1989-946 �,,•' BUILDING PERMIT
>K
TOWN OF QUEENSBURY No. s4- ��� A
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted tonan
Street, Road or Ave. ti
OWNER of property located at 2R, nd nod Dries
w
in the Town of Queensbury, To Construct or place a Spwa g.e Alteration p.
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 . OV4NE WS Address is
Same
2. CONTRACTOR or BUI LDEWS Name
r
c
cn
Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
Y
v
�o
e�
4. ARCHITECT'S Name m
iPl
S. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X) rV
1 ) Wood Frame I I Masonry ( 1 Steel ( )
�p
7. PLANS and Specifications �+
Cf
No. Existing 1000 gal tank with three 6 ' x 3 ' seepage pits as per to
application and plot plan EEC
rM
8. Proposed Use
Sewage Alteration
$ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES D mb r 4, , 199_
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the q
town of Queensbury before the expiration date.)
xx
Dated at the Town of Queensbury this Day of _._ D pMhPr _fg_ � rr=
SIGNED BY for the Town of Queensbury
Building and tom 1 nspector
MWN OF QUEENSIBURY ~�
T N OF QUEENSBURY
APPLICATION FOR . f! RECEIVED
=_o Z SEPTIC D[SPOSAI:�,� PERM. NOV 1989
I r
t.
BLDG. & CODE DEPT.
DATE �;?��/ —
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name ' � ~�.f#N Telephone:.
Address: c� rp ! : W o o ) 75 r ri C -
Installer's Names s 3lc.G�'^V Telephone: `7 - 7-a
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom) /,7 9
Topography: Circle one Flat Roiling Steep Slope % of Slope
Soil Nature: Circle one Sand Loam Clay Other r /Depths Feet
Ground Water: At what depth? W— Feet
Bedrock or impervious 'Material: At what depth? Feet
Percolation tes#: Circle on Wert requ- _ iredJ� required rate min. inch.
Domestic water supply* circle one: 45ici a Well Other
If domestic water supply is a well: feet
Separation: Water supply from septic absorption
PROPOSED SYSTEtit* Septic Tank 1 0040 gal, ( minimum size: 1 .000 gal.)
TILE FIELD : Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of ---I Size each—feet by _feet
Size of stone to be used #k�IDeQth or Thickness
�7_ feet
I have read the regulation on the reverse Tsheet and agr to abide by these
and all requirements of the Town of Queeterry Sewer e p al Ordinance.
SIGNATURE OF R7ESPONSIB.LE PERSON6
DATE* �'� ` rX � '2�.� �—
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
b+e 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 linen
3 . ) location and distance to structures
4 . ) location and distance to any water supply
5 . ) size and dimensions of all tanks , distribution boxes ■
file fields and / or drywells
B , No system shall be covered before inspection and approval by the
Building Insp4ctor . 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
be submitted to the Queensbury Building Department before further
construction .
Town of Queensbury
BUILDTNG and CODES DEPARTMENT
Bay and Haviland roads
Queensbury , New York 12804
lz >j0 3
_Josue o� �cteen .t � eerc�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISP7SA SYSTEM INSPECTION
NAME N
LOCAT I ONa 490
DATE 1 PERMIT NO . �;f!f
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 l;ravel —
SEEPAGE ;? ITS4Number of)
Size- eft . X _ ft.
Gravel size
PIPING : Sit T pe
Bldg . to tank. � .5 f-
Tank to d±st. box
Dist. boy: to field/pit t,`G
Openings sealed? YES NO % Partial
LOCATION/'SEP*RATIONS
Foundation to tank ft.
Foundation to abscrption ` 't .
Absorption 'to lot line ft-
Separation .. of pits ft]
IATION OEM SYSTEM ON PROPE 'A-c . � one)
.00.
Front -- Rear - Left side - Right de
C C MMENT S
r
i
SYSTEM USE APPROVEDCYES '-:�'07 O
r
Building Inspector
01/86 and vl
7 . ,« .., .
DATE Joe&
•
,� 3� y�►