1987-013 BUILDING PERMIT
TOWN OF QUEENSBUR'Y No- 87-13
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to John Farrell
OWNER of property located at 68 Helen Drive Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Sewage Alteration o
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. w
rt
�t
1 . OWNER'S Address is 68 Helen Drive
Glens Falls , New York
2. CONTRACTOR or BUILDER'S Name
Morning Star Exec .
rn
3. CONTRACTOR or BUILDERS Address 00
x
m
M
ra
d
4_ ARCHITECT'S Name
r-
M
m
5. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by XI
to
I ) Wood Frame { I Masonry l ? Steel { 1 (D
as
tYe
7. PLANS and Specifications M
Dist . Box. and 3 6 ' x8 ' drywells per plot and application �
No. rt
ra
�-S
N
rt
8. Proposed use o
0
Sewage system for dwelling
$ PERMIT FEE PAID — THIS PERMIT EXPIRES 3anuary 22 Ig�2�
IIf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration dare.?
Dated at the Town of Queensbury this `2�2n�d ,s❑day of January 19_�Z
SIGNED BY +r ff � for the Town of Queensbury
Building and Zoning Inspector
Joee.r� aueer� s6eerr) APPLICATION FOR SEPTIC DISPOSAL PERM I T
BUILDING and ZONING DEPARTMENT � � ti � !*- � i � �;gr�
Bay and Havitand Road, R.Q. 1 Box 98 . s . 3 +� ' �. t¢1
f Oueensbury, New York 12801 DATE MI 2 -�
LOCATION OF PROPERTY FOR INSTALLATION
OWNER ' S NAME "' G
ADDRESS /� C � u TEL
INSTALLER ' S NAME TEL
Number of bedrooms ( residential only) 7
Total daily f low ( compute @ 150 gal per bedroom )
Topography * ( Fl; - Rolling - Steep slope - ( circle one ) % of slope,
—
Soil natures Sandy - Loam