1986-183 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-183
WARREN COUNTY, NEW YORK
PEEERM /1 •
\� /�/�� Edward Gillis
ISSION is hereby granted to
OWNER of property located at
Cleverdale Road Street,Road or Ave.
Sewage repair b.)in the Town of Oueensbury,To Construct or place a
at the above location in accordance to application together with plot plans and other information hereto filed and n
a
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ct
1. OWNER'S Address is Box 204
Cleverdale, New York
2. CONTRACTOR or BUI LDERS Name Jay Sweet
3. CONTRACTOR or BUILDER'S Address
RR 'rl
Lake George, New York
4. ARCHITECT'S Name
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Pafi. ARCHITECT'S AddressI,
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6. TYPE of Construction—Meese indicate by XI
1 1 Wood Frame 11 Masonry 1 )Steel 11
7. PLANS and Specifications
emergency repair to d/box/system as necessary per application
No.
submitted.
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B. Proposed Use
Septic system for dwelling w
April 1988
$ none PERMIT FEE PAID—THIS PERMIT EXPIRES
(If a longer period is required an application for en extension must be made to the Building and Zoning inspector of the
town of Queendwry before the expiration date.)
Dated at the Town of Queensbury this �92nd Day of ,gMay
19 86
SIGNED BY 7/y/wz U' /�.I p for the Town of Queenabury
Building and Zoning Inspector O
aCc77 / TOWN OF QUEENSBU'
wn of QueenJbury n 2 fa (p
BUILDING and ZONING DEPARTMENT lilxU( L5 l�9 V' U
Bay and Haviland Road, R.D. 1 Box 98 h o1f 1986
.
Queensbury, New York 12801
71819+ }12)3i4G
r SEPTIC DISPOSAL
PERMIT APPLICATION
Owner' s Name jb fi 1R[O)J 6:/!✓ii`S Tel.
Address J 'x toy CGrvE[4)4[.6t rid.
Person/Firm installing system 07cr Sear ExG.41/,A72k/¢__
Number of bedrooms (residential only) _7
Total daily flow: (compute @ 150 aal.per bedroom per day)_ 4/00
Topography: - rolling - steep -(circle one) Decree of slope z %
Nature of soils: 1111111
clay- other- Depth SS ft. 't
Ground water-- at what depth? !if ft.
Bedrock or impervious material--at what depth? ij/!/* ft.
Percolation Test - Not required / Required -Rate S min/inch.
Domestic Water Supply - Municipal 0 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 / gal. AEX/577AA6
Tile field- Length of each trench SO ft. Total field ,Ze ft. E>c 7".
Size of stone # 3
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.
E/terieaeitldY (TEP,4e/2 7 7 D/pogfsysrety% 49 NECESSrgY
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tin rjck_. , 2-1 JJwJ s .- a
Signature of Applicant Date
01/86 and/vl
Septic System Inspections:
A. All applicationd for septic system installation,
alteration or repair, as required by the Town of ..
Oueensbury 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.
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 Buildina
Department before further construction.