S): Number of / Size each feet Wy feet
Size of stone to be used II 2' / Depth or Thickness / feet
* * * * * * * + * * * * * * * * * * * * * *.4 * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * *•* * * * * * * * * * * * * * 44 * * * * * * * * * *'* * •
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(over) .
Section II Septic System Inspections: • •
A. An 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
Z.) 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•
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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:
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Date: ����-.�/f5 b
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• Town of Queensbury
Building and Code_Department
Bay at Haviland Road •
Queensbury, New York 12801
(518) 792-5832
7, �.. C; I
awn 01 Queen ury
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME nre.,7 n..e Go, -(r,'
LOCATION 157 ,R7h ,--c-e
DATE /.V / \PERMITNO. c � /" -2 J
SOIL TYPE Sand ` Loam - Clay -
Percolation Test Required? YES -CD)--
Percolation rate - Min/Inch •
TYPE of SYSTEM:
Absorption field, total length Zo d
Length of each trenc ,1Q
Depth of trenches " \ 2 3 ,'
Size of gravel '7j
SEEP E P {Numbe of),
Si e- ft. X f \////
rav size -----\ /
PIPING: Sie/ Type
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Bldg. to tank g)((5 fdlco.- 2
Tank to dist. box / ( pU-L
Dist. box to field/. / 4PCC,
Openings sealed? Nb Partial
LOCATION/SEPARATIONS.
Foundation to tank /Ukft.--
Foundation to abs ption 5t._
Absorption to / line / \t. —
Separat,ion of DiFs ,r/-ft,.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
rk(ST-(,if p f/ C 1T 3 AZ( ,
Ar&W 0 (5 BOX —
�o eo L,R TLC— 1 ID
SYSTEM USE APPROVED YES ; /
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Buildi'g Ins/ctor
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