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89-574 X BUILDING PERMIT x su TOWN OF +QUEENSBURY No. 09- 574 �. / WARREN COUNTY, NEW YORKf1 PERMISSION is hereby ran�twed to Arthur Richardson told , car OWNER of property located at)at )6 mi nnesota Avenue 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. f- OWNER'SAddressis Same x p 2. CONTRACTOR or BUILDER'S Name t� to 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name tom: S. ARCHITECT'S Address s rt> to r7 6_ TYPE of Construction — (Please indicate bV-;0 e•F w I . 1 Wood Frame. i 1 Masonry ( ) steel I ) m 7. PLANS and Specifications No. 1000 gal . stank , 1 6 '} x 8 ' seepage pit as per plot plan and application S. Proposed Use SEWAGE ALTERATION r�r July 20 , :E $ 25 . U0 PERMIT FEE PAID -- THIS PERMIT EXPIRES KlfiliEX MiKKKOXXX 19 91 IIf a longer period is raqu tred an application for an extension must be made to the Building and Zoning inspector of thNe A town of Oueensbury before the expiration date.) CD rD Dated at the Town of Oueensbury this �20th Day of 'duly 19 89 r_+ SIGNED BY c for the Town of Oueensbury � Building and Zoning 1 c'tor �NSPLIRY .. APPLICATION FOR / SEPTIC DISPOSAL PERMIT '/' ' 7/o J f� or . 10 F � � •i.J�vf DATE � ©{ CODe Q�P LOCATION, Qr PROPERTY FOR INSTALLATION Owner's Name: � �'� � - I^ n-'L Telephone: T . r Address: v; I r ' r Installer`s Name: Telephone: r� Number of bedrooms (residential only) Total daily flow (compute Cd 150 gal per bedroom) r Topography: Circle one: F Fla 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 Percolation test: Circle one: not required required rate min. inch. Domestic water supply: circle one: /Municip&V Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tank :' �� �� .� gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / / Size each ?ri feet by feet Size of stone to be used # rT /Depth or Thickness / �( feet I - I have read the regulation on the reverse side of this street and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON:�l� f DATE' : OVER. t Y i u Septic System Inspections : ` rF 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 . ) tlxe proposed location of the system 2 , ) location and and distance to lot lines 3 . ) loca � ion and distance to structures 4 . ) loc,� rion acid distance to any water supply 5 . ) 0,,4ize and dimensions of all tanks , distribution boxes , the fields and /or drywells Ls . No system sht.11 be covered before inspection and approval by the lsuilding lnspuctor . Failure to comply with this requirement may result in the uncovering; of tile system by ttxe installer and a fine uF up to $ 250 . 00 . approved copy ❑ f the plot plan shall be available on the construction rite , failure to produce said plot plan a. : time of inspection may _ result in an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installa— Lion , alteration or repair of an approved .system , a new proposed must he submitted to the Queonsbury Building Depa.r;tment before further construction . _ .. .. -_ -- _ -- — --- Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 h�rua r ks ; It , . 1 � -e '9 J 1 fowrt o/ Quern" iurty BUILDING and ZONING DEPARTMENT Bay and Maviland Road, R. D. i Box 98 Queensbury, New York 12801 " SEPTIC DISPOSAL SYSTEM INSPECTION NAME ?` LOCATION - J7.' DATE I ,Fq PERMIT NO. r3 " 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 III --- SEEPAGE PITs4Nuinber of) Size- ft. x _ ft. Gravel size PIPING : s1zer Typ SLdg . to tank. Tank to dirt . box Dist. box to field/pit openings sealed? YES No Partial LC3CATION/SEPARAT20NS : Foundation to tank ft. Foundation to absorption ft . Absorption to dot line ft . Separation of pits _ ft. LOCATION OF Sy ROPERTY (circle one) Front - Rear { Left aid - Right side CCt* M TS : f/,/.-r j E N SYSTEM USE APPROVED ' Y itding Inapectcar ' 01/66 and V1 f / 6 ._ /ourn 01 ueens6ury 74 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION DATE /L I I 'a f PERMIT NOW 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 PvITS4NuMber of) _ Size- ft. Xft . . t Gravel size T- PIPING : size Type Bldg . to tank Tank to disc . box Dist. box to field/ L f openings sealed? YES O Partial LOCATION/SEPARATIONS . Foundation to tank iFtW Foundation to absorption t - Absorption to lot line Separation of Pits ft. LOCATION OF SYSTEM CN PROP (circle one) Front - Rear Left side - Right side COMMENTS : o / ■ F f ,�ram SYSTEM usE APPROVED YES IJ(? Build in nspector 01/86 and vl IV 0 191