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89-793 • BUILDING PERMIT TOWN OF QUEENSBURY No. 89-793 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Robert Adamson OWNER of property located at Lake Parkway 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 s 35 Park Avenue RR 1 Box 1285 Old Greenwich Lake George, N.Y. 12845 • 2. CONTRACTOR or BUILDER'S Name 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) 1 )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications No. 1000 gal . XXXX tank, 325' XXXX tile field as per plot plan and application 8. Proposed Use Sewage Alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES XXX October 6 19 91 (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 6th Day f october 19 89 SIGNED BY for the Town of Queensbury Building and Zoning Inspector TOWN OF QUEENSBLIRY �, //'� Robert W.gdamson 285 i` "I I Lake orge,NY 12845 APPLICATION FOR stft TOWN OF QUEENSBURY 'v SEPTIC DISPOSAL PERMIT RECEWED OCT b ., 1989 6)/‹./ BLDG. & CODE DEBT DATE /- /5. /ei ., i a T'ax ,,,,4- 9—1 —Ik LOCATION OF PROPERTY FOR INSTALLATION / Owner's Name: IRO 1j 4 12 �1 . ASone: 7,0 -- 631 7 6 ©5. Address: Id a 0 �' tV le) c ! k 111 Robert W.Adamson J � R.R.1,Box 1285 Lake George,NY 12845 Installer's Name: Telephone: 1 — 4'7 )>-- `- 53 Number of bedrooms (residential only) Total daily flow (compute (d 150 gal per bedroom) ‘l U' Topography: Circle onedD Rolling Steep Slope % of Slope Soil Nature: Circle on- : o) Loam Clay Other /Depth: Feet Ground Water: At what depth? 'E Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: not required required rate 6 Vf in. inch. Domestic water supply: circle one: Municipal Well Other G-4. If domestic water supply is a well: !A _ Separation: Water supply from septic absorption /,0 feet PROPOS, D SYSTEM: Septic Tank MOO gal. (minimum size: 1,000 gal.) z' TILE FIELD: Each Trench(9j feet/Total system length 2 5- ' feet SEEPAGE PIT(S): Number of mod. / Size each feet by feet Size of stone to be used # /Depth or Thickness feet ************************* I have read the regulation on the reverse side of this sheet and agree to abide by these and all requirements of the Town of Queensbu y Santary Sewage Dispo 1 Ordinance. SIGNATURE OF RESPONSIBLE PERSON: VA. lAU ` � DATE: 0674—? 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 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 t.he ,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 installa— tion, alteration or repair of an approved system, a new proposal must be 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 : • _l®cun O/ Qu?enitur/ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL�SYSSTEM INSPECTION NAME s ,, L f`�1Z�P�1�6�9�'�u LOCATION _.: ►,�_'' -�7'srr`�/k ah- a4-r-' /tc•7 DATE /04T PERMIT NO. 4 / 1%13 SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch _ % TYPE of SYSTEM: Absorption field, total length 309 } Length of each trench _ C, j r •�- f�ry�/,yf Depth of trenches 711, t Size of gravel - ID SEEPAGE PITS{Number of) Size- __ft. X _ ft. Gravel size PIPING: Size ype Bldg. to tank ,• C-y', 40 Tank to dist. box / `�: R`4N,5�-i&,� /`!` c/c- Dist. bor to field/pi -• /-�(/.4:. Openings sealed? YES_1 NO Partial LOCATION/SEPARATIONS: Foundation to tank ft. Foundation to abscrption 30. ft. Absorption to l/ot line left. Separation of $its (, t. LO ON OF SYSTEM ON PROPERTY(circle one) rout Rear%- Left side - Right side - TS: atH, ,5--Ary", . Z44)tif 1 SYSTEM USE APPROVED ES NO 1.3`.(0a ii ' tn,' F3 3: 3I Bui Lding Iris ector , 01/86 and vl prr . - H 1 .1 • . - 1 - ' 1 1. - • . 1. ; - . ; . • ;. 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