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1989-661 004 BUILDING PERMIT » X TOWN OF QUEENSBURY =� No. 89-66I WARREN COUNTY, NEW YORK o r , PERMISSION is hereby granted to Herb Richardson c OWNER of property located at k/ , Ada i n Street Street, Road or Ave. in the Town of Queensbury, To Construct or place a SPwage Al terati nn 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. OWN R'S Address is Same 2. CONTRACTOR nr BUI LDER"S Name S Sanitary Sewer � v cn a z 3. CONTRACTOR or BUILDER'S Address .. Box 224 Queensbury , N . Y . 12804 4. ARCHITECT'S Name b_ ARCHITECT'S Address ko c,3 ct+' 6. TYPE of Construction — {Please indicate by X} �.. I I Wood Frame I I Masonry { ) Steel r.- tD m ]. PLANS and Specifications c-r• No. 1000 gal XXXKXK tank only as per plot plan and application . S. Proposed Use SEwage Alteration ro $ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES August 21 19 91 R {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.) e+ rro Dated at the Town of Queensbury this. i7ay of August 1989 ._ h SIGNED BY r the Town of Queensbury wilding and Zoning Inspector TOWN OF QULENSBUPY APPLICATION FOR TOrnr —j..-,��� SEPTIC DISPOSAL PERMIT Q�VED s$� RY !4 p 0 _ AUG 1 1989 C� '' V7 / SLOG. & CODE DEPT, DATE r � l t r` , . . . LOCATION OF PROPERTY FOR INSTALLATION a A14Me Owner's Narne: ,, ; lc , c# �f c �,a. �Telephone :. Address: Installer's Name: A2 a 774ye-+j tj ,�G'{ � -/L Telephone: .�- Number of bedrooms (residential only) + _ Total daily flow (compute (d 150 gal per bedroom ) !�✓ Topography: Circle one: Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: and Loam Clay Other /Depth : Feet Ground Water: At what depth ? "'"" Feet Bedrock or Impervious !Material: At what depth ? Feet Percolation test: Circle one. not require 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 I ODD gal. ( minimum size : t . 000 gal.) TILE FIELD : Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of J Size each feet by feet Size of stone to be used # /Depth or Thickness feet I have read the regulation on the reverse si a is sheet and agr to abide by these and all requirements of the "Gown of QuIee sb ry . n%tary Sewa is sal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: DATE : -" Jr OVER t Septic Systeni Inspections : AV All applications for septic system installation , alteration or repair , as required by Chc Town of Queensbury Sanitary Sewage ortfinance , shall be submit-ted to the Building Department at least 24 hours before start of consrrucrion and s `iall include a plot ,plan silowing : 1 . ) the proposed location of tffe system location and distance to lot lines 3 . ) locarion and distance to 5rructures 4 . ) location and distance to any water supply 5 . ) size and dimensions of all tames , distribution boxes , tile fields an.1 / or drywells B . No :system shall be covered before inspection and approval by the i: uiltling Inspector . failure to comply with this requiremunt may 1'� 5ult in tIle uncoverin , of rhu system by the installer and a fino of up to C . An aapproved 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 . DO Should unforeseen problems during construction prevent prosper installa— tioil , alteration or rufair of an approved system , a new proposal must he submitCud to the Queunsbury Building Department before further coiat; rruction . Town of Queensbury BUILDTNC and CODES DEPARTMENT bay and Haviland Roads Queensbury , New York 12804 awn ©f Queenil" ry & � 1Jrti7 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R .D. i Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME _ �r'rL. �yT} LOCATION -3 DATE Lkrl7L PERMIT NO. SOIL 'TYPE - Sand - Loam - Clay - Percolation Test'sRequired? YES - NO - Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field , total length Length of each trench Depth of trenches 7�` - Size of gravel --- SEEPAGE PITS4NUinber of) of Size- ft. X _ ftt Gravel size PIPING : !' S e T %� Bldg * to tank f Tank to disc . box r Dist . box to fielli/ t Openings sealed?,;A° YES NO Partial LOCATION/S EPAF4 TI ON S : Foundation to .+'tank ft• Foundation to- absorption ftA Absorption to lot line `ft . Separation of pitst- I.00ATION OF SYSTEM ON PROPERTY (circle one) Front - Rear - Left side - Right side - cnMMENTSx ' ' - To""--, SYSTEM USE APPROVE4633, NO B pector 01/86 and vl • ' a U� a� }