1992-293 w
BUILDING PERMIT �
TOWN OF QUEENSBURY a
No. 42-293
WARREN COUNTY, NEW YORK ate'+
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PERMISSION is hereby granted to John & Janice King cc
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OWNER of property located at 44 Y7ncrest Drive Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a Septic 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, r
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t. OWNER'S Address is 0
Same
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2. CONTRACTOR or BU1 LDEfi'S Name
ARIA Excavating a
Gansevoort . NY
3. CONTRACTOR or SUILDER'S Address
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R. ARCHITECT'S Names
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S. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X) qr++.
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1 ] Wood Frame I 1 Masonry ( I Steel f ] �'
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7, PLANS and Specifications
Septic Alteration to include _
No. 1500 gal _ Tank with 2 seepage pits each 8 ' x 10 ' using #3 stone
2 ' thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
S 25- 00 PERMIT FEE. PAID — THIS PERMIT EXPIRES JUNE 1 , 199_
(If a longer period is requ fired an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.f
Dated at the Town of Queenstaur 1s st a of June 1942
SIGNED BY for the Town of Queensbury
Building a ing 1 nspector
TOWN OF QUEENSBU�Y
APPLICATION FOR SEPTIC DISPOSAL PERMIT aermit #
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LOCATION OF PROPERTY FOR INSTALLATION :
owner ' s dame : TO &� 1� Ta,viae- 1r;ovq
Owner ' s Mailing Address : or &
Installer ' s Name : Phane :
Number of bedrooms ( if residential ) :
Total daily flow ( residential - compute @ 150 gal . per bedroom ) :
Topography- Circle One : Flat Rollin Steep Slope % of Slope
Soil Nature- Circle One : Sand Loam Clay Other /Depth :
Ground Water-At What Depth ? _ ? Feet
Bedrock or Impervious Material -At What 'Depth? � Feet
Percolation Test-Circle One : Not Required Required/ Rate Min . Per Inch
Domestic Water Supply- Circle One : Municipal Wel Other
If domestic water supply is a well _..._.
Separation : Water supply from any septic absorption feet
XSW
PROPOSED SYSTEM: Septic Tank A&W gal . ( Minimum size : 1 , 000 gal . )
Tile Field : Each Trench J GG�� feetflTotal System Length feet
Seepage Pit ( s ) : Number of coC f Size Bache ft . x /0 ft .
Size of Stone to be used : # _/ Depth or Thickness c9, feet
HOLDING TANK SYSTEM IF REQUIRED
No . of Tanks Size \ of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
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 ?�2
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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 , 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 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 installation ,
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 & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks :
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