88-720 BUILDING PERMIT
TOWN OF QUEENSBURY b
No. 88-720
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David Sperry
OWNER of property located at DINEEN RD. — Glen Lake Street,Road or Ave.
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
RR#1 Box 1640
Lake George, New York 12845 t7
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service rn
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3. CONTRACTOR or BUILDER'S Address
P.O. Box 224
Glens Falls,N.Y. 12801
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( 1 Masonry ( )Steel 1 1 7:J
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7. PLANS and Specifications
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No. 1000 gal tank, 200 feet tile field
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8. Proposed Use
Sewage Alterations
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 11 19 90
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the OQ
town of Queensbury before the expiration date.)
Dated at the Town of Quee r is 11th Day o October 19 88 n
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SIGNED BY for the Town of Queensbury o'
Building and Zoni Inspector 0
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�0 f DATED 71y 1 °}.
APPLICATION FOR SEPTIC DISPOSAL PERMIT Zpni�►��t�G Cpt)CS our.
1Ohht Of UL,eui UUla
DATE 7 / fF
LOCATION OF PROPERTY FOR INSTALLATION lle.44n Pet - Cleh La.kt,.
Owner's Name: G<<1ls H. Sp€Y'ry Telephone: 67esto)7173 A./.S'rp
Address: Leo, Tax; / La.. 't o1y �y, / 2- E,LJr
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Installer's Name: '5641 1 y Se1th ye 5ev"- Telephone: 774 _za,�7
Number of bedrooms (residential only) _ 3
Total daily flow (compute @ 150 gal per bedroom) _ I/622 .
Topography: circle one: f Rolling Steep Slope 9L of slope ^_
Soil Nature: circle one: i J Loam Clay Other / Depth: feet
Ground Water: At what depth? /46 feet
Bedrock or Impervious Material: At what depth? _ 519 feet
Percolation test: circle one not required required / rate min. inch.
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Domestic water supply: circle one: Municipal !' ,? Other
IF domestic water supply is a Well:
Separation: Watersupl►ly from Septic absorption / 2 /�,,r,/, feet
, PROPOSED SYSTEM: Septic Tank/an" gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench se) feet / Total system length Owe feet
SEE E PIT(S): Number of 4(4 / Size each /v feet by�g- feet
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Size stone to be used .0 o� / Depth or Thickness // f*.ext
4 4 4 * 4 4 * + 4 44 4 4 4 * 4 4 4 4 4 4 4 4 M 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
IMPORTANT
...Pleasc...LIST NEW EQUIPMENT TO 1tE INSTALLED
• . 4 4 * 4 * * 4 44 4 4 4 4 4 4 4 4 * 4 4 . 44 4 • 4 • 4 4 } • 4 4 * 4 4 4 4 4
(over)
Section II Septic System Inspections: '
A. AU 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:
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1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
.i.) 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. t'ailure 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 ' wag Disposal Ordinanc
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of rest ,►sible rson: -` / �f'(� _
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Town of Queensbury
Building and Cpde_Department '
Bay at Haviland Road
Queensbury, New York 12801
• (518) 792-5E32 .
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awn of Queenitury
BUILDING and ZONING DEPARTMENT
Aa Bay and Haviland Road, R.D. 1 Box 98
/ Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME X i/(2- tCX/ - ' .'2-'4
LOCATION4;k -Le ti„L /t - 1' /,;Kie„4 L
DATE 'G; / ` b PERMIT NO. X - V)
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length !'
Length of e ch trench 7
Depth of tre hes
Size of grave "
SEEPAGE PITS{N er of)
Size- ft. X ft. t
Gravel size
PIPING: Siz.eI
, Type
Bldg. to tank ' '`
Tank to dist. box ' `f f
Dist. box to field/ ,4; '*
Openings sealed? jY' NO Partial
LOCATION/SEPARATION :
Foundation to tank! t ft.
Foundation to absOrptionft.
Absorption to lots line " ft.
Separation of p' s
LOCATION OF SYS EM ON PROPERTY ircle one)
Front -'Rr eft side - Righ side -
COMMENTS L �`t
SYSTEM USE APPROVED (YES
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B ilding Inspector
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