1986-352 BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-352
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Charles Fisher
OWNER of property located at Sherman avenue Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage Alteration w
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. ce
1. OWNER'S Address is En
RD #3
Glens Falls, New York
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address "d
b
P. 0. Box 224 'D
Glens Falls, New York
4. ARCHITECT'S Name rt
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m
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( )Steel ( )
co
7. PLANS and Specifications
±fxxBk, 8'x8' seepage pit #3 stone per plot plan,
No. and application submitted.
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8. Proposed Use
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Sewage system for dwelling o'
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 26 19 88
(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 26th Day of June 1986
SIGNED BY )Z a/: 11J, Ntr:Zr for the Town of Queensbury
Building and Zoning Inspector
v1
gown o Queen3lu .rm APPLICATION FOR SEPTIC Bd,S4PSL sac. gENSE3UP�.
PERMIT
-
BUILDIh and ZONING DEPARTMENT -'' '"`. a
Bay and Haviland Road, R.D. 1 Box 98 "YE9 JE II \J Of
Queensbury, New York 12801 //oZ O - /- (, 5-
DATE C� /
LOCATION OF PROPERTY.FOR INSTALLATION 7,8,9,Riiii2,,
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a- ' Tic 12K014614 \'-j
OWNER',S NAME R 4. .r_ F
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ADDRESS 1✓' pi2,,L, 6-)A ,e,./ti,i/mri khj� T E L 93 �Jc l
INSTALLER' S NAME c�I Ip ,, . PIJV )(,-,,K„„...„ TEL 7 7 r7
` Number of bedrooms (residential only)
Total daily flow(compute @ 150 gal per bedroom) (g V D
Topograph Rolling - Steep slope - (circle one) % of slope
Soil nature: Sand Loam - Clay - Other Depth /0 ft.
Ground' water -At what depth? -• ft.
Bed-rock or impervious m e ial At what depth? "`" ft.
Percolation test - Not require Required - -Rate min-inch.
Domestic water supply - unicipa - Well - Other
Separation - Watersupply(if well) from Septic absorption ft.
��jj y�,� 'tJ T l
Proposed System: Septic tank `VU) gal. ( Miniiin size, 1000 gal. )
Tile Field - Each trench ft. Total syst 1p legnth ft.
Seepage pit(s) Number of' ' ' ' d . Size each ' ft X - f t
Size of stone to be used # - ? Depth or thickness ' ft.
IMPORTANT! '.
On a separate piece of paper, submit a diagram of the proposed system
with all dimensions shown; including distance from any structure ,
distance from property lines and from ANY DOMESTIC WATER SUPPLY or
shore-line of lake, stream,pond or wet-lands . Include all dimensions of
the system, itself .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
I .have read the regulations on the reverse side of this sheet and agree
to abide by these and all requirements of The Town of Queensbury
Sanitary Sewage Disposal Ordinan .
Signature of- responsible person /1______,/
Date '60 I/ ......�L /X.,.I ' Diu-z bu1✓ CC-
.05/86 and/vl � L-
• Section II Septic System Inspections:
A. All applicationd for septid system installation,
alteration or repair, •as recuirRdby, thetOwm of
• Queensbury Sanitary Sewage Ordinance, ' shaU 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 cif 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-amVor 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 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 installation, 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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•
gown of Quee,;iiur y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /1: z
LOCATION /Gi>o`4ri71 (227
DATE ��1 / 4r PERMIT NO. n - .35
SOIL TYPE San - Loam - Clay -
Percolation est Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field; total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE .PITS{Number of)
Size- j ft. X . ft.
Gravel size ,2,
PIPING: Size Type
Bldg. to tank
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank l0 ft.
Foundation to absorption •�f ft.
Absorption to lot line5- ft.
Separation of pits ft.
LOCATION OF SYSTEM 0 OPERTY(circle one)
Front - Rear - Left side Right side -
COMMENTS:
1_xy 577/V 6"/'i'z ,1f/<
SYSTEM USE APPROVED 41,
NO
Building Inspector
01/86 and vl
T D SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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