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1989-814 BUILDING PERMIT TOWN OF +QUEENSBURY No. 89-$14 x (l{{ 1 WARREN COUNTY, NEW Y©RK 3b%* 1 M ram' PERMISSION is hereby granted to GEORGE GORE OWNER of property located at Bedford Close " V Street. Road or Ave. c�'n k in the Town of Oueensbury. To Construct or place a Sewage Al terati an `" at the above location in accordance to application together with plot plans and other information hereto filed and Cr approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. 1 . OWNER'S Address is Lot 109 - Honey Hollow Bedford Close c� 2. CONTRACTOR or BUILDER'S Name m 0 A . J . Catalfamo Constructions Inc . 0 3_ CONTRACTOR or BUILDER'S Address .'t7 r+'k 4. ARCHITECT'S Name b. ARCHITECT'S Address va m a M 6- TYPE of Construction — (Please indicate by X) t`� { ) Wood Frame I 1 Masonry { 1 Steele ( i C5 47 f0 7. PLANS and Specifications No. 1000 gallon tanks 3 6 ' x 8 ' seepage pits as per application and plot plan . B. Proposed Use CAP rD Sewage Alterationo u� ro p J $ 25000 PERMIT FEE. PAID — THIS PERMIT EXPIRES _ October 19 7991 ro (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of trie m town of Queensbury before the axpiration data.) `� O Dated at the Town of O.ueensbury this th i]ay of October t4 SIGNED BY '� for the Town of Queensbury Building and Zoni nspector APPLICATION FOR v � SEPTIC DISPOSAL PERMIT `` ° 0 C ! uLCC. 3� COI7c F' f, DATE --- LOCATION OF PROPERTY FOR INSTALLATION ; -fcy1Q� C3 S Owner's Name: 4 ,�L9 ie!j P // C fP� / Telephone: �? Address: , Z& Y " / 0 yf-tt�rUC � � 0 d nu ) Lie r l 42;tcr._ Installer's Name: f e4 �n5 t - Telephone:_ �t; S r Number of bedrooms (residential only) Total daily flow (compute Cd 150 gal per bedroom) t7 D Topography: Circle one: Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: Sand 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 min. inch. Domestic water supply: circle one: Municipal Well Other If domestic water supply is a wells Separation: Water supply from septic absorption feet PROPOSED SYSTEM : Septic Tankp0 C: _ gal. ( minimum size: 19001) gal. ) TILE FIELD : Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of -` / Size each 4:� feet by feet r 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 Queensbury Sanitary Sewage Dispos O finance. SIGNATURE OF/RESPONSIBLE PERSON: DATE: / 'J /G 14000 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 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 , rile 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 rusult in the uncovering of the system by the installer and a fine Ot 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 worts. stoppage , D . Should unforeseen problems during construction prevent proper installa— tion , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury BUticting Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 dodo kid ems:• �,,.� �*,p �i,4+'' � � MLJ IM •`1 1 } 4 � 1 - 'S i t k 1 1 w_ S n} Grp s