1987-208 BUILDING PERMIT
TOWN OF QUEENSBURY 87-208
No.
WARREN COUNTY, NEW YORK
H
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PERMISSION is hereby granted to Thomas E. Haley
cn
OWNER of property located at 2 Colonial Court Street,Road or Ave. •
txi
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.
1. OWNER'S Address is
2 Colonial Court
Queensbury, New York
2. CONTRACTOR or BUILDER'S Name C
Pro—Craft
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3. CONTRACTOR or BUILDER'S Address
Pheasant Walk
Queensbury, New York 12801 1-1
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications N
No. new dist. box and 2 7'x8' seepage pits per plot and application °p
8. Proposed Use
Sewage system for dwelling
$ 10.00 PERMIT FEE PAID—THIS PERMIT EXPIRES May 5 19 87
(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 5th Day of May 19 87
SIGNED BY (�• ' for the Town of Queensbury
Y
Building and Zoning Inspector �/
TOWN OF EENS - -
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au#OWn. of QIeuzd p _' lq [i-d31
APPLICATION FOR SEPTIC DISPOS . ' T
APR z 1987
p BUILDING & C013F DEPT.
DATE / i V Or , e /levi'(WP/' - t)
LOCATION OF PROPERTY FOR INSTALLATION Cc) �G/L' /,. y -1 CV
Owner's Name: -%7ii�7;�%f . /% /, - Telephone: .-,c7�f+3 cf J
Address: 30 /c:% 'G' /_-,r / L-/-.
Installer's Name: i'r'o (1/!=/` Telephone:
Number of bedrooms (residential only) _ 3
0)Total daily flow (compute @ 150 gal per bedroom) Vi
Topography: circle one: (Flat ,Rolling Steep Slope % of slope —
Soil Nature: circle one: \Sand ' Loam Clay Other / Depth: feet
Ground Water: At what depth? 0 feet
Bedrock or Impervious Material: At what depth? 0 f et
Percolation test: circle one: not required required /rate____________F_
min. inch.
Domestic water supply: circle one( Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption — feet
PROPOSED SYSTEM: Septic Tank ,ram d e) gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S): Number of2.--- / Size each _ feet by feet
i
Size of stone to be used # — V
/ Depth or Thickness J -+feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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4 d\ 5 -ar A-Y-- 17
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Section II 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, tile 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.
•
I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
S�
Signature of responsible rs n: t__ „ �'i nat e person: -�,.,,-,-� -� �/
gP Y / �
Date: 67' 6?- - c?
— 1
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
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Down .of Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ht ivi as Ogre /
LOCATION oZ C.01 d n i kit (11-.
DATE 5// / 27 PERMIT NO. 39- 02 O 8
SOIL TYPE San - Loam - Clay -
Percolatio' t Required? YES '
Percolation rate - Min/Inch _ 0—
TYPE of SYSTEM:
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank rst
Tank to dist. box s t''
Dist. box to field/•.
Openings sealed? NO Partial
LOCATION/SEPARATIONS:
Foundation to tank t.
Foundation to absorption 4l ft.
Absorption to lot line d i fir
Separation of pits �,/, ft.
LOCATION OF SYST RTY(circle one)
Front - Rear L ft side - ight side -
COMMENTS:
po ._ C►- f s- Cer-A 4O -
SYSTEM USE APPROVED(S)
NO
0/3
Building Inspector
01/86 and vl