1986-192 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-192
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to
Amer Folsom
OWNER of property located at 7 Lyndon Drive Street,Road or Ave.
Sewage Alteration n
in the Town of Queensbury,To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. m
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I. OWNER'S Address is 34 Lyndon Drive,R011ing Ridge
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Glens Falls, New York
2. CONTRACTOR or BUILDERS Name
Sanitary Sewer Service
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3. CONTRACTOR or BUILDER'S Address
P. 0. Box 224 6
Glens Falls, New York
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction-(Please indicate by XI
( I Wood Frame I )Masonry ( I Steel 1
7. PLANS and Specifications 1 - 1000 gallon septic tank
No. 1 - 6 hole dist. box
250 ft. leach field per plot and application submitted. E
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B. Proposed Use
Sewage system for dwelling a
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$ 10.00 PERMIT FEE PAID-THIS PERMIT EXPIRES May 5 1986 0
(If a longer period is required an application for an extension must be made to the Building end Zoning inspector of the
town of oueensbuw before the expiration date.l
Dated at the Town of Queensbury this 5th Day of May 19 86
SIGNED BY / 't'- a ' /n"O for the Town of Queensbury
Building and Zoning Inspector (�(�
Sown of Queen!tory
BUILDING and ZONING DEPARTMENT TOWN OF QUEENC°-'
Bay and Haviland Road, R.D. I Box 98 ('f I
Queensbury. New York 12801 (IYfyll( '2
i0'&iC� lac •91 `r,�rk?
MA. z .,
//)l SEPTIC DISPOSALGr) PERMITj APPLICATION 7I'lq yprnf (` 1
Owner' s Name) MR f ' lk1 r�l l- r oc. . s 0f t Tel.Pi
7 Id- �I3g�
Address 2L1 l-U Ma04) r�>�<. AAA
- o(1(tie RIUi[
Person/Firm installin
lg system SAO ( 1(0 1 S?AA�A-A Q inetuiri
Number of bedrooms (residential only) , 7 ��jj
Total daily flow: (compute @ 150 aal.per bedroom per day) _ o
Topography: flat - rolling - steep -(circle one) Degree of slope %
Nature of soils:Ciand-lO2 clay- other- Depth ft.
Ground water-- at what depth? ft.
Bedrock or impervious material--at what depth? ft.
Percolation Test - of required)/ Required -Rate
min/inch.
Domestic Water Supply - Municipal - Well - Other
IMPORTANT!
On a separate piece of paper, submit a diagram of the proposed septic
system with all dimensions; including distance from any structure,
distance from property lines and distances from any domestic water
supply or shore-line of lake, stream, pond or wetlands. Include all
dimensions of the system itself.
Description of proposed system:
Septic tank size /000gal.
Tile field- Length of each trench Sift. Total fielda6O ft.
Size of stone # •
Seepage Pit(s) Number / Size ftX__ft. Size of stone#_
Any contractor, corporation, individual,Etc. , engaged in the
construction of a Sanitary Sewage Disposal System, who covers the
same before inspection, does not have an approved Permit, or varies
from the approved application, will be subject to a Penalty of $250
as provided for in Section 6. 010 of the Town of Queensbury Sanitary
Sewage Ordinance.
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nature of Applicant Date
01/86 md/vl /- re - 4.C-(, D/$r, EOl
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Septic System Inspections:
A. All applications for septid 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. 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.
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C. An approved copy of the plot plan shall he
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 installation, alteration or
repair of an approved system, a new proposal
must be submitted to the Queensbury Building Department before further construction.
lenteX
TOWN OF QUEE QUEENSBURY
Building. Department
ie + 1tWa Date
Name
Location Wm er
Permit No. � ' —.
Remarks
ExcaOation
Footin• Forms
Footin. s Piers
Foundation •
Cement Coat .
Water.roofin•
Backfill
•
Final Surve
Framin•
Sheathin•
Roof Felt
Roofin.
• Siding
Masonr Veneer
•
• Rou•h Plb. .
Relief Valves
Wall Board
Ext. Porches
Finished Floor
Interior Trim
Stairs s Railin•s
Cellar Dr. Tile
Concrete Floors
Pl.. . Fixtures
Gar. Fire.roofin.
Door Closers
Chimne _
Water Meter Inst. ���
Se.tic A..roval /_'aa
Floors
Foundation
Insulation Walls
Ceill .
Building Inspector
REMARKS
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SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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