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1986-460 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-460 WARREN COUNTY, NEW YORK PERM SION is hereby granted to Fay DiRoma OWNER of property located at Ce/Seward Ave. 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. ry Y• 1. OWNER'S Address is 3 Seward Ave. Glens Falls, New York 2. CONTRACTOR or BUILDER'S Name Andy Scarpellino 3. CONTRACTOR or BUILDER'S Address v' xxxxxxxxx Seward Ave. Glens Falls, New York CD 4. ARCHITECT'S Name m 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( ) Steel ( ) E w crq rD 7. PLANS and Specifications 9 1000 tank, 2 4'x7' seepage pits per plot and application No. rrt o ri rt 8. Proposed Use J• Sewage system for dwelling 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 30 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 30th Day of July 19 86 SIGNED BY A Ad a` 4.ae-7"0 for the Town of Queensbury Building and Zoning Inspector own of Queeniitiry 'S `�+;APPLICATION FOR SEPTIC qts BUILDING and ZONING DEPARTMENT - C Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 / �g �_ �O. DATE � / �(��OL �� A ,,�/�Y� LOCATION OF PROPERTY FOR INSTA LATION Aot'N. �1d �12�) II Di tc) m S'cw��-�� 1 9 OWNER'S NAME Y J✓C /?anima ADDRESS 3 .5-e 6; - TEL INSTALLER' S NAME t./7 5'Chfo,/7G at/0 TEL ?93`67/b Number of bedrooms (residential only) 2. Total daily flow(compute @ 150 gal per bedroom) 3 ,e, Topography- Flat Rolling - Steep slope - (circle one) % of slope Soil nature: and - Loam - Clay - Other Depth ft. Ground water -At what depth? / 0 ft. Bed-rock or impervious - At what depth? /4/4-- ft. Percolation test of require — Required - -Rate min-inch. Domestic water supply Municipal . Well - Other Separation - Watersupply(if well) from Septic absorption kAL ft. Proposed System: Septic tank " rnI10_gal. ( Minimun size, 1000 gal. ) Tile Field - Each trench AO-ft. Total system legnth ft. Seepage pit(s) Number of .0 . Size each L ft X ft Size of stone to be used # ' Q2 Depth or thickness l 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 aZZ requirements of The Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person Date 7 Z 05/86 and/vl l 0 0-0 . a , .y l ' 5 e.Q- ,t-v, �% 1 • • • Section II Septic System Inspections: • A. All ' applicatiohs 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 Building Department before further construction. .own o/ Queenibur, BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAMEif4"v W1A 1449 LOCATION5;41.441 DATE 0 / ( PERMIT NO. Y60:104, Z5 SOIL TYPE - Sand Loam - Clay - Percolation Test 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 PITS4Number of) Size- S—ft. X ft. Gravel size 3 <1- -2"-- PIPING: Size / CTy �© Bldg. to tank Tank to dist. box _ A ( z7 ?3 Dist. box to field/ '/ -? /3• Openings sealed? NO Partial LOCATION/SEPARATIONS: J Foundation to tank ' Z. ft. Foundation to absorption -y& ft. Absorption to lot line C 04f''t. Separation of pits ft. LOCATIO STEM ON PROPERTY(circle one) Front �--. Left side - Right side - COMMENTS: CU(A) tertykop-g e,tur_,L0 4-t) 744g 40-t/P(\4-k\ W-:(if) VU,i/Urg-1 ?„..L.62_4) vt/tAm I fro SYSTEM USE APPROVED NO _ � l Building Ins ctor 01/86 and vl -1\--3 310 awn o/ Queenaburcy BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME D ! CAJI, LOCAT I ON, 1 DATE 1 �) / 2lo PERMIT NO. 3 1- o SOIL TYPE - Sand - Loam - Clay - G Percolation Test 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- ft. X ft. Gravel size 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 ft. Foundation to absorption ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENT : 1 64A NU11Tu < SYSTEM USE APPROV NO �r Building In ector 01/86 and vl /...5117 i)e /P 10,t9L- 3 Sc Lvitra/ d/ cam 2f fir,irr' Gig c ` deice ICJ f.J - 7 lOr _ I HOC) • eu)09rr,( I l t ee./