1990-745 BUILDING PERMIT
TOWN OF QUEENSBURY o
No. 90-745
n \ \ . 7V(ARRENCOUNTYNEWYORK
PERMISSION is hereby granted to
PATRICK E. BREAN
OWNER of property located at \'C) -'34AaIndi ana Av 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 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
RD#4 Bx 131 Indiana Av
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
self '~
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3. CONTRACTOR or BUILDER'S Address m
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
fD
( )Wood Frame ( ) Masonry ( ) Steel ( ) ro
ro
7. PLANS and Specifications
No. Sewage alteration to include one 1000 gallon tank with 2 8'x8' seepage
pits with #2 stone.
8. Proposed Use
Sewage systemCD
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m
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 29 19 92
(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.) -5
c+
Dated at the Town of Queensbury this Day of , October 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning I ctor
TOWN OF QUEENSBURY
� j - APPLICATIO'1 FOR SEPTIC DISPOSAL PERMIT P ►7Y�
_.;v q OF i.6Et;NSBLIR
DATE: /z2/ // �� /a REC .t G
LOCATION OF PROPERTY FOR INSTALLATION IRA/ /3/ _ rif%9/i//7 Fc .3 1990
Owner's Name: Xei if-��/� /FfrlP,7/1/ 91 DG
Address: (9 / ,8eX /3/ X/1/c/iiW Q /,7 J i V
Installer' s Name: 3.P Telephone: % —
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: 4110, Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? 5g /'0 . Feet
Bedrock or Impervious Material : At what depth? 99/c// Feet
Percolation test: Circle one: not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Municipal Well Other
If domestic water, supply is a. well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /O 1 2 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPA PIT(S Number of r- /Size each feet
by * e-
Size of stone to be used iV =-%2 /Depth or Thickness feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
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 Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ;‘ g DATE: /0/ZW,
Optic 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 co 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 co lot lines
3.) location and distance co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks. distribution boxes,
tile 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 co $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure co 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
be submitted to the Queensbury Building Department before further
Construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury. New York 12804
kaniarks: :.
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Down o/ Queen3ur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /-)A7 B‘2- A/
LOCATION /—j f f/t/1Oi/niJ4 A-vit----
DATEJ2/21/ PERMIT NO. CIO—t71-F-,-
SOIL TYPE - Sand - Loam - Clay' -
Percolation Test Required? YES - NO
Percolation\rate - Min/Inch
TYPE of SYSTEM:
Absorption fiel , total length( .
Length of each ench '
Depth of trenched • )• .
Size of gravel 1
SEEPAGE PITS4Numb6r of)
Size- ft. X \ ft. s •
Gravel size , - 4 I
PIPING: Size / Type
Bldg. to tank k 1 •
Tank to dist. box \ I
Dist. box to field/pit p
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS: V
Foundation to tank i\ - ft.
Foundation to absorption' \ ft.
Absorption to lot line \ ft.
Separation of pits \ ft.
LOCATION OF SYSTEM ON. PROPERT\(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
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Crn AlCbL i
SYSTEM USE APPROVED N
Building In pector •
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. ..;14N OF QUEENS-BURY
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OCT 25 1990
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TOWN OF QUEENSBURY 66?
BULD1NG & CODE DEPT.
REVIEWED-BY
DATE A FILE COPY