1990-140 BUILDING ' PERMIT [ _ 6-3
TOWN OF : "QUEENSBURY":
No. 90 -140
WARREN COUNTY, NEW.YORK
P MISSION is hereby granted to NORTHWINDS I "
OWNER of property located"at / Vh & 35. Street,Road or Ave.+
in the Town of Queensbury,To Construct or place a Sewage system
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
Dan Drellos O
PO Box 2-24
Glens Falls NY 12801-0224 1-3
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer
3..CONTRACTOR or BUILDER'S Address r+
•
same
4.'ARCHITECT'S Name
cn
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( ) _
7. PLANS and Specifications
No. Sewage system as per plans on file and application.
8.,Proposed Use. -
O.•
sewage system cn
$ , 25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES April 11 19 92
(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 Day of April 19 =.
SIGNED.BY for the Town of Queensbury
Building and Zonfn Inspector
TOWN OF QUEENSBURY
APPLICATION FOR IS i 'Ali I F 4
�,�-ma L� . �3 i k `i 1�, i,
�-v_,>` SEPTIC DISPOSAL PERMIT APR 1 r1 199O
0
A.
-I e9
DATE �(' !/ Dbc_____\f2
LOCATION O OPER OR INS ALLATION /ttO&)7i-Wi /�//1 06 Z E gi/"
Owner's i f et o Telephone: 792- 72- 7 .
:Address: 7 2X �2-c(
6
��
. Installer's Name: e-/l/ ICA/44 _ Telephone: 7 17.2-- 72..r7
Number of bedrooms (residential only) /117,--
Total daily flow (compute Cd 150 gal per bedroom) Ai ,/!"
Topography: Circle one: Flat .Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet . . • :. , get_
Percolation test: Circle one: not requir=,• required rate min. inch. r �v
Domestic water supply: circle one.1130Well Other744-/-c"
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank /0 6 v gal. (minimum size: 1.00n gal.)
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of / Size each 6 feet by f feet
Size of stone to be used #j /Depth or Thickness • 2ii feet
*************************
I have read the regulation on the reverse side • is sheet and a: - - to abide by these
and all requirements of the Town of Quee.• y Sa itary Sewa_1- Disp•sal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ! GJLJLI 11 / f
DATE: /c 90
OVER
1
•
•
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: •
Jown o/ Queenitur,
- BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME •
LOCATION
DATE/// PERMIT NO. 1D -4(i
SOIL TYPE _ Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field total length
Length of each trench
Depth of trenches.:
Size of gravel
SEEPAGE PITS{Number of) '
Size- 'ft. X _ ft.
Gravel size ,
PIPING: Size f Type
Bldg. to tank
Tank to (list. box j
Dist. boa: to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank "ft.
Foundation to abscrptionlI ft.
Absorption to lot line -ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
•
fV
SYSTEM USE APPROVED YES NO
•
•
Building Inspector
•
01/86 and vl