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1986-512 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-512 WARREN COUNTY, NEW YORKQA6 .\O\ 17) n DD PERMISSION is hereby granted to Carl Baker 20 Owen avenue OWNER of property located at 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 20 Owen Ave. Glens Falls, New York • 2. CONTRACTOR or BUILDER'S Name Condon's Septic and Drain Servi:e N) 3. CONTRACTOR or BUILDER'S Address 0 17 Grant Ave. cn Glens Falls, New York rb 4. ARCHITECT'S Name 0 CD 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( )Steel ( ) En cD 7. PLANS and Specifications oq No. 2 8'x'8 seepage pits per plot plan and application a rr 8. Proposed Use ri Sewage system for dwelling 0 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 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 a'of August 19 86 SIGNED BY (/��c August for the Town of Queensbury Building and Zoning Inspector �� c7 TOWN O OUE:ENS'!t3_;ry .Juu'n off ueensbur C pTOgi.. tEgMliT, �" � y APPLICATION I ON FOR SEP�I4 BUILDING and ZONING DEPARTMENT 1I'f:, L L i Bay and Haviland Road, R.D. 1 Box 98 � t, qm �. Queensbury, Nev, York 12801 ct DATE 6 C�v0 4 A.M. LOCATION OF PROPERTY FOR INSTALLATION OWNER' S NAME C4,;QJ_ ? AE ADDRESS a.f 6UcocC/v,S2o I'1/K// / TEL INSTALLER' S NAME( O 2).0,1J .g sC�" 1- TEL • acc'-- Number of bedrooms (residential only) . < Total daily. flow(compute @ 150 gal per bedroom) 1/,S O • Topography: Flat - Rolling - Steep slope - (circle one) % of slope 4 Soil nature: Sand - Loam - Clay - Other WAbl r Depth ft. Ground' water -At what depth? /2/ 'nie ft. Bed-rock or impervious material - At what depth? /'OWE ft. Percolation test - Not requiredw Required - -Rate min-inch. Domestic water supply Municipal '- Well - Other Separation - W'atersupply(if well) from Septic absorption ft. Proposed System: Septic tank /t/0 0 gal. ( 1inimun size, 1000 gal. ) Tile Field - Each trench ft. Total system legnth ft. Seepage pit(s) Number of . Size each 8 ft X B' ft Size of stone to be used # 3 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 Ordinance. Signature of responsible person 4y„,,„,, p 05/86 and/vl Section II Septic System Inspections: A. All applications for septid system installation, alteration or repair, as reauired by the Town of Queensbury Sanitary Sewage Ordinance, shall be submitted to the Building Department at least 24 hours l)efore_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 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. 6L _locun of Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME (10-1,-I gQ /(e�^ LOCATION (,:•?_ (S 6 GU-6'1-+ AU e DATE 5 / /76 PERMIT NO. P 6 _ 5 )2 SOIL TYPE - an - Loam - Clay - Percolation t Required? YES -ce ) O 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) _ De, Size- - ft. X q ft. `�"l Gravel size ` PIPING: Size Type Bldg. to tank Li" 10 Tank to dist. box _ Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank I,-ft. Foundation to absorption 145- ft. Absorption to lot line 1.,,,--ft. Separation of pits 30 ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTS: oe one 6' 6 Tb cr 6-U26-5,e_ ;6;f SYSTEM USE APPROVED ' NO ,.... wn/f3A,v© Building Inspector 01/86 and vl Con C f Gviie)fi - V 4 0 g ttA /, o9-L 6,1-f,Z,z7L/ - ?c) 1,W./ .6-17 n -A i, i /4 Kc - 7q3- `Z.l 76 co o PLJ _ /.0 ie,Avx) l ,“1/iv &ic 0 oFefusQv Ay Ny id—Rty /(0.Aisirdiff-s' ivy y()__ g--0/ L y ii) Ft Eid ' , ,y r P a r I tH.,---. c) ,...G 9-9 1- \ .' - � [ API .04 Uk i o Jo y -4 3 0° �ash -r�' .\,)[