1989-696 BUILDING PERMIT 70
TOWN OF +QUEENSBURY fl
No. 89- 696
WARREN 1111"T1, NEW YORK
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PERMISS
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ION is hereby granted to NnrasPn lCa hn
OWNER of property located at F, Sher-wood--Dri vl* _ Street. Road or Ave.
in the Town of Queensbury, To Construct or place a Sewage ❑l tPrati on
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
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2. CONTRACTOR or BUI LpE R^S !Name r3
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Bill Threw ti
3. CONTRACTOR or BUILDERS Address
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d. ARCHITECT`S Name {,.z
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5, ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame ; ) Masonry ; ) steel ;
7. PLANS and Specifications
No. 1000 gal . existing tank 3 6 ' x S ' seepage pits as per plot plan ,
and application .
B. Proposed Use
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Sewage Alteration
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25 _ {ln PERMIT FEE PAID — THIS PERMIT EXPIRES April
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(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.)
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Dated at the Town of Queensbury this 5th Day of Septputber 19 89
SIGNED BY for the Town of Queensbury
Bui ing and Zoni Spector
OWN OF Q UEE• N'S B UR Y
TOWN OF QUEENSBURY
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APPLICATION FOR RECEIVED
SEPTIC DISPOSAL PERMIT r � rr)- AUG 3 1989
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� BLDG. $i CODE DEPT,
DATE ,,rj" , 4
LOCATION OF PROPERTY FOR INSTALLATION-
Owner's Name:YM „ .e6Z 0 & jy k {„tNr Telephone:
Address: �
Installer's Name: �Ia/ T ,t,Ggpx&. f f / c% Telephone:
Number of bedrooms (residential only) _
cr c►
Total daily flow (compute (d 150 gal per bedroom) 1✓ �,, 5
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 required equired 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 SYSTEAI : Septic Tank gal. ( minimum size: 1 , 000 gal.)
TILE FIELD : Each Trench feet/Total system length Feet
SEEPAGE PIT(S): Number of / Size each feet by __feet
Size of stone to be used 4f6epth or Thickness ► 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 Queensbury Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:����'cp+-�Z,y
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 small include a plot plan showing :
le ) 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 lospector . Failure to comply with this requirement may
result in the uncoverinb of the system by the installer and a fine
of up to $ 250 . 00 .
C . Aa 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 immediace work stoppage .
D . Should unforeseen problems during construction prevent proper installa—
tion , alteration or repair of an approved system , a new proposal must
tau submitted to the Quuensbury Building Department before further
construction .
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
K4marks
BUILDING and ZONING DEPARTMENT
Say and Haviland Road, R,D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCAT�I.�ON �Llr]r ,r
DATE 2Sf S 1 / PERMIT NO . -- !G� qfc'
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percol tion rate - Min/Inch -
TYPE of STEM:
Absorptio field , total length
Length of ch trench
Depth of tr ches
Size of gran _
SEEPAGE P�TS{ e7c o
Size- ft. c' 4rt_
Gravel size
PIPING : Size Type
'Tang . to tank
Tanis to dist .
]listv box to f ' Id/
Openings seal ? Y S NO Partial
LOCATION/SE , RATIONS :
Foundation o tams ft. C ' f
Foundation o absorptio 22--�ft .
Absorptio to lot line ft.
Separatio of pits ft-
ECATION ST
A _ -- pp Y (circle one)
Front -gfear - Left side) - R ' ht side -
COMMENT
SYSTEM USE APPROVER YES
Bui ding Inspector
01/86 and vl
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