6521 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 6521
WARREN COUNTY, NEW YORK y
0
PERMISSION is hereby granted to Thomas Rave •
OWNER of property located at Mason Road, Cleverdale Street, Road or Ave.
(D
in the Town of Queensbury,To Construct or place a Sewage .System
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
Cleverdale, N. Y.
2. CONTRACTOR or BUILDER'S Name
John Mason -
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3. CONTRACTOR or BUILDER'S Address
Cleverdale, N. Y. O
4. ARCHITECT'S Name C]
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications 1250, gallon concrete septic tank, 750 gallon
No. concrete receiver with pump and drain field per
application submitted.
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8. Proposed Use
Sewage system for dwelling •
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$5. 00 PERMIT FEE PAID —THIS PERMIT EXPIRES Dec. 1 1980 't
(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 12th Day of August 19 8 0•
SIGNED BY - ' � Q c� for the Town of Queensbury
Build g Zoning Inspector
TOWN OF QUEENSBU ,
,IAGE [LuE
TOWN OF QUEENSBURY
BUILDING AND ZONING DEPARTMENTA(JG I 1980
BAY AND HAVILAND ROADS RD g �� Ic�
GLENS FALLS, NEW YORK `?280I A.M. - FCC a.
7IMPA11I1AMV 516
APPLICATION FOR A. PERMIT TO CONSTRUCT, ALTER OR ENLARGE
A SEWAGE DISPOSAL SYSTEM WITHIN THE TOWN OF QUEENSBURY
OCCUPANT' S NAI:IE Thomas Rave ADDRESS Cleverdale, New York 12
TELEPHONE 656-9493 OVNER,S NAME Thomas Rave
ADDRESS Cleverdale, New York 12820 NUMBER OF BEDROOMS 2
GARBAGE GRINDER? no o (YES OR NO) TOPOGRAPHY: FLAT, ROLLING, STEEP, SLOPE,
GENTLE SLOPE, OTHER gentle slope .
NATURE OF SOIL: CLAY, SANDY, LOAM, GRAVEL, ROCKS;, ETC.. claZr_= loam
PERCOLATION TEST 4 min. WATER SUPPLY: MUNICIPAL,. WELL, OTHER lake M_
DIAGRAM G' i ROP(DSED SEPTIC,
- 2" line to drain field
I
- 750 gal. concrete receiver
with pump
- 1250 gal. concrete septic tank
House
OTHER R PERTINENT INFORMATION RMATION
wmuorz
1,T` IS HEREBY AGREED TI-IAT IF THIS APPI, C__.T:i.Cis AND ...ir`...C'�'`T`'' ..-.._ r•,-, �� r....___..._._........�_..
L.0 ARE APPROVED,
INSTALLATION OF SEWAGE DISPOSAL . FACILITIES WILL DE MADE IN ACCORDANCE
WITH DETAILS SHOWN. - -
DATE /�/, SIGNATURE OF APPLICANT. - �
LAKE GEORGE PARK COMMISSION APPROVAL:
IdateT
r. .-.
Percolation Test
Thomas Rave
Run # 1 • 2.5 minutes
Run #2 3.0 minutes
Run #3 3.0 minutes
Run# 4 3.25 minutes
Run #5 3.5 minutes
Run #6 _ 3.75 minutes
Run #7 4.0 minutes
Run #8 4.0 minutes
Run #9 4.0 minutes
Run #10 4.0 minutes
TOWN OF C1UEENSEv;-. .
IMEGEOVED
Aub ' d1980
.�I&�91@Q�11�12I1�2�3J;II5J6
APPLICATION FOR A PERMIT
' TO CONSTRUCT, ALTER or ENLARGE a SEWAGE DISPOSAL SYSTEM
FOR A PRIVATE RESIDENCE WITHIN TilE LAKE GEORGE PARK
•
TOWN OF Queensbury
1. Name of Owner: Thomas Rave Address: Cleverdale, New York
• 12820
•
2. Specific location of property: Mason Road •
3. Application is for The alteration of, pr enlargement of an existing system.
X New construction.
