91-038 ,r -
BUILDING PERMIT
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TOWN OF QUEENSBURY No. 91-038
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Kenneth Fuchslocher 'I
OWNER of property located at East side of Dunhamsbay Street, Road or Ave. w
in the Town of Queensbury,To Construct or place a Septic 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. In
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1. OWNER'S Address is
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Same
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2. CONTRACTOR or BUILDER'S Name ms+
Same
3. CONTRACTOR or BUILDER'S Address e+
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address tn
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6. TYPE of Construction—(Please indicate by X) fD
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( 1 Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
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No. Septic alteration as per plot plan specification and application
to include: 1000 gal . Septic tank, 192' Tile Field, 3/4" Stone c
8. Proposed Use
Septic alteration
$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES February 12, 19. q2
(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 t s J 2th Day of February 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
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�� TOWN OF QUEENSBURY 04
. APPLICATION FOR SEPTIC DISPOSAL PERMIT /
DATE: // `.J
LOCATION OF PROPERTY FOR INSTALLATION Eas%sole ( f)a ha c k,,, J�r�rl
Owner' s Name: J�e��e[� `'uc �c do c L e //
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Address: RR 1 13av - 1, ALe Crco � e N.Y. /ZF0S--
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Installer' s Name: feehkelA (aclrsfa ( IY j— Telephone: 793 —yZY d
Number of bedrooms (residential only) 2
Total daily flow (compute @ 150 gal per bedroom) ,3 0
Topography: Circle one: eF Rolling Steep Slope % of Slope
Soil Nature: Circle one: (an7) Loam Clay Other /Depth:
Ground Water: At what depth? 7 4//us Feet
Bedrock or Impervious Material : At what depth? r Feet
Percolation test: Circle one: . not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Municipal Well Other a k e lcla7e—
If domestic water supply is a, well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /0 0 0 - gala (minimum size: 1,000 gal )
z - 3o'
TILE FIELD: Each Trenc1h1 -o° feet/Total system length / 9 Z feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
3 (I /
Size of stone to be used #'. /Depth or Thickness ,2 2ie 2 feet
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HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
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 Qu 'hsbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: -P,U t DATE: a/// 4
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Septic-System inspections: •
A. All applications for septic sys.tem -installation, •alteration or repair,y
as required• by the Town of Queensbury Sanitary• Sewage Ordinance, shall .
- be submitted .co the Building Department at- least 24 hours before start
. of 'construccion .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 cu any water supply •
5.) size and dimensions of all tanks, distribution. boxes, •
cile fields and/or. drywalls
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
uf 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 say
. result in an immediate work stoppage.
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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:.;
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Town of Queensbury
BUILDING and CODES DEPARTMENT
. - Bay and Haviland`Roads
. - Queensbury, New York 12804
Remarks c
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256•
SEPTIC DISPOSAL SYSTEM INSPECTION
Name R jc,HAt C CmF /
Location L.L-i1 -2? 2
Date 21 t Us ctci Permit # q 1--.;L
SOIL TYPE: S.nd-Loam-Clay-
Results of Per olation Test-
(if applicable) Rate-Minute Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each. tr- ch
Depth of trenches .
Size of stone : -
SEEPAGE PITS: Numbe =
Size - ft. .x ft.
Stone size -
PIPING: .. Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field 'it
Openings Sealed? Yes o Partial
LOCATION/SEPARATII S:
Foundation to Tan feet
Foundation to Ab•orption feet
Separation of Pi s feet
Conforms as per 'lot Plan . Y:s No
LOCATION OF SYS M ON PROPERTY: . V
(circle one)
Front - Rear - L'eft Side - Right Side
Middle Front - Middle Rear
COMMENTS:
Vc ‘s)
v -fEMDEVPUC-Prrm0PSYSTEM USE APPR . YE
Arrived: V
Departed: ( .
diY`� Insp t r V .
*.T, TOWN OF QUEENSBURY
Bay at Haviland Road, Queensbury,NY 12804-9725-518-792-5832
Building & Codes Department
INSPECTOR'S REPORT
19 9/ •
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PROPERTY,,�� LOCATION
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OWNER OR TENANT •
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BUILDING SEWAGE SIGN OTHER
REMARKS:
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CONTACT THIS OFFICE WITHIN \
INS ECTOR
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"HOME OF NATURAL BEAUTY...A GOOD PLACE TO LIVE"
SETTLED 1763
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