1989-753 --t
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BUILDING PERMIT
TOWN OF QUEENSBURY No $9 .753 < `
WARREN COUNTY, NEW YORK a
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PERMISSION is hereby granted to Carter White co
OWNER of property located at 2EL ,ferome AVenue Street. Road or Ave.
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in the Town of Queensbury, To Construct or place a S wa a Alteration
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1 _ OWNER'S Address is
Same
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2. CONTRACTOR or BUILDER'S Name W
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Condons Septic & Drain �
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3,. CONTRACTOR or BUILDER'S Address
Glens Falls , N . Y - 12801
4. ARCHITECT'S Name
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5_ ARCHITECT'S Address
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B. TYPE of Construction — (Please indicate by X} CD
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I 1 Wood Frame ( I Masonry ( } Steel ( Y R'
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7. PLANS and Specifications
No, Existing tank , 200 ' the field as per plot plan and application
B. Proposed Use
Sewage Alteration
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$ 25 * 00 PERMIT FEE PAID — THIS PERMIT EXPIRES September 21 ig 91 �
(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 21st Day of September 1989
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SIGNED BY for the Town of Queensbury
Building and Zon!4 Inspector
f OWN OF QUEENSBURY
APPLICATION R _
SEPTIC DISPOSAL ER IT r r c( TOWN OE OUBENSBURY
> RECEIVE0
SEP 2 7989
^ BLDG. &DATE CODE DEFT.
LOCATION OF PROPERTY
] FOR INSTALLATION
Owner's Namec/ryjkT)! (Q. iif N / 7r-, Telephone: 6 ■ '�
Address: cr 0 CrEk e l f f E AV
Installer's Name: aMbOA)�!i :cjo L , C.: Telephone: �T 80 8
Number of bedrooms (residential only)
Total daily flow (compute (a 150 gal per bedroom) ! �
Topography: Circle one: Ia Rolling Steep Slope % of Slope
Soil Nature: Circle one: San 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 required rate /4!/'� min. inch.
Domestic water supply: circle one: 16unicipal Well Other
If domestic water supply is a well:
Separation; Water supply from septic absorption feet
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PROPOSED SYSTEA-I : Septic Tank CAI.Sfto''f gal. (minimum size: 1 ,000 gal.)
TILE FIELD : Each Trench feet/'Total system length 1 Q 40 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # ' /Depth 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 Rueensbury Sanitary Sew a a Disposal Ordinance,
SIGNATURE OF RESPONSIBLE PERSON:
DATE: �` a-d
OVER
--Sep-tic 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 ,
the 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 uncoverin8 of the system by the installer and a fine
of up to $ 250 . 00 .
C . An approved cagy 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
he submitted to the Quoensbury Building Department before further
construction .
Town of Queensbury
RUILDTNG and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
Remarks
_Down of QueenJ mte y
BUILDING and ZONING DEPARTMENT ,
Bay and Haviland Road, R .D. 1 Sox 98
Queensbury, New York 12801
A
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION 2 C� ,✓
DATE ' PERMIT NO , . 1 - � D
7A2
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch -
TYPE of SYSTEM:
Absorption field , total length
Length of each trench
Depth of trenches
Size of +Iranvel - -
SEEPAGE PITS-(Number of)
Size- ft . X ft, A
Gravel Size
PIPING : Size. �j'�' Type
Slag . to tank °trs�
Tank to clist . box #
Dist. boy: to f iel
openings sealed? YES NO artial
LOCATION/sEPARAT DNS :
Foundation to t k �' Dom'- ` ;fto
Foundation to scrption ft -
Absorption to of line �ft,
Separation f its -"'tft .
LOCATION S 'STEM ON PROPERTY {circle one }
Front - ear Left side - Right side
COMMENTS
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SYSTEM USE APPROVED S NO
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