1989-467 BUILDING PERMIT
. _ a
TOWN OF QUEENSBURY
No. 89-467
WARREN COUNTY, NEW YORK •
•
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PERMISSION is hereby granted to Harold Kirkpatrick
OWNER of property located at Rockhurst Road Street, Road or Ave. •
in the Town of Queensbury,To Construct or place a Sewago 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 -
Same
rc
•
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2. CONTRACTOR or BUILDER'S Name
Self -
C
3. CONTRACTOR or BUILDER'S Address • C
Same
4. ARCHITECT'S Name
C
5. ARCHITECT'S Address
Q
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry " ( )Steel ( )
7. PLANS and Specifications
No. Two 1250 gal. tanks only as per plot plan and applciation
C,
8. Proposed Use
PD
Sewage Alteration co
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES ,Tune 22, 19 91
0
(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 2 ar Day o 19 89 - _
- SIGNED BY . v!d for the Town of Queensbury
Building and Zonin spector
/
TOWN OF QUEENSBURY
TOWN OF QUEENSBURY
. \, e., RECEIVED
l�� ,` APPLICATION FOR s
•._v�� SEPTIC DISPOSAL PERMIT JUN 21 1989
For -Pot K . P'PLAc-*01� '' 0 N ZLLDG. & CODE DEPT.
DATE g I I ) ~,1 c
6,10 C-,('/%. Co
LOCATION OF PROPERTY FOR INSTALLATION e., G_4(e Ge-diz6c ( J 0 bi.s- ---
Owner's Name: Qv-) (<(tR 'ite/f/c Telephone: G SY' /f Z 7/ 3 ^c`tOb
/
Address: P 7_ - (PD uipgrsla F. ?A/ i 12cK/4-Glks'--
Installer's Name: c/-F Telephone:
Number of bedrooms (residential only) -2. -
Total daily flow (compute (d 150 gal per bedroom) 3co0 rt a J Lk( + Al `C
,)
Topography: Circle one: Flat Rolling Steep Slope % of Slope FLt T-
Soil Nature: Circle on:: Sand Loam Clay Other /Depth: 2 ^ 3 Feet
Ground Water: At what depth? 2- " S Feet ,
Bedrock or Impervious Material: At what depth? 4 Feet
Percolation test: Circle one:�ot require required rate min. inch.
Domestic water supply: circle one: Municipal Well Other LJANK��' -
If domestic water supply is a well:
Separation: Water supply , - septic absorption feet
PROPOSED SYSTEM: Septic - -t.S SO - gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench (\lk feet/Total system length •(V -- feet
SEEPAGE PIT(S): Number of )(/A / Size each feet by feet
Size of stone to be used # NA/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 Queens u y Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: d/u-e—Z. Kiti---(
DATE: 6 -- / 1 - - F7
OVER
Septic System Inspections:
'A —A. ll '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. Nu 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 : - •
Jocun oQur '/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road; R.D. 1 Box 98.
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM .INSPECTION
NAME # e , , d
LOCATION c;if i y
DATE 7 /i 7 PERMIT NO.r'9 4/6 7
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: := r , -
Absorption field, total length . 6A16:- /cxfl
Length of each,trench" , el-
Depth
of trenches t`y.
Size of gravel
SEEPAGE PITS{Number of)
Size- ft. X. �� ft.,
Gravel size 4 r
PIPING: • . /Size Type
Bldg. to tank
Tank to dist. box t. \
Dist. box to field/pith,
Openings sealed? DYES \NO Partial
LOCATION/SEPARATIONS: y
Foundation to tan t
k f7 ft.
't�
Foundation to abfsorption .�9i4 f t.
. Absorption to lot line' J, ft.
Separation of plots ;ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side° -
COMMENTS:
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�o.tf�/7 ki;fri.e /a0e/A-5"
SYSTEM USE APPROVED
Bui• ding Inspector
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