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1989-772 BUILDING PERMIT TOWN OF QUEENSBURY No. s�_772 - -- WARREN COUNTY, NEW YORK 14 1 PERMISSION is hereby granted to Ja k Cl ose OWNER of property located at 32 Holden Avenue Street, Road or Ave. in the Town of Queensbury, To Construct or place a _ Sewage Al terati 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 Oueensbury Building and Zoning Ordinance. F2CONTRJAC-Ti WNERS Address is Same r— t^ N'1 rTt OR or BUILDER 'S Name su c'a Paul Naylor 3- CONTRACTOR or BUILDER'S Address Glens Falls 4. ARCHITECT'S Name rV S. ARCHITECT'S Address C? Ck 1'11 x 6. TYPE of Construction -- (Please indicate by XI d< tD I ) Wood Frame i ) Masonry i l steal ( 1 rD r7. PLANSand Specifications No. 1000 gal . tank , 1 61 x 81 xjjijpjX#ak seepage pit as per plot plan and application . Proposed Use u cc Sewage Alteration a n $ 25 . 0 PERMIT FEE PAID — THIS PERMIT EXPIRES 'September 29 19 91 � C 0f a longer period is required an application for an extension must be made to the Building and Zoning inspector of the n town of Oueensbury before the expiration date.} A e Dated at the Town of O.ueensbury this 29th Day of September 19 89 a SIGNED BY for the Town of O.ueensbury Building and Zoning Inspector APPLICATION FOR TOWN OF t ''ci `- } SEPTIC DISPOSAL PERMIT # `• 's-;7 '- � S E P BL©G, & CODE DLEPT, DATE ry f LOCATION OF PROPERTY FOR INSTALLATION +�`� ,70:2 Owner's Name. f? (� � Telephone: 725 0� S �f Address: c`J ' ` Installer's Name: G{ r'�� i';r�<' k ' Telephone: Number of bedrooms (residential only) / Total daily flow (compute (d 150 gal per bedroom) 15 r- az Topography: Circle one:�Flat Rolling Steep Slope % of Slope Soil Nature: Circle on<m oam Clay Other /Depth: Feet Ground [Hater: At what depth ? A Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle ones not requirep required rate min. inch, Domestic water supply: circle one:( Municipat.) Well Other If domestic water supply is a well: Separation: Water supply from septic absorption - -- -- feet PROPOSED SYSTEM : Septic Tank 1 ,1,oegal. ( minimum size : 1 , 000 gal.) TILE FIELD : Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of _/ Size each tol 'feet by feet Size of stone to be used # 3 /Depth or Thickness c :�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 Rueensbury San�)itaryy� Sewage - Disp'}osal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: `� /1 c� -, 'L t` e� DATE: OVER z ` 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 , vile fields and /or drywells B . Nu 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 . G . 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 installa- tion , alteration or repair of an approved system , a new proposal must bu submitted to the Queensbury Building Department before further construction , Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 BUILDING and ZONING (DEPARTMENT /YJ'7y Bay and Haviland Road, R. D. I Box 98 Queensbury , New York 12801 SEPTIC DI SPOSAU SYSTEM INSPECT I Ohl KAME LOCAT ION 4 PERMIT DATE h-LIA�01 SOIL TYPE - Sand - Loam - Clay - �— Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TypE of SYSTEM total length Absorption £ field Length of 'gach trench Depth, of t> enche s Size of SEEPAGe,-j2T.TS4NuVnber of) Size_ e'S ft!, Gravel size 5iz "hype PIPING : Bldg . to tank Tank tO c3i.st . box Lust_ bog-- to fit�Id/ NO Partial Openings sealed?, Es. /ry LOCATION/'SEPARATIONS : Oft. Foundation to tang, ft . Foundation tO absc '�ption Absorption to lotTss ft. Separation Of pits&LOCATIC?ls S'r(l5TEN1OPERTY (cixcle One3 FrontearLefe - Right Side - CCHMENTSn SYSTEM USE APPROVED Y 5 NO Building I s ctor (31/86 and v1 ................................... Up >6 rn Jo rlm W4