1990-156 BUILDING PERMIT
TOWN OF QUEENSBURY .
No.90-156
WARREN COUNTY, NEW YORK/30q P
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PERMISSION is hereby granted to STANFORD GILMAN -'
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OWNER of property located at 19 Pine Street Street, Road or Ave.
in the Town of Queensbury,To Construct or place a wage 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 C'
same
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2. CONTRACTOR or BUILDER'S Name
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Sanitary Sewer n
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name -
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. Sewage alteration-2 Seepage pits 8x8 with #3 stone at 2ft depth as per
plot ._plan and application m
8. Proposed Use
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Sewage alteration
$ 25.000 PERMIT FEE PAID —THIS PERMIT EXPIRES April 13 19 92 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 _ _ 13th Day of April 19 90
SIGNED BY l.U' �� j for the Town of Queensbury
Building and�spector
TOWN OF QUEENSBURY
APPLICATION FOR �'
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::v > SEPTIC DISPOSAL PERMIT r .
150, f.'
DATE /71— 9/C)
LOCATION OF PROPERTY FOR INSTALLATION' '-' "` l �`�
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Owner's Name: 4 � Ce1MA)` Telephone:793 •4 /2
Address: (9 pi N e
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installer's Name: ilk (11Ari ��r�-A.A.-4x.. Telephoner qt)_ - / 7
Number of bedrooms (residential only) _
Total daily flow (compute C. 150 gal per bedroom) 155
Topography: Circle onzilla Rolling Steep Slope % of Slope
Soil Nature: Circle on:112, Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? '---- Feet . • _
Percolation test: Circle on : not require - required required rate min. inch.
Domestic water supply: circle one: Municipa Well Other
If domestic water supply is a wel .
Separation: Water supply from septic absorption ..feet
PROPOSED SYSTEM: Septic Tank f OO gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length — feet
SEEPAGE PIT(S): Number of —/ Size eac feet by feet
Size of stone to be used #3 /Depth or Thickness , feet
*************************
I have read the regulation on the reverse this sheet and to abide by these
and all requirements of the Town of Qu ensa ury anitary Se a e Di osal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
DATE: . ( -9O
OVER
1
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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:
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,
— _ — — t-ile fields an?/o drywellc —--- — -- _
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 .
_Down of Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Oueensbury, New York 12801
i
SEPTIC DISPOSAL\ SYSTEM INSPECTION "
NAME � , \ !
LOCATION (9 1 C , ; .
DATE 41S/ l() PERMITNO. C1C^;i I )4,
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Requirfed? ;YES - NO
Percolation rate - Min/Inch
g
TYPE of SYSTEM: 1z't'
Absorption field, totallength
Length of each trench
Depth of trenches ' 1t, .
Size of gravel
SEEPAGE PITS{Number of) ^, ,' "L
Size- . (oft. X `is ft. t
Gravel size . 'S
PIPING: Sig Type
Bldg. to tank ^' i i V(`,
Tank to dist. box ii k'i,-
' Dist. box to field/p. gvc--7.
Openings sealed? ES ) O Partial
LOCATION/SEPARATIONS;:
Foundation to tank i '' ,i.. t.
Foundation to absorption 'iifft.
Absorption to lot line jii jft.
Separation of pitsl • . , 4' ft.
LOCATIO OF SYSTEM ON PROP;R' Y(circle one)
Front - Ream- Left side - Right side - •
COMMENTS:
. 7-. 7 )''‘.-
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,7--,- .
SYSTEM USE APPROVED /NO
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jam ,, a
Building Inspector
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