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1989-787 w BUILDING PERMIT TOWN OF QUEENSBUR.Y No. 89-787 WARREN COUNTYr NEW YORK PERMISSION is hereby granted to r �^f"f� Iv OWNER of property located at + Pitcher Road Street, Road or Ave. in the Town of Queensbury, To Construct or place a _ Sewage Alteration at the above location in accordance to application together with plat plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. F2CONFTRrACTOR NRS Address is Same z or BUI LDER S Name T'y V Sanitary SEwer 07 3. CONTRACTOR or BUILDER'S Address Luzerne Road Queensbury , N . Y . 12804 4. ARCHITECT'S Name 5. ARCHITECT'S Address cr C's C t6 ^f B. TYPE of Construction — (Please indicate by X) tw sz ( I Wood Frame f ? Masonry ( 1 Steel ( ) 7. PLANS and Specifications No. 1000 gal . tank , 2 b�PPl81 seepage Pits as per plot plan and B. Proposed Use Sewage Alteration m rn XXX September 3 19 91 $ 9F llff PERMIT FEE PAID — THIS PERMIT EXPIRES p fif a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 00+ town of Queensbury before the expiration date.) rt C] Se tember 11989 Dated at the Town of Queensbury this ^� rd Day of P SIGNED BY for the Town of Queensbury Building and Zoning Inspector TOWN OF QUEENSBURY �� APPLICATION FOR SEPTIC DISPOSAL PERMIT � 79(99 DATE 12 dP 7 LOCATION OF PROPERTY FOR INSTALLA'T`ION Owner's Name: r,4v f`• f*j^jt � Telephone: ' Address: i Ti n t_ _R=!�t A!¢ Installer's Name: J 04#" t Troll r c, Alf-''A_ Telephone* � 4� - ni ..� S77 Number of bedrooms (residential only) , Total daily flow (compute (d 150 gal per bedroom) �7f Topography: Circle one: OfR Rolling Steep Slope % of Slope Soil Nature: Circle on Sand Loam Clay Other /Depth: Feet Ground Water: At what depth ? Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: Eirequire required rate min. inch. Domestic water supply: circle one: Municipa Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic 'rank ! 60 ED gal. ( minimum size: 1 , 000 gal.) TILE FIELD: Each Trench -- feet/Total system length -- feet SEEPAGE PIT(S): Number of ,_/ Size each feet by dp� feet Size of stone to be used #,3 /Depth or Thickness feet I have read the regulation on the reverse si this sheet and agree to abide by these and all requirements of the Town of Rue sb ry Sanitary Se ge Disposal Ordinance. n Z SIGNATURE OF RESPONSIBLE PERSON: DATE: f 0OVER Septic System Inspections , A . All applications for septic system installatlon , 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 Buiidfng liispuctor . 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 .installa— tion , alteration or repair of an approved system , a new proposal must hu submitted to the Qu` unsbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 K� ni;a r k s : .-�Jawn e7� ��`ee►r ,3hur�r BUILDING anp ZONING OEPAATMENT Bay and Haviland Read, R. D. T Box 98 C]ueensbury. New York 1280, SEPTIC DISPOSAL SYSTEM INSPECTION "r f NAMELOCATION rf A DATEe J PERMIT No. SOIL TYPE - nd Clay Percolation T st Requp1,Es Percolation r e - Min/Inch TYPE of SYSTEMs Absorption field total lengt Length of each tr ch Depth of trenches Size of gravel_ SEEPAGE p a Numb Gravel size - nldg . to tank �� <. Tank to list . bax Dist , box to field/ Openings sealed? ES Partial IOCATIQN/SEPARATI Ss Foundation to t Foundation to 1 ft. Absorption to l ©rption t . Separation of t line � . LOCATION OF g its 2�f T QPERTY (c role one) Front - Rear eft side +CCHMENTS + R�Right e _ 4 SYSTEM USE APPRCIVE YES nIQ Bull n3 Inspector 01/86 and vl r� l� GUS �� dr 4