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89-494 BUILDING PERMIT TOWN OF QUEENSBURY No. 89-494 • WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Dr. Hallam Young OWNER of property located at Assembly Point 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 89 Sheriden Glens Falls,N.Y. 12801 C. 2. CONTRACTOR or BUILDER'S Name Sanitary Sewer 3. CONTRACTOR or BUILDER'S Address Glens Falls,N.Y. 12801 4. ARCHITECT'S Name 5. ARCHITECT'S Address v v rr 6. TYPE of Construction—(Please indicate by X) ix 1 1 Wood Frame ( 1 Masonry ( )Steel ( ) - C I- 7. PLANS and Specifications — No. 1000 gal . tank only as per plot plan and application. 8. Proposed Use Sewage Alteration v R $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 27 19 91 R (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r town of Queensbury before the expiration date.) rT Dated at the Town of Queensbury 7th Day of June 19 89 SIGNED BY for the Town of Queensbury Building and Zo i Inspector TOWN OF QUL•ENSUURY �� ` APPLICATION FOR s %:ice- `' "' .•.a;• --��� > SEPTIC DISPOSAL, •f FRMIT m, e alb {Y DATE lf/ DATE LOCATION OF PROPERTY FOR INSTALLATION n sjie 6. . Owner's Name: A- lbw, ( .1 OvA}&'I'elephone: 79,3 --v s0 Address: P ,-NA e, 4 "iJ 6- i-/j Installer's Name: j-kkt? 17T)/Z` v fcA Qf� Telephone: �� - Number of bedrooms (residential only) A-1/4- Total daily flow (compute (d 150 gal per bedroom) IL/A-- Topography: Circle one: Flat Rolling Steep Slope °'o of Slope Soil Nature: Circle one`` nd Loar3 Clay Other /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: of require required rate min. inch. Domestic water supply: circle one: Municipal Well - Other J-4-/i,,.5 If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM: Septic Tank I (O© gal. (minimum size: 1.000 gal.) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of / Size each — feet by feet Size of stone to be used # /Depth or Thickness — feet ************************* V ci +C- I have read the regulation on the revere side o this sheet and agree to abide by these and all requirements of the Town of Q ee sbur Sanitary Sewag ' posal rdinance. SIGNATURE OF RESPONSIBLE PERSON: CZAAA/Cil 4 DATE: (O J / OVER • 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 submit-tad 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. Nu system shall be covered before inspection and approval by the luilding 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 installa— tion, alteration or repair of an approved system, a new proposal must he submitted to the Queensbury Building Department before further construction. Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 Remarks: (� _� 41 / ' ' . . 1 � II • i 7 L.sc 4. +� - pit — -- • . 1 $ ` i Q .. i i I • ' 1 . mot 7 .1 I ' rE ti \ 4 4 1 1 • . TAi s w c r . 11ti 14i 1 }" s"`•• r 6�c rifx 1,,•>.y Sfrr E(ouA �39�xj� r_. s. IF - _ - d .:. .:• • 1 ' . ... .C?40 A"CY 1-^;:._ 0..i':.AA V?&.. 1 • (-A.. 4 �- • _.. . \I" .... .) _;.._ .__...._... :tr1•j 2 R: v ' - _..79.....P ,.c P r: .;r!D!V,� _. awn of Queen.sturf BUILDING and ZONING DEPARTMENT `t �I , Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME oak. ,1 -el :-Y. _ Cjel.A..--1 LOCATION 'L/p40-1..,.' DATE05q/ PERMIT NO. S-9 - 49(4 SOIL TYPE - ,Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS{Nukber of) • Size- ft. X ft. Gravel size PIPING: SLz Ty e Bldg. to tank Tank to dist. box Dist. box to fiel pi Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank 6{j ft. Foundation to absorption Oft. Absorption to lot line ft. Separation of pits TWft. LOCATIC--- Front S TEM ON PROPERTY(circle one) r - Left side - Right side - Ca COMMENT /Vest) 'OM cae./la : ,,,gi n,44- �-v� 4- ' 4-1--- 123 ait/C10/. Pc % (244( ce,e.0.c:dtc. 16, 1 /et'F SYSTEM USE APPRO D Y NO 1/4 .0 .,Ak Bui ding Ins ector 01/86 and vl