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1986-424
BUILDING PERMIT TOWN OF QUEENSBURY No 86-424 WARREN COUNTY, NEW YORK -.301 Kathy Denio PER ISSION is hereby granted to `VNIcorl j OWNER of property located at 48 Kens' ■ - P:.; , Street, Road or Ave. in the Town of Queensbury,To Construct or place a Sewage 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 48 Kensington Road rwr Glens Falls, New York t7 m 0 1-4 2. CONTRACTOR or BUILDER'S Name 0 Sanitary Sewer Service 3. CONTRACTOR or BUILDER'S Address P. 0. Box 224 Glens Falls, New Yorkoo - -- x 4. ARCHITECT'S Name m r• 0 CrQ rt O 5. ARCHITECT'S Address 0 0 0 a 6. TYPE of Construction—(Please indicate by X) ( I Wood Frame ( ) Masonry ( 1 Steel ( ) 7. PLANS and Specifications rD No. 1000 gallon septic, 200 ft. leach field per plot and application submitted. 8. Proposed Use rt Sewage system for dwelling H. rt $ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 24 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 24th Daayy of July ig 86 SIGNED BY �G✓ (�(. ��,�,� for the Town of Queensbury Building and Zoning Inspector e7.-- )1 _ awn of Queen3lury APPLICATION FOR SER IcAV I1NEEUT BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 C Queensbury, New York 12801 // 7L. 3r-J DATEA r 3. V E DI LOCATION OF PROPERTY FOR INSTALLATION c5; A.M. Imo. tom w (1 e►tb,ep'3 RM.OWNER' S NAME K41 rJ �� 11 - o rT 9 ADDRESS il y K-e /U<S / ,-/s72)/J iiQ 41 TEL L/ ( INSTALLER' S NAME c..J )g t, i7- (/ (J,J Jf( b`, < TEL 7 7d,5-7 Number of bedrooms (residential only) 3 Total daily flow(compute @ 150 gal per bedroom) iK�(D Topography: Flat - Rolling .- Steep slope - (circle one) % of slope Soil nature: and Loam - Clay - Other • Depth © ft. Ground water . -At what depth? ft. Bed-rock or impervious material - At what depth? ft. Percolation test Not requi - Required - -Rate min-inch. . Domestic water supply - Municip_ -- Well - Other Separation - Watersupply(if well) from Septic absorption ft. Proposed System: Septic tank /600 gal.-( Minimun size, 1000 gal. ) Tile Field - Each trench- 5-0 ft. Total system legnth An b ft. Seepage pit(s). Number of - . Size each " ---- ft X ft 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, strea-m,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 Ordinanc . • Signature of responsible person Date I • 05/86 and/vl • Section II 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 the1installer 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. • • • • . . . Jown of Queen3Lry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME D LOCATION I Q,1 Q DATE �,�Z/ (0 PERMIT NO. to - 4. LL SOIL TYPE - and - Loam - Clay - Percolation t Required? YES F N Percolation rate - Min/Inch TYPE of SYSTEM: r Absorption field, total length at)() Length of each trench 51 Depth of trenches 9 Size of gravel" SEEPAGE PITS{Number of) Size- ft. X ft. Gravel size PIPING: Size Type Bldg. to tank V" VD Tank to dist. box Dist. box to field0--- Openings sealed? NO Partial LOCATION/SEPARATIONS: Foundation to tank a5'' ft. Foundation to absorption —ft. Absorption to lot line /0 ft. Separation of pits - ft. ) LOCATION 0 YSTEM ON PROPERTY(circle one) Front (Rear - Left side - Right side - COMMENT • I aor SYSTEM USE APPROVEDAP NO \ 6r6717t1(b- Building Inspector 01/86 and vl n. - .1 SANITARY SEWER SERVICE LUZERNE RD. 19( GLENS FALLS N.Y. PHONE 792-7257 U G �0 ' U 11-1t. C? � C)