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1989-938 BUILDING PERMIT 512 x TOWN OF QUEENSBURY F No. 89-938 WARREN COUNTY, NEW YORK a PERMISSION is hereby gra to RORERI A AI�DALL ------- f] Street, Road or Ave. HIV OWNER of property located at ji. in the Town of Queensbury, To Construct or place a _ Sewage Alteration lzz'" 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. -4, 1 . OWNER'S Address is Same 2. CONTRACTFOR or BUILDER 'S Name f ' f� X NAYLOR WELLS - HOMETOWN SEPTIC a m 3. CONTRACTOR or BUILDER 'S Address I*1 2y 4. ARCHITECT'S Name S. ARCHITECT'S Address COW) 6. TYPE of Construction — (Please indicate by XI Q ( I Wood Frame I ) Masonry [ I Steel ( D Vn m i_ PLANS and Specifications No. 200 , trench field system as per application and plot plan . m S. Proposed Use Sewage Alteration $ 25 00 PERMIT FEE PAID — THIS PERMIT EXPIRES November 29 , 1990 19 rn [1f a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Pt1 town of Queensbury before the expiration date.] :V* l— Dated at the Town of Queensbury this 29th Day of November 19 89 M SIGNED BY for the Town of Queensbury Buildirg and Zoning ctor -rativrr OF QvErzvsBUrr APPLICATION FOR :SEPTIC DISPOSAL PERMIT 30 3000 +p'Jh133 :jO Nrp,C31 DATE � LyJ > "�. � . ( � � `�1 htil'198N3�nO LOCATION OF PROPERTY FOR INSTALLATION L+ i :�lt r 3 � e.Q4n5 6kAf. ,1 Owner's Name: FAG 4� ©A Telephone: + Address: [ 0^ ( 4w2 � .� �A � 5 � Telephone: Installer's Name: Number of bedrooms (residential only) Total daily flow (compute ( . 150 gal per bedroom) /AA04 Topography: Circle one CEDRolling 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: of required equired rate min. inch. Domestic water supply: circle one: Iunicipa Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM. Septic 'rank gal. ( minimum size: 1 . 000 gal.) TILE FIELD : Each Trench feet/Total system length ,71fk5 feet SEEPAGE PIT(S): Number of / Size each feet by feet 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�Saniitaaryy SSewage �Disposal Ordinance. .- SIGNATURE OF RESPONSIBLE PERSON: r y, ri DATE: 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 drywalls 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 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 roust be submitted to the Queensbury Building Department before further corisrruction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Ruviland Roads Queensbury , New York 12804 k,:nisrks ; _town 0ueenS6urr� fi, rp BUILDING and zoNiNG DEPARTMENT ( Bay and Haviland Road, R D . i Box 98 � & Queensbury, New York 12801 SEPTIC DISPOS L SYSTEM I,N,+S/PECTION NAME LOCATION ( d DATE PERM T NO SOIL TYPE - tsa'�` _ am - Clay - Percolation Test Re !red? YES - NO Percolation rate - M ' /Inch TYPE of SYSTEM : Absorption field , tat 1 lengt �F7 � Length Of each trench Depth of trenches Size of ;Travel SEEPAGE ;? ITS ENuinber o size- f t_ X _ f • �--- Gravel size -• e PIPING : 7 xe Type Bldg . to tans Tanis to (listo box t I Dist. baa: tea field/p ' Openings sealed? , Y NO partial LOCATION/SEPARATID ft. FoundatiOn to tank ft - Foundation to abs rption ft - Absorption to 10 line ft. Separation of p s LOCATION OF SYS EM ON PROPE TY (circle one ) Front - ,Rear 'Heft side - ght side - CCMMENTS* a r i SYSTEM USE APPROVE .` YES � NQ M Build g Inspector 01/86 and vl 4 a �, aQ ., m ]: � _ N�7 � � t1 '� swan �} ._ _ ter-- X h 1 dT III— ff � �7 t vivo r y i i