1989-966 BUILDING PERMIT A
TOWN OF QUEENSBUR.Y �
No. 89- 966
WARREN COUNTY, NEW YORK �
Cp" - _ 6 : .
PERMISSION is hereby granted to Ri dhard Hayi l l and .P
OWNER of property located at Ri due Road Street, Road or Ave_
r—
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.
i_ OWNER'S Address is
Box 74 - RD # 1 gw�
Ac
2. CONTRACTOR or BUILDERS Name
O
Condon ' s Septic & Drain Service
3. CONTRACTOR or BUILDER 'S Address
4_ ARCHITECT'S Name
5_ ARCHITECT'S Address ap
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6. TYPE of construction — (Please indicate by x)
a
{ ) Wood Frame { ) Masonry { ) Steel { ►
7. PLANS and Specifications
No, Existing 1000 gal concrete tank with 400 ' trench field system each trench 50 feet as per application
s. Proposed Use Irm
Sewage Alteration m
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r4
$ M00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 14 19_2.1- ;
(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 _ 14th _Day D*ee*6'er
SIGNED BY for the Town of Queensbury
Building and Zo ing Inspector
TOWN OF QUEENSBURY
TOWN OF QUEENSBLJRY
APPLICATION FOR � RECEIVED
'• } SEPTIC DISPOSAL PERMIT DEC 1 w 798 1
54 - g:t) - 12 E3LDG. & CODE DEPT,
DATE
LOCATION OF PROPERTY FOR INSTALLATION d7 ; { G
Owner's Name:41( b 4 �! llj 1�� Telep/h' one:
Address: N _DCc:)L + 0X 7 Y d /
Installer's Name: ' O n+ ,r � ! [ ttl�' '► .. Telephoned-
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom) '7� ]
Topography: Circle one: tat Rolling Steep Slope 96 of Slope
Sail Nature: Circle one: Sand Loam Cla Other /Depth: Feet
Ground Water: At what depth ? ( Feet
Bedrock or Impervious Material: At what depth ? OFeet
Percolation test: Circle one: not required required rate W/ min. inch.
Domestic water supply: circle one: Municipal Well Other
If domestic water supply is a well:
Separation: Water supply from sept ' absorp ion feet
eeNZ1E E
PROPOSED SYSTEM : Septic Tank ,�4000 gal. ( minimum size: I Xor) gal. )
TILE FIELD : Each Trench 0 feet/Total system length �� feet�Yr
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # Z-- /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 Sews Disposal Ordinance.
WD
SIGNATURE+�� OF RESPONSIBLE PERSON: C.
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 , shrill
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing :
I * ) 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 ,
the 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
rwsult in the uncovering; of the system by the installer and a fine
or 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
BUILDING and CODES DEPARTMENT
Bay and Uaviland Roads
Queensbury , New York 12804
ktira�arka ; ,
_.J'own of Qttee4n36t4rry
BUILDING and ZO ING DEPARTMENT
Bay and Hav hand Roadt R. D. 1 Sox 98 �
Queensbury, 4ew York 12801
SEPTIC DISPOSAL SYSTEM IN PECTION
NAME
LOCATION
DATE ��/ r PE T NO .
SOIL TYPE - Sand - am - lay
Percolation 'rest Re tred YES - NO
Percolation rate - n/I h _
TYPE of SYSTEM:
Absorption field , t al length
Length of each tren
Depth of trenches
Size of gravel.
SEEPAGE 'PITS-(Number
Size- ft. x _
Gravel size
PIPING : Size Type
Bldg - to tank `�------
Tank to dist. box � ,
Distm box to field/ NO Parti l
openings sealed? E
LOCATION/SEPARATI Sz L E f� gt .
Foundation to tan . ft.
Foundation to ab rPt- In
Absorption to to line _ , t-
-A� f t.
Separation of Pi s OP one)
LOCATION SYS ON - Right side
Front - air - eft sid -
ccmMENT _. __._
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l
SYSTEM USE PPROVED YES N
Bui ding Inspector
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15 :pis
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300
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