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1990-132 BUILDING PERMIT a TOWN OF QUEENSBURY No 90_132 WARREN COUNTY, NEW YORK cn l cn PERMISSION is hereby granted to MICHAEL H()MENTCK cri OWNER of property•located at Triphammer T,a—BMfnrcl Close Street, Road or Ave. in the Town of Queensbury,To Construct or place a Sewage alteratinn 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. L� 1. OWNER'S Address is • RD#3 Triphammer La Queensbury NY 12804 • 2. CONTRACTOR or BUILDER'S Name Condon's Septic & Drain 3. CONTRACTOR or BUILDER'S Address 17 Grant Av Glens Falls NY 12801 n 4. ARCHITECT'S Name rp' Sv CD 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) 0 ( )Wood Frame ( ) Masonry ( ) Steel ( ) C) ca 7. PLANS and Specifications O No. Sewage alteration—seepage pits (2) 8x8' with #3 stone at 2 ft. depth, per specifiations and application. 8. Proposed Use O Sewage Alteration r+ 0 $ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES April 9 1919 0 (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.) Dated at the Town of Queensbury this 9th Day of April 19 90 7 SIGNED BY for the Town of Queensbury Building and Zoning Inspector TOWN OF QUE•ENSBURY 4 -mr- i 2.,5-- 4 y�� APPLICATION FOR I"OWN OF QUEENSB -f SEPTIC DISPOSAL PERMIT APR 0 6199t% I ' BLDG. & CODE DEPT.. DATE `6 ` 6 y „3� c6h4 C/os4 e LOCATION OF PROPERTY FOR INSTALLATION R D 3 1,Q )7amrJ 'Q Lod Owner's Name:) ChM)/ l9oThEttJI C..d Telephone: 79 F` -5 f'9 3 (TEct-gri,1--d— �`IOS&Address:/,p�? �A�ti� haf�YI1e� La h?�, .. � e Cs Installer's Name:Crn/cL9,v S SEp .l C)d") V fM Telephone:7? -9S Number of bedrooms (residential only) 9 Total daily flow. (compute (d 150 gal per bedroom) y,j Q Topography: Circle one: Flat' Rolling Steep Slope % of Slope Soil Nature: Circle one:Sand ' Loam clay Other /Depth: Feet Ground Water: At what depth? )VA Feet Bedrock or Impervious Material: At what depth? eh) Feet Percolation test: Circle one: not required required rate 44 min. inch. Domestic water supply: circle one: b'Iunicipal Well Other. If domestic water supply is a well: Separation: Water supply from septic absorption. feet PROPOSED SYSTEM: Septic Tank .-2()$tf gal. (minimum size: 1,000 gal.) TILE FIELD: Each Trench feet/Total system length • feet SEEPAGE PIT(S): Number of 2 / Size each g feet by 3 feet Size of stone to be used # 3 /Depth or Thickness 2 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 Sanitary S age Disposal Ordinance: SIGNATURE OF RESPONSIBLE PERSON: ----Rao „Lib", DATE: / —U/ ` ?0 OVER 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 .ofthe 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. s • Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York. 12804 • • Remarks: . cc77 // _Down of Queenibur , BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME in( \ j4a- LOCATION !a 3 ` j 01)71, DATE 411 / gin PERM T NO. LID -- 1 `.)'' • SOIL TYPE - Sand - Lo.. - Clay - Percolation Test Requi ed? YES NO Percolation rate - Min Inch TYPE of SYSTEM: Absorption field, total Length of each tr Depth oft� es Size�rY'"gravel_�'"� �rp' SEEPAGE PITS{Number of) Size- S-ft. X ft. 1 r 0.u6.r /0 Gurmt- Gravel size PIPING: Siz= Type Bldg. to tank s 714/‘• Tank to dist. box _ p Uc_ Dist: box to field/pit A. /?`/L Openings sealed? ►` 0 Partial LOCATION/SEPARATIONS: , Foundation to tank ;J(numCa ' Foundation'to absorption Absorption to lot l'. e Separation of pits ft. �— LOCATION OF SYSTEM •N PROPERIY•(circle- one) ron - Rear - Lef side Right side - ENTS: • SYSTEM USE APPROVED Y Building Spector • 01/86 and vl • in i Ct-, 8-1— J7 okr c.d./r C, . 798".5-515 0OIVC10niS SEp.• 'Cy I9W &,,ez. 1,� 3 -f,q tp h am in. A /.d ! � .,,- 0e-aiv 4- Ave 7 98-8-s'4°'� ' ` co.Jnv f1 cm���c1�rs©rc� ��G�.S� - elsivs Falls , jv y./2.8-01 '0()E6,vs h i ,v , r V # hod(' 71. N !1 P--.7-vow-- APR 0 6 1990 BLDG. & CODE DEPT. 1 ... 1060e4k .._s .10 ( -----4-3--- ' ' Ir covcre-tE T y?- x`r .f«yP rf ihnm'a,' 2_ \ V' R. L r ea,. :,c.....1, t 4 Cv o'