1989-710 BUILDING PERMIT =
TOWN OF QUEENSBURY No. 84-710
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to � Harold Goodwin
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OWNER of property located at 7 Arbutus Drive Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Spwaqp 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
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer
3. CONTRACTOR or BUILDERS Address
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Luzerne Road
Queensbury , N . Y . 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X)
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( ) Wood Frame ( 1 Masonry I ) Steel ( I
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7. PLANS and Specifications
No. Existing tank , 200 feet tile field as per plot plan , and application .
S. Proposed Use
SEwage Alteration
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$ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES 19 c
(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 thkr 7th Day of September 19 89
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SIGNED BY �'I for the Town of Queensbury
Building and Z ing Inspector
APPLICATION FOR SEPZZG DILSPOSAle l 2 1 I6 M�VT
OF QUEENSB RY
.DATE
REVIEWED BY
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DATEr'' �r�'"'�" fOC 4a
LOCATION OF PROPERTY FOR INSTALLATION r _1�1�-�T,+� f�
Owner's Name: �TFK { � + 6 E1�L.04 ■ / M Telephone:
Address: 77
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Installer's Name: r Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: at Rolling Steep Slope 1ci of slope
Soil Nature: circle one: and Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock. or Impervious Materialx At what depth? _ feet
Percolation test: circle one: of require required / rate min. inch.
Domestic watev supply: circle one: unicipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
J!; G C.S ram e AJ (499�
PROPOSED SYSTEM: Septic Tank _ gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench { feet / Total system length .274W feet
SEEPAGE PIT(S) : Number of _ % Size each feet by �~ feet
Size of stone to be used # _ / Depth or Thickness _ feet
IMPORTANT
.._Please.._LIST' NEW EQUIPMENT TO BE INSTALLED
(over)
Section II 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
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
Inspector. Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of up to $250.00.
C. An 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.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
I have mead the regulations above and e o abide by the all requirements
of the Town of Queensbury Sanit wag Disposal Ord- ce.
Signature of responsible person:
Date: GF
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-583Z
SETTLED 1763 . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE
_lawn of Queen36ury ��' ]
BUILDING and ZONING DEPARTMENT r � f
Bay and Haviland Road, R. D. t Box 98 // �.
Queensbury , New York 12BOl
SEPTIC DISPOSAL SYSTEM�INSPECTION
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NAME
LpCAT I CN -
f T PERMIT NO -
DATE .= —�--
SOIL TYPE - Sand - Loam - Clay
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percolation Test Remfired? YES
Inch .�--�--
Percolation rate - Min/
TYPE Of 3YSTEMa
Absorption field , total lengt ---
Length of each txench
Depth Of trenches �-
Size of s3ravel_�_
SEEPAGE i?1TS-( er 'of ) ��-
size_ _ft . X _�ft '
Gravel size . S x rpe
PIPING : f {
Bldg . to tank box
Tank tO <list . iel
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Dist , bon_ to field NO Partial
Openings sealed'' S
LOCATION j SEPARATION
F oundatio n to tan)' .
absc ption
Foundation to �- t.
Absorption to lot line � _
Separation Of P1 ON PROPERTY (a role one)
LOC.P,TIO f t side - Right 'de
Front - . ear
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SYSTEM USE APPROVED YES
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Y3u 163ing Inspector
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