1990-137 BUILDING PERMIT
TOWN OF QUEENSBURY No 90-137
WARREN COUNTY, NEW YORK30k , Ick— \—
PERMISSION is hereby granted to LAWRENCE SMITH
OWNER of property located at tQ3-7 Sherman Av Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration
cn
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 t"
170 Sherman Av
Glens Falls NY 12801 ro
2. CONTRACTOR or BUILDER'S Name
Steven Sanders
V
V
ro
3. CONTRACTOR or BUILDER'S Address
CD
'-s
4. ARCHITECT'S Name
•
CD
5. ARCHITECT'S Address
CD
6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( )Steel ( ) (CrclD
7. PLANS and Specifications
No. Sewage Alteration — as per plot plans, specifications, application.
8. Proposed Use
Sewage alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 10 1992
(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 10th Day of April 19 90
SIGNED BY . for the Town of Queensbury
Building and Zoning Insp ctor
I?OIVN OF QUEENSI3URYit
_,......„ i .) v\d-D
APPLICATION FOR I ..---
1_
5 k i..----
. _v,J > SEPTIC DISPOSAL PERMIT 3'
(OWN OF QUEENSBx'B'
DATE 0 7-t/ 9 i6 APR 0 9 1990
/ '
LOCATION OF PROPERTY FOR INSTALLATION Op9Ee.S►4M.Av Ntc.)� . BLDG. & CODE DEPT.
tOyefric C.-
Owner's ame: , 5-Tim ;tfl Telephone: 2 O -7/
Address: I -20 ,S'A..,'v✓19.vl 6/ L.) / `/F"l%c? 7 //5
Installer's Name: - 4' 7 ,Sal nl'ys Telephone: 7%LT ',%2//j
Number of bedrooms (residential only) _.?
r
Total daily flow (compute (d 150 gal per bedroom) A/.3 17 i�i/
Topography: Circle one:0Rolling Steep Slope % of Slope
Soil Nature: Circle on:. Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: Municipal Well ther
If domestic water supply is a well: r
Separation: Water supply from septic absorption / j feet
PROPOSED SYSTEM: Septic Tank JDOO - gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench c5 V feet/Total system length • a U r feet
SEEPAGE PIT(S): Number of / Size each feet by feet
/Size of stone to be used # 09 /Depth or Thickness / 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 Sa 'tary Sewage Dis sal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: —L -- �'- - ----�__
DATE: .?O) )/ ��
/-
OVER 1
/ 21 — z - i7
•
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 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 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
Remarks:
i'Usc— FA-o-r PAS 0 /Avg.
__loamo/ Qti- een9 burc�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 �
Queensbury, New York 12801 P/A" ,
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME L/'tek. RL-(J C(S TAJ l 1
LOCATION V P Y✓ t� cAnizMA.,U A , -
DATE ( //b / .J PERMITI NO. Lf f/, 7
SOIL TYPE San - .Loam - Clay -
Percolation est Required? YES - NO
Percolation 'rate - Min/Inch
TYPE of SYSTEM: a
Absorption field, total length X(s-E7
Length of each trench: 5'0
Depth of trenches • [/:/
Size of gravel:
SEEPAGE PITS{Number of)
Size- __ft. X - ft. r`
Gravel size
PIPING: r4Size Type/
Bldg. to tank ,,,
Tank to dist. box ;,i/1/ fVC-
Dist. bo): to field/.- q 4
Openings sealed? YES1,, NO partial
r
LOCATION/SEPARATIONS: " /
Foundation to tank U�/D ii ft.
Foundation to abscrption ` fit ft.
Absorption to lot line `, ft.
Separation of pits j_ �- ft.
LOCATION SYSTEM ON PROPERTY(circle one)
Front ea .- Left sideAf- Right side -
COMMEN /.✓ c_---r
l
r
P `
gCt'--441 - .)7."{litt_.\ a6gigec12
c/G f'F ,_ fir`
c ,1
t
i
SYSTEM USE APPROVED ES O
)//
Buil ing Inspector
01/86 and vl
.3 :
3 r3'3
r
6 DWN F Pr''-
UEPt' '
i
'R09
1990
BLDG. & CODE
,EPt
. i
1 kX ,
. C. 1 t ,
- 1
Gl
c -
�1` / Nor __:.:TI.,
. i 1 a\
' rk ' ,/ 10 V
20afP' _ •
e
1 k
________,
, Y
1 • 1 .0