If new construction, is property in an approved subdivision?
Name of Subdivision: •
and has been approved by __tile Town, Dept. 'of Health, Adirondack Park
Agency
•
4. Property line dimensions, or total area of property: 12, 000 sq . ft. -
-
' 5. Description of building: Number of Bedrooms _ 2__
6. Topography: (flat) (rolling) (gentle slope) (steep slope) gentle slope
7. Nature of soil; (Describe to a depth of 5 feet below bottom of leaching device.)
clay loam >3 ' to ground water > 5' to bedrock
• Give soil t't:e, distance to ground water and distance to bedrock,
8. A SOIL PERCOLATION TEST MAY BE REQUIRED. For details on ;,procedure, refer to
"INDIVIDUAL HOUSEHOLD SYSTEMS - WASTE TREAITENT HANDBOOK" N.Y.S. Dept. of Health
Test Results: • 4 mins.
9. Attach a carefully drawn plan of the proposed sewage disposal system. Give all
dimensions and distances to lot lines, [:ells (yours and neighbors) , streams,
and Lake George (if applicable).
10. Construction will begin on 8/15/80 by Sunsoval, Inc.
(Date (Contractor)
11. The Lake George Park Commission reserves the right to inspect the completed
systa;n beere backfilling. The o:•r.ier, or his agart, is required to notify the
Commission at least 2.4 hours in advance of backfilling, to facilitate the final
approval inspection.
I hereby r.g-ree that if this application and attached plans dated 8/2180
or any axen lr.en?:s or revisions tb.e reof, are approved, installation of cew•age dispoca_
facilities till_ bn nnde in accordance with the details threof as shown on such
approved plans, within lu0 days. of the above date. One extension of 160 days will
be allowed if applied for and secured in writing.
(Sig ia.ture of owner) (Date)
The Lake George Park Commission has reviewed the plans and site location for
this project and accordingly recommends approval.
Date
Charles W. Glass, Eng. Tech.
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q The above sketch shows the locations of the units comprising your sewage disposal
system for future reference in case of difficulty. It shows measured distances
from buildings, trees, garage, fence posts, etc. , to septic tank, sewers, distri •
-
bution box and absorption field or seepage pits. 1
CONTRACTOR: Suns oval, Inc. .DATE INSTALLED: •
• ' DESIGN ' BASIS - ' �
1. No. of bedrooms: 2 5. Septic tank: type concrete
2. Daily flow: gpd capacity 2000 gals.
3. Undisturbed soil depths: 6. Size of leaching device: 120 ft. •
a. To groundwater. >3o ' 7. Type of system (conventional , fill , . • '
b. To impervious lens: >5,
etc. ): pressure
4. Percolation rate: 4 min/in.
LGPC MAP NO.: ' APPROVED BY: DATE:.
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FRQM SEPTIC , I VALVE
TANK -rA J
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W. NIGH WATER ---. I I VAINi.,
ALARM SwtrcH I
ON SWITCH ;, I ✓,TEit •
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N 306 ON CZI'tTER. •M 13"
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TOWN OF U ENSBURY
Building Department
Inspectors Report — ' Date !I ii;/
Name C� C� � �r
Location 77f e-y
Permit No. (o s—A Weather
Remarks
Excavation
Footing Forms
Footing & Piers L
Foundation
Cement Coat
Waterproofing
Backfill
Final Survey
Framing
Sheathing
Roof Felt
Roofing
Siding
Masonry Veneer
Rough Plbg.
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs &Railings
Cellar Dr. Tile
Concrete Floors 1 •
Plbg. Fixtures-
Gar. Fireproofing
Door Closers
Chimney
Water Meter Inst.
Septic Approval
Floors
Insulation Foundation
Walls
Ceiling
Building Inspector
REMARKS