1990-159 BUILDING PERMIT
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• TOWN OF QUEENSBURY
No. 9 0-15 9 z
WARREN COUNTY, NEW YORK °
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PERMISS N is hereby granted to MELTON HERRINCOSH:AW 'i`
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OWNER of property located at 0 Bo 4 Luzerne Rd 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. x
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1. OWNER'S Address is
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2. CONTRACTOR or BUILDER'S Name >
Condon's Septic & Drain Service
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3. CONTRACTOR or BUILDER'S Address 0
4. ARCHITECT'S Name
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5. ARCHITECT'S Address ND
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6. TYPE of Construction—(Please indicate by X) 'y
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( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
No. Sewage alteration as per plot plan and application. rn
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8. Proposed Use
Sewage alteration co
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 17 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 7....17th Day of April 19 90
SIGNED BY /',/y� for the Town of Queensbury
Buil ing and Zoning n pector
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I u WN OF QUE•r-NSJ3ur.Y
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APPLICATION FOR
v > SEPTIC DISPOSAL PERMIT
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DATE ' / C APR 13 1990
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LOCATION OF PROPERTY FOR INSTALLATION L t) 2- e-Q/� j"j . BLDG. & CODE DE1PT.
Owner's Name: ek7L6,0 Iri'1-ll'v/ SimCL) Telephone:
Address: QQ'x GC( L- (l?,ap,os!3or' ,,eq (Leor
Installers Name: r cL -b iio S&& Telephone:
Number of bedrooms (residential only) 3
Total daily flow (compute Cd 150 gal per bedroom) ,)
Topography: Circle one: OP Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? IJflA 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 Other
If domestic water supply is a well: -
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank /00 gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench 4) feet/Total system length 300 feet
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SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # "7-- /Depth or Thickness feet
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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 Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: g
DATE:
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 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 : •
_Down of Queen3bur, P
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSALSYSTEM INSPECTION
NAME fl '=}eAft.L lCLuo
LOCATION 2-4-4- P�Q
DATE 1-)'(p / 4,1() PERMIT Ni. qi)49?
SOIL TYPE nd Loam Clay -
Percolation T=st Require;? YES� :Ne.3
Percolation ra e - Min/I ch
TYPE of SYSTEM
Absorption fie d, total j ength 3oO
Length of each rench
Depth of trench:s 2- y F./—
Size of grhvel. �sy
SEEPAGE PIT n •er of. r �.--
Size- ft. ft.
G. avel size
PIPING: Size Type
Bldg. to tank 4/ Pt_
Tank to dist. box L./ (Jic
Dist. box to field pit Li A/C
Openings sealed? ep NO Partial
LOCATION/SEPARATION'ir
Foundation to tank ft eif -
Foundation to absorp;; ion ft AS pot,
Absorption to lot 1' 'e ft kflAiS
Separation of pits Op ft
LOCATION OF SYSTEM 'ON' PROPERTY(circle one)
Front - Rear - Lef, &de -,Right si e d -
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COMMENTS:
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SYSTEM WE APPROVED YES) •
Bui' ding Ins!Actor
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