1990-829 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-829
WARREN COUNTY, NEW YORK o
30 I
PERMISSION is hereby granted to Scott Shevy
OWNER of property located at 4 Michael Drive 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 Same
(N
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2. CONTRACTOR or BUI LDER'S Name `{
Steven Sanders
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Sewage alteration as per plot plan specification and application
including: 195' Tile Field with #2 Stone 1' thickness ro
8. Proposed Use —'
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Sewage alteration -5
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 11, 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.)
Dated at the Town of Queensbury this Day of .December M 19 90
SIGNED BY for the Town of Queensbury
Building and Zoni nspector
► W�N OF QUEENSBURY
##:�' APPLICATIl l� 'SEPTIC �TSP
��l a�91/i� � BURY
RECEIVED
DATE: Gee- 9 0 404
LOCATION OF PROPERTY FOR INSTALLATION `� �� G'A�e� .E/ , �9 pe0 auk/
�C�# SI BLDG:.& CODE D?T
Owner's Name: ����
Address: '/ �L'�ec7/ Gv r. t)ic)c shrlr�
Installer' s Name: "�',t-r'rl 5e k,? '9' Telephone: ? f$ -/Is
Number of bedrooms (residential only) :
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: F�,t Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other /Depth:
Ground Water: At what depth? Feet • ,
Bedrock or Impervious Material.: At what depth? ------ Feet
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Percolation test: Circle one: not required required
Rate - -- Min. Per Inch
Domestic water supply: Circle ne: Municipa Well Other
If domestic water supply is a wel :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ,f-y5,�al . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 4! 6"-- feet/Total system length ����' feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. /R /Depth or Thickness / feet
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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: / DATE: (_/ / JC)
1
Septic System Inspections:
A. All applications for septic system installation, alteration or repair,
es 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:
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1.) the proposed location of the system
2.) location and distance co 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 drywalls
B. Nu system shall be covered before .inspection and approval by the
Building Inspuctor. Failure to comply with this requirement may
result in the uncovering of the system by the installer and a fine
uf 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—
eion. alteration or repair of an approved system, a new proposal suet
bu submitted co the Queensbury Building Department before further )
construcci"on.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks:
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OWN OF QUEENSBURY •
RECEIVED
DEC 10 1990
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BLDG. & CODE DEPT.
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