88-491 BUILDING PERMIT 4
TOWN OF QUEENSBURY 88-491 b
No.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Christopher Healy co
BayRoad Street, Road or Ave.
OWNER of property located at
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.
N.
1. OWNER'S Address is c
Same C
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2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer Service `C
3. CONTRACTOR or BUILDER'S Address
RD#1 — Upper Bay Road
Glens Falls, N.Y. 12801
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) CD
( )Wood Frame ( 1 Masonry ( 1 Steel ( ) rt
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CD
7. PLANS and Specifications r'
N.
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No. 1000 gal. tank, 180' tile field as per plot plan and application
8. Proposed Use
Sewage Alteration
10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1 19 90
(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 Queensb is 11 th Da of July 19 88
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
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QTO N; C ' T >
/ APPLICATION FOR SEPTIC DISPOSAL PERMIT P
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JUL '51988
DATE Th-e _:5---/ , c BUILDING.& CODE DEPT.
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LOCATION OF PROPE TY F R I TALLATION
Owner's Names �(,1 A c.. Telephone:
Address: _ c'''Z ��
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Installer's Name: c
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Number of bedrooms (residential only) _ L.
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Total daily flow (compute @ 150 gal per bedroom) ) �`Z,
Topography: circle one:, tat 'Rolling Steep Slope % of slope
Soil Nature: circle one:(andf Loam Clay Other / Depth: _ feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other _
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption t --z, feet
PROPOSED SYSTEM: Septic Tank / I:727 gal. (minimum size: 1,000 gal.)
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TILE FIELD: Each Trench 6c, feet / Total system length / `?s'`=' feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # � / Depth or Thickness — feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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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 Sanit Sewage Disposal Ordinance.
Signature of responsible person: c"`z'/
\ 8
Date: -
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD.PLACE TO LIVE
Jou in o f Quenihur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION //� d'
DATE / '(p /A7' PERMIT NO. 2i-4 q
SOIL TYPE - Sand - Loam - Clay -
Percolation: Test Required? YES - NO
Percolation; ate - Min/Inch
TYPE of SYST
Absorption fiela , tot•1 length
Length of each t. en. P i9
Depth of trenches ♦—
Size of gravel
SEEPAGE PITS4N ter of)
Size- ft. X .t.
Gravel size
PIPING: :iz: T p9�
Bldg. to tank
Tank to dist. box
Dist. box to ield/-- l7
Openings sea ed? '0 Partial
LOCATION/SE'ARATIONS:
Foundation o tank < t.
Foundation to absorption ) ' .
Absorption to lot line _ y-' ft
Separatio of pits ft.
LOCATION 0E' SYSTEM ON PROPERT ire one)
Front - •-ar - Left side •ight
COMMENTS:
SYSTEM USE APPROVED YES NO
Buildin I spector
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