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1986-574 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-574 WARREN COUNTY, NEW YORK ( 0q PER MIS ION is hereby granted to Harry Sutliff 20 Luzerne Road OWNER of property located at Street, Road or Ave. CD 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 U, approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ,y 1. OWNER'S Address is 20 Luzerne Road rt, Glens Falls, New York 2. CONTRACTOR or BUILDER'S Name Condon's Septic and Drain Service N 3. CONTRACTOR or BUILDER'S Address 17 Grant Ave. Glens Falls, New York cD 4. ARCHITECT'S Name 0 CD CD 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) (. ) Wood Frame ( ) Masonry ( ) Steel ( ) CD 7. PLANS and Specifications OQ co No. 1000 gallon tank, dist. box and 2 6'x8' seepage pits per plot and application submitted. n 8. Proposed Use W rt N. Sewage system for dwelling 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 15 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 15th" Day of September 1986 /1 SIGNED BY / 4' I _. for the Town of Queensbury Building and Zoning Inspector C116% TOWN OF QUEENSBU ,Y Joa.,n of Qucn.iturjhr41 ON FOR SEPTIC DISPOSAL PERMIT BUILDING and ZONING DEPARTM Bay and Haviland Road, R.D. 1 Box 98 • Oueensbury, New York 12801 ku\ . © �f{-) f DATE G� / 6 18 v��� l. �i&1 rt),e l41 e e LOCATION OF PROPERTY FOR ' 5®?TAILLATION Ur k/Ve_ ZA , OWNER' S NAME44,/,VZyt J , LI.FI ADDRESS LvvE gQ TEL INSTALLER' S NAME ��� -0Vii l`Y°J..S r : - r C J) i /jZ1 Sg/z TEL7. -k5 L- Number of bedrooms (residential only) ` • Total daily flow(compute @ 150 gal per bedroom) 700 Topography: Flat- L Rolling - Steep slope - (circle one) % of slope Soil nature: Sand - Loam - Clay - Other _ Depth ft. Ground' water -At what depth? ./'V I,1' ,, ft. Bed-rock or impervious material _- At what depth? - ur 9 (4_ft. Percolation test - Not required Required - -Rate min-inch. Domestic water supply -(Municipal)- Well - Other Separation - Watersupply(if well) from Septic absorption ft. Proposed System: Septic tank j6CO gal. ( Minimun size', 1000 gal. ) Tile Field - Each trench ft. Total system legnth ft. Seepage pit(s) Number of 2_ . Size each 4-/ ft X ft ri 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. rinclude all dimensions of the system, itself . * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I have read the recu2ations on the reverse side of this sheet and agree to abide by these and aZZ requirements of. The Town of Queensbu-ry Sanitary Sewage Disposal Ordinance. • 1 I Signature of responsible person, 0 /l�! ?r ` _�C !P v �1, 05/86 and/vl - 7 • • • • • Section II Septic System Inspections: • A. All applicationd for septic 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 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. _loiun of QueenJburey BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 • • SEPTIC DISPOSAL SYSTEM INSPECTION NAME s er LOCATION a Lti _ DATE (/`/ PERMIT NO. (o — SOIL TYPE c - 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 tek.3 SEEPAGE PITS{Number of) Size- le ft. X IS ft. Gravel size 3 PIPING: Size Type Bldg. ' to tank 'Tank to dist. box Dist. box to field/e.' Openings sealed? NO Partial • LOCATION/SEPARATIONS: Foundation to tank 2O ft. Foundation to absorption 9 S ft. Absorption to lot line j5--- ft. Separation of pits 34-ft. LOCATION P^ YSTEM ON PROPERTY(circle one) Front Rear - Left side - Right side - COMMENT`. • SYSTEM USE APPROVED NO • jj/q4/6/eiZttZ2) Building Inspector 01/86 and vl A-. /44 R Ry S t.)*1. I'1:-71 C C.11,o Don;S 6 e44,(sc -4--DR9i,u SM. ao L 02 to. iv E )(Z.D - 7fa- g.6.3-1 i 1.7 eRhiti i /4tf&- 7ea-eSc/2 - :4G W.Ertzi),07 /iv y f )--s-ol :N a,i e;A)E 1--agc iv '/ 8-0/ (V dr— fi i 00/ / ! • "(L) - --------)_ i - s _____ _ 0(A/co &di i - ait roAfit-- ... % '‘ , N F-1 ,- , L kf9c6:tu - \ 7 , 1 - 33 1 . . • .,=. } \\ J..) 0