1991-149 BUILDING PERMIT
TOWN OF QUEENSBURY No. 91-149 au
WARREN COUNTY, NEW YORK a
PERMISSION is hereby granted to Lambi Investments Inc.
OWNER of property located at BAy Rd Street, Road or Ave. a- o
1-1
in the Town of Queensbury,To Construct or place a Septic Alteration
kip
at the above location in accordance to application together with plot plans and other information hereto filed and y
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
rD
1. OWNER'S Address is r+
to
00
gj
2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer a
Vf
co
3. CONTRACTOR or BUILDER'S Address
e+
4. ARCHITECT'S Name
0
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
Septic Alteration to include:
No. 120 Tile Field With #2 Stone, 10" thickness as per plot plan
specifications and application
8. Proposed Use
Septic Alteration
$ 15.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 15, 19 93
(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 _1...5th Day o- / April 19 91
SIGNED BY ��G2zC� for the Town of Queensbury
Building and Zonirig,(nspector
TOWN OF QUEENSBU
kSll�1�:.j APPLICATIO�� FOR..SEPTIC DISPOSAL PE ' 0.i/j '.
DATE r A A J0, 7( opt, &Cl/r10(-\
,._ ''-‘0
LOCATION F PROPE Y FOR INSTALLATION (0
Owner's Name: .0�,4,,C� 1 /1 U,, A4- . 14 _ /'1(./G ; �v \v
Address: 0 //� p
1 _
Installer's Name: r- c{ „,,, ,4L.‘ k,--v--/ 1: Telephone: 7 rJ3C Ver-
Number of r r bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) x3 )
Topography: Circle one: ai Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Imperv.ious Material: At what depth? Feet
Percolation test: Circle one: not require required TOWN OF QUEENSEUR1
RECEIVED
Rate - Min. Per Inch
Domestic water supply: Circle one: uric paj Well Other APR 4 1991
If domestic water supply is a, well: DE DEFT.
Separation: Water supply from any septic absorption BLDG. $tecQ.
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench ,' 0 feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size. of stone to be used #. _ /Depth or Thickness �� feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED -
NO. of Tanks Size of Each Gal .
*Alarm systems 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: iv -.T j
• 1 t
•
•
•
•
•
.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 sublitced 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 co any water supply
5.) size and dimensions of all tanks, distribution boxes,
cilee fields and/or drywalls -
B. Nu system shall be -covered before inspection and approval by the
uuilding 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. Anapproved 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
cion. alteration or repair of an approved system, a new proposal music
be :submicta'd .co' the Quuunsbury Building' Department before further
construction.
•
•
Town of Queenibury •
• BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
• Queenibury, New York 12804 •
•
kumarks:
•
•
•
•
•
•
•
•
•
•
•
•
TOWN OF QUEENSBURY
BUILDING:.& CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518)761=8256
SEPTIC'DISPOSAL SYSTEM INSPECTION .
, Name
L_A l I13VE. 1-1-A Eta
Location (71 c P(m R )EN
Date „�--q .-91 Permit # 11-H4C
SOIL TYPE: Sand-Loam-Clay
Results of Percolation Test-
(if applicable) Rate-Min nch.
TYPE OF SYSTEM:
ABSORPTION FIELD: To Leng h
Length of ach. tree
Depth of tr ches
Size of stone
SEEPAGE.PITS:. ' umber--
Size -. ft. _x '.. ft.
Stone size
PIPING: Size ype
Bldg. to Ta
Tank to Di ` . Box
Dist. Box o Field/Pit . ;
Opening ealed? Yes No Partial
LOCAT,• /SEPARATIONS:
Foundation` to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan`. :.-:Yes No
LOCATION. OF SYSTEM ON;PROPERTY:
(circle 'one)
Front Rear - Left Side 7 Right Side
Middle Front - Middle Rear
COMMENTS
C Lob ;ate: PV' ri
' Ev-P, w,
SYSTEM USE APPROVED: YES ° . NO
Arrived:
Depart,L0'. .. AtifiM :
i�
Aarir. , r
ui 1 di•n9 p'ctor
=
TOWN OF QUEENSBURY
BUILDING C S DEPT. TOWN OF QUEENSBURlr
RE=CEIVEr
REVIEWED
DATE P 1 APR 41991
BLDG. & CODE DEPT.
a:Bt&tLois
Oa4 , T \
GP'
�1