1990-018 BUILDING PERMIT
TOWN OF QUEENSBURY No. 90-18
WARREN COUNTY, NEW YORK 0
3 0 -6 •Ict
PERMISSION is hereby granted to William Russell
Ogden of property located at � g den 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 LaJ
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Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
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 ( ) Masonry ( ) Steel ( ) p,
7. PLANS and Specifications
No. Existing 1000 gal tank with 250' trench field system as per application and
plot plan.
8. Proposed Use •
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Sewage Alteration
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$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES February 1 19 92
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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 this 1st Day of February 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning Inspe or
TOWN OF QUE•E-NSBLII:Y
APPLICATION FOR Y v
�-_v � SEPTIC DISPOSAL PERMIT W IN! OF QUEEN MR`
.PP'IN! RECEIVED
JAN 1990
DATE / ' 02 7 / 9 9 • ,',,. BLDG. �: CODN DEPT.
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LOCATION OF PROPERTY FOR I NSTALLATION ®Vibes"✓ /
..Owner's Name:// I/O n R
Llfr q Telephone:
Address: r 6 ,✓` 72.04-1 .
Installer's Name: AA,i .T s;. r/AC6-46t Telephone: 7?.„ 2�<S.9
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Number of bedrooms (residentialonly) 0
.
Total daily flow (compute Cd 150 gal per bedroom) C 6
Topography: Circle one: alelP Rolling Steep Slope % of Slope
Soil.Nature: Circle one: 0 Loam clay Other /Depth: Feet
Ground Water: At what depth? "'— Feet
Bedrock or Impervious Material: At what depth? -- Feet . • _
Percolation test: Circle one: not require) required rate min. inch.
Domestic water supply: circle one: Municipal We1l Other
If domestic water supply is a well: •
Separation: Water supply from septic absorption • feet
PROPOSED SYSTEM: Septic Tank i 0 Q 3 gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench Sp feet/Total system length fit% feet
SEEPAGE PIT(S): Number of / Size each feet by — feet
Size of stone to be used #2.—/Depth or Thickness / feet
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I have read the regulation on the reverse 'de of thi sheet and agree o a e by these
and all requirements of the Town of Queensbi San tary Sewage sposal dinance.
SIGNATURE OF RESPONSIBLE PERSON: Grpv) /! At"'Z --
DATE: 1---/ . 9- 7 0/1 /
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:
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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 to1250.00.
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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 •
R marks:
Jown of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME . U,S 0.0
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LOCATION O cie�.. i?'+1
DATE I / l i3 PERMIT NO. qO qe
SOIL TYPE - Sand Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
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TYPE of SYSTEM: �7�2) i
Absorption field:, total length C5
Length of each trench (p
Depth of trenches \
Size of gravel \ 4,75
SEEPAGE PITS{Number of)
Size- ft. X \ ft.
Gravel size '
PIPING: Si e Ty e
Bldg. to tank ' ;
Tank to dist. box 1 1 '
Dist. box to field/ i't
Openings sealed? YE ; NO Partial
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LOCATION/SEPARATIONS:
Foundation to tank , i Oft.
Foundation to absorption ] 'j ft.
Absorption to lot line \. /Ot.
Separation of pits ft.
LOCATION ' 'YSTEM ON PROPERrY(circle one)
Front - ' - Left side )-` Right side -
COMMENTS: 1 'i
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SYSTEM USE APPROVED ES NO ;
Bu ng In pector
01/86 and vl
SANITARY SEWER SERVICE
Division of G. P. Drellos, Inc.
53 .FOURTH STREET GLENS FALLS, N.Y. 12801 .
TELEPHONE 792-7257 ')UEENSSURV
JAN L 1990
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I BLDG. & CODE DEPT.
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TOWN OF' ¢_ a E 8BURy
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l Zoning Adrini„rite:
Date.. "!j 'a
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