1990-358 I..
BUILDING PERMIT
TOWN OF QUEENSBURY No 90-358
WARREN COUNTY, NEW YORK b
hereby3 0 1 , •
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granted to AVID MOUSAW o0
PERMISSION is
OWNER of property located at 20 Centennial Drive 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.
1. OWNER'S Address is
same p
0>
2. CONTRACTOR or BUI LDER'S Name
Condon's Septic & Drain Service t7
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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r-r-
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
CD
( )Wood Frame ( ) Masonry ( )Steel ( ) _
7. PLANS and Specifications
No. Sewage alteration to include 2 seepage pits 8'x8' with #3 stone at 2 ft depth. cn
8. Proposed Use
CD
Sewage alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 19 1990
(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 ' th Day of June 19 90
SIGNED BY for the Town of Queensbury
Building and Zon'ng Inspector
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47"4---
,f. -. APPLICATION FOR ..
2,1 , SEPTIC DISPOSAL PERMIT
01,12.ENCGURA
AMP
// G� .— 1o. 1 JUN 0 7 1990
DATE (a
BLDG. ex CODE Derr-
LOCATION OF PROPERTY FOR INSTALLATIQN
Owner's Name: MO(.1 rcb I Telephone: 7Pa 69 2 - /0'
Address: aO C /i,i "A nii6+i` > , .
Installer's Name:CpN dD•�j‘V s�� /sG 11.I�Aic‘i/ti gPA Telephone: M.—es-
Y
Number of bedrooms (residential only) 3
Total daily flow (compute Cd 150 gal per bedroom) life,
Topography: Circle one: Flat Rolling Steep Slope % of Slope .
Soil Nature: Circle one: sand' Loam Clay Other /Depth: Feet
Ground Water: At what depth? /l,, Feet
Bedrock or Impervious Material: At what depth? /0) Feet
Percolation test: Circle one: r6rrequir3 required rate min. inch.
Domestic water supply: circle one: b'funicipa' Well Other
If domestic water supply is a well:
- Separation: Water supply from septic absorption " feet
PROPOSED SYSTEM: Septic Tank/OO" mni'I' �t�(minimum(min mum size: 1.000 gal.)
'TILE FIELD: Each Trench , feet/Total system length • feet
SEEPAGE PIT(S): Number of / Size each U feet by 6. feet
Size of stone to be used # 3 /Depth or Thickness 2 r • 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.
SIGNATUR F RESPONSIBLE PERSON: A ,/ e0,„//ai �'
E ,
DATE: C gild ,
OVER
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• Septic System Inspections:
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. A. All applications 'for septic system installation, alteration or. repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall -
be submitced. to the Building. Department at least 24 hours before start
of Construction- and' shall include a plot plan showing:
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. 1.) the proposed. lpcac.01, 01 the system
• - 2.) locatidn 'anddistance to lot lines
3.) location and distance to structures
• -r4.) location and distance to any water supply . _'. •
5.) size and 'dimensions of all tanks, distribution boxes,
tile fields and/or drywells _
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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 uvto $250.00.
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C. An approved copy of the plot plan shall be available on the construction
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site. Failure co 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.
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Town of,QueensbUry
BUILDING DEPARTMENT
Bay and Haviland Roads
• Ameeesbury-,.,New York 12804
Remarks: •
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• Jown of Queeniur, '
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC, DISPOSAL SYSTEM INSPECTION
NAME " /,ox it/
LOCATION ! r 'Gd
/
DATE (ply/ /9 PERMIT NO: Ll�✓ �
SOIL TYPE - S. d - Loam Clay -
Percolation Te'_t .Require' ? YES - NO
Percolation ra,.e - Min/ ch
TYPE of SYSTEM:
Absorption field, tota length
Length of each .,tench
Depth of trenches.
Size of gravel _
SEEPAGE $ITS4Numb7 ., ) '
Size- 6?` ft. X '', 't.
Gravel size '
PIPING: Size Type
Bldg. to tank
Tank to dist. box
Dist. box to fiel.. at
Openings sealed? IS 'NO Partial
LOCATION/SEPARAT 'ONS. `
Foundation to t_. k eA4 0 '
Foundation to a.sorpt' on ' ft. ,
Absorption to l;:t lin:, f t.
Separation of .its 'ft.
LOCATIO Y'. ...,' 011 '•ROY 'RTY(circle one)
Front ea i eft 'sid,e - Right side -.
COMMEN
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a ( (° re dla '_ 2
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SYSTEM SE APPROVED YES '0
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Buildi'g nspector
01/86 and vl
a •
wn of Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPO,/S{//T�/�.L SYSTEM INS'ECTION
(-7,.NAME
(/1.1 4 / ..CJ. V'W
r-
LOCAT I ON /e /ei 7/to
DATE (0 -zdi q PERMIT NO. 0 ,c
SOIL TYPE - S?nd - Loam - Clay -
Percolation T: st Required? YES - NO
Percolation rate - Min/Inc;
TYPE of SYSTEM:
Absorption fie :d, total .ength
Length of each trench _
Depth of trenc s
Size of gravel ; .
SEEPAGE PITS*N )ber of)
Size- ft. X ' ft:
Gravel size
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PIPING: I Si, ^ty e
Bldg. to tank ')type
Tank to dist. bo _
Dist. box to fie j./. t
Openings sealed? 1 ES ° NO Partial
LOCATION/SEPARATI V S: r - J
Foundation to tan: t. _
Foundation to abs:4 ption ft.
Absorption—to lor line ft.
Separation o p' s', ft.
LOCATIO O SY 'EM ,ON PROPERTY(circle one)
Front Rear - eft: side - Right s'de -
COMMENT I
411-' /
rpm!.
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sY �P , USE APPROVED 1 Noy •
Ir/la
Bu . 'ns•' Inspector
01/86 and vl ,
ocun ,of Queeniur1
BUILDING and ZONING DEPARTMENT
Bay an Haviland Road, R.D. 1 Box •:
Q eensbury, New York 12801
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SEPTIC I 1�OSAL SYST INSPEiTION
NAME Z0,74 , (12/— ,R-16/
LOCATION 31/ a://k 1
DATE 6//// / /' PERMIT NO. (-1O.- A
SOIL TYPE - Sand. - Loam - Clay -
Percolation Ti' t Required? YrS - NO
Percolation rae - Min/Inch
TYPE of SYSTEM:
Absorption fie ;. , total lens th
Length of each ,rench
Depth of trenchas
Size ,of gravel _
SEEPAGE n ITS{ in Nu .- of)
Size- 6 ft. X ft.
Gravel size ,
PIPING: Sze Type
Bldg. to tank
Tank to dist. box
Dist. box to field/.'t .
Openings sealed? Y NO Partial
LOCATION/SEPARATIONS
Foundation to tank ft.
Foundation to absor',t': On ft.
Absorption to lot ,inc ft.
Separation of pit ft.
LOCATION OF SYST ON '•ROPERTY(circle one)
Front - Rear - Lft si,;e - Right side -.
COMMENTS:
AW,/ 0/ / ,
V ) ii° d L
(9 A- .k .
SYSTEM -SE APPROVED YES, 0 /
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. Building ns°•ector
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