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TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
.. Community Development - Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: BOTH-000412-2016
Tax Map No: 266.1-143
Permission is hereby granted to: Morning Star Septic
For property located at: 88 FOX RD
In the Town of Queensbury,to construct or place at the above location in accordance with application together
with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform
Building Codes and the Queensbury Zoning Ordinance
Type of Construction
Owner Name: David Seaman Septic Disposal $0.00
Owner Address: 88 Fox RD Total Value $0.00
Queensbury,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
Morning Star Septic
107 Jewell RD
Gansevoort,NY 12831
Plans&Specifications
Residential Septic Alteration
$ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,June 24, 2017
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town o uee ury; Wed ed , June 29,2016
SIGNED BY: for the Town of Queensbury.
Director of Building&Code Enforcement
��L,<
SEPTIC DISPOSAL APPLICATION Office Use Only
Received �}o�
DATE: JUN 2 2016 Tax Map ID ;W6, / -r --4-3
Permit No. 5 o i H It 1 2 -.10�S�
TAX MAP ID: 2(a -J- Permit Fee ®°% /nr u,CC 752
ZONE: 7-70-v,. .:.
BUILDiNG C(
APPLICANT „, C PHONE/E-MAIL
ADDRESS t ��
INSTALLER/ PHONE/E-MAIL
BUILDERo„Y„�
OWNER
ADDRESSx
CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: -
PHONE/E-MAIL `7 t f 1`7✓
RESIDENCE INFORMATION
Year Built #of bedrooms X gallons per bedroom =total Daily flow
1980 or older Garbage grinder installed Yes ZC No
1981-1991 Li p„ Spa or Hot Tub installed —Yes ,C No
1992-Present
PARCEL INFORMATION
Topography Fla rolling Steep slope _%Slope
Soil Nature Sand _�Loam Clay Other
Groundwater At what depth:
Bedrock/Impervious material At what depth: 6 tom'
Domestic Water Supply Municipal ___K Well(if well,water supply from any septic system absorption is ! ft.)
Percolation Test Rate: S:r 2 per minute per inch(test to be completed by licensed engineer/architect)
PROPOSED SYSTEM FOR NEW CONSTRUCTION
Tank size /2 5 L, gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub
System Absorption field with#2 stone Total length ,2$O ft.;Each Trench o
Seepage Pit with#3 stone How many: ;Size
Alternative System Bed or other type:
Holding Tank System Total required capacity? Tank size #of tanks!Z]
Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will
no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the
septic system layout on file—no exceptions.
Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation or failure
to make a material fact or circumstance known by or on behalf of an applicant,shall be void.I have read the regulations and agree to
abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
PRINT NAME: S DATE:
SIGNATURE: DATE:
Town of Queensbury Building&Codes Principal Structure Application Revised September 2014
518-793-2290
�
Fax 518-793-2115
a
515
E-mail: morningstarseptic@hotmail.com
www.morningstarseptic.com
- pvlc sonvic!
Date: 107 Jewel Road,Gansevoort,NY 12831
TO: � -
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JUN 2
� I 9 2016
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266.1-1-43 BOTH 412-2016
Morning Star Septic Systems
for David Seaman
88 Fox Road SEPTIC SYSTEM EERMIT_PLOT PLAN
I HAVE PERSONALLY MEASURED THE DISTANCE
FRON/I THE PROFJERTY LINES TO THE
PROPOSED - ? G RE(S) OR SIGN(S)
c
TOWN OF QIU Sic URE l7ATE
BUILDING & OD D T.
Reviewed By
Date:
G. Peter Jensen
17 West Road
South Glens Falls
New York 12803
JUN 29 2016
(518) 798 -3859
T70MKI*b�-
Junel6, 2016 .7- N-BURY
BUILDING & CODES
To Whom It May Concern:
I have performed a percolation test and reviewed a test pit dug for David Seaman at 88
Fox Road, Queensbury, Warren County New York. The test pit revealed:
0 0-6"top soil.
0 6"-23" brown sandy clay.
0 23"- 53"gray brown gravely clay.
0 53"-76" clay with coarse sand.
6 No evidence of mottling observed.
The percolation test resulted in a stabilized percolation rate of 8 minutes 58 seconds.
Sincerely,
G. Pe r Jensen o Ft ED Aje?C,
CR J.
Od?8-0 10
Op pw*
.V
518-793-2290
Fax#518-793-2115
E-mail: morningstarseptic@hotmai1.com
www.morningstarseptic.com
MAR
/ OPTIC SMIRVIC■
Date: l t� 107 Jewel Road,Gansevoort, NY 12831
TO: S,..",.+,.a,..,_
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