1989-961 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 89- 9513(, 8 , jt4 �
WARREN COUNTY, NEW YORK �
PERMISSION is hereby granted to--. MICHAEL ITALIANO
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01NNER of property located at Street, Road or Ave. �tr+
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in the Town of Queensbury, To Construct or place a Sewage Alteration N
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
RD #3
2. CONTRACTOR or BUI LDE R"S Name
3
Chris G . Crandall
3. CONTRACTOR or BUILDER'S Address
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yam.
4. ARCHITECT'S Nance +�
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5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X) rn
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( } Wood Frame ( 1 Masonry I } Steel I 1
7. PLANS and Specifications L7
No. Existing 1 , 000 gal . tank with 250 ' trench field ( 50 ' @ trench )
a. Proposed Use
Sewage Alteration
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$ 25 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES December 11 19 91 m
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the b
town of Queensbury before the expiration date.) r�1
Dated at the Town of Queensbury this _1 Day of ., December is 89
SIGNED BY for the Town of Queensbury
Building and Zoning InspeFictor
-TOWN OF QUEE vSBURY
APPLICATION FOR OWN OF QUEENSBURY
,e ;,A RECEIVED
SEPTIC DISPOSAL PERMIT
DEC C _ 1989
BLDG. & CODE DEFT_
DATE
LOCATION OF PROPERTY FOR INSTALLATIONzFr
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Owner's Name: r � h'""� '"` �- r'� 4 //qd( o - Telephone: 1 1 3 '`+ '-�0
Address: �fn U � !�' E .10- D 4* C x ut 0>;ri..JS 8 L�( Ce
Installer's Name: H �2 S C R n1 an Telephone:
Number of bedrooms (residential only)
Total daily flow (compute a 150 gal per bedroom) 60c)
Topography: Circle one: Fiat Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sanc! Loam Clay Other /Depth: Feet
Ground Water: At what depth ? hoot/ A v 1 4/ Feet
Bedrock or Impervious Material: At what depth? I . 1 6r� Feet U% . , �...; . ;.
Percolation test: Circle one: not required required rate } - S min. inch.
Domestic water supply: circle one.(' Nlunicipal Well Other
If domestic water supply is a welir---� feet
Separation: Water supply from septic absorption
PROPOSED SYSTEM & Septic Tank /. .0*6 gal. ( minimum size: 1 , 000 gal.)
TILE FIELD : Each Trench 6- 0 feet/Total system length feet
SEEPAGE PIT(S): Number of - / Size each fe/et //b^^y "Meet
Size of stone to be used # 2- /Depth or Thickness / `a ° 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 Sewage Disposal Ordinance,
SIGNATURE OF RESPONSIBLE PERSON*
DATE:
OVER
Septic System Inspections :
A . All applications for septic system installation , &.Iteration or repair ,
as required by the Town of Queensbury Sanitary Sewage Ordinance , shall
be submitted to the Building Department at least 24 hour& 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 ,
the fields and /or drywells
B , No 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
of up to $ 250 . 00 ,
C , An approved copy of the plot plan shall be available on the construction
cite . 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—
Lion , ,alteration or rupuir of an approved system, a new proposal must
hu submitted to the Qu� cnsbury Building Department before further
construction .
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. i Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME I
L-OCAT I ON $ f
DATE / PERMIT Nfl . c• ` �
SOIL TYPE - San - Loam - ay
Percolation Test Required? YES - NO
Percolation rat - Min/In h -
TYPE of SYSTEM:.
Absorption field total length ' ^
Length of each d each I7
Depth of trenche
Size of gravel_
SEEPAGE PITS-EN r ) _
Size- ft. R t •
Gravel size
PIPING : Size Type
Bldge to tank C ''
Tank. to dist . box
Dist, box to fie
openings sealed? NO Partial
LOCATION/SEPARA I S : -
Foundation to nk Y+-A0ft.
Foundation to bsostion =ft -
Absorption to of l ne -.4L..ft .
Separation of pits ft*
LOCATION STEM PROPERTY (circle one)
Front - ea - Left ide - Right side -
COMMENT
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Y
SYSTEM USE APPROVED YE N
Buil in Inspector
01/86 and vl
Dote
CLIENT.............:......................................................
Prepared by
PROCEDURE............................................................. Reviewed by
CHARTNO................................................................