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1989-600 x BUILDING PERMIT TOWN OF QUEENSBURY No sg_ soo ff WARREN COUNTY, NEW YORKLID .spa rV PERMISSION is hereby granted to OWNER of property located at Lupine Elianiva Street, Road or Ave. w in the Town of Queensbury, To Construct or place a c wags_ A 7 to- ra t i an 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 r Same rri �o Y 2. CONTRACTOR or BUILDER'S Name Horning Star Exc . 3. CONTRACTOR or BUILDERS Address rre Glens Falls , N . Y . 12801 4. ARCHITECT'S Name ry tri r 5. ARCHITECT'S Address C -v m a �o 6. TYPE of Construction — (Please indicate by }t) ' rn [ 1 wood Frame { ) Masonry I 1 Steel { 1 i. PLANS and Specifications No. 1000 gal . tank , 2 8 ' x 8 ' seepage pits as per plot plan and application . & Proposed Use rn Sewage Alteration rn b r $ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES — ROltXXXXXXXXXJulY 31 19 9491 llf 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.l O Dated at the Town of Queensbury this 31 st Day of July 79 89 ter SIGNED BY '`:.�Lslr" for the Town of Queensbury ' Buiidirig and Zor�il g nspector TOWN OF QUEENSDURY * APPLICATION FOR SEPTPC DISPOSAL PERMITf 0 % .; •,� p e R 3 a s s ,s u" fw.:i, 3..,I&'[1. '�w i a w0 E3 ? ti Yh.j DATE DATE LOCATION OF PROPERTY FOR INSTALLATION S t Y3, Owner's Name: / ei*P4 Telephone : ¢ / Sr Address: Installer's Name: Telephone: 'Z 9` Number of bedrooms (residential only) 3 Total daily flow (compute (Ic3 150 gal per bedroom) Topography: Circle one: (fi Rolling Steep Slope 06 of Slope Soil Nature: Circle ones San 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: louniciP Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEL1 : Septic Tank /066 __gal. ( minimum size: 1 , 000 gal.) TILE FIELD : Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of le. / Size each feet by feet Size of stone to be used # `a /Depth or Thickness 2. 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 Queens bury _5,ju2i14Ty SewageZDisosal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: C; - 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 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 anJ /or drywells B . No system shall be covered before inspection and approval by the l: uilding Inspector . Failure to comply with this requirement may r � Sult in the uncovering; of the system by the installer and a fine UL up to $ 50 . 000 C . r.n 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 , U . Should unforeseen problems during construction prevent proper installa- tion , alteration or repair of an approved system , a new proposal must tic submitted to the Queensbury Building; Department before further construction . Town of Queensbury SUILDTNG and CODES DEPARTMENT Say and Haviland Roads Queensbury , New York 12804 _ Jown v 't,Cueert � e< reaf B+U1LDjt-4G and ZON%NG DEPARTMEfIT gay and Haviland Road. R .CI. i Box 98 pueensbury. New York 12801 SEPTIC DISPOSAL SYSTEM i f1SPEGT I bhl / e 'e..,e A LOCATION CO 3t G f PERMIT NO- pATE . Low _ Clay, Id - No SeTL TYRE Required? percolation Te t - Min/lnoh percolation ra TYPE of SYSTEM' total l gth Absorption field . 1.eng th of each tr ch Depth of trenches size of gravel SEEPAGft �ef size- ,hype Gravel size S ze p T P-14G : �- sldg . to tank. — Tank to disc. box ��- Dist- 'box to fief Pam. ~ Partial i openngs sealed? 4 LOCP.TIf7t1/SEF"ARAT L35 = Farr ft. IL G ft- Foundation to ab orption Foundation t - t- Absorption to 1 line one) s ircle Step aAT2 of YS C�L3 PROPBRT siae Front Rea - ft side - R19h CCMMTS l 3 ,J r SYSTEJ4 USE APPROVE �� 14 gu ding Inspector 01/96 ma vl IA a u ,aFe Crs c,/x �`- � . _.... rn r c.� r © x71h 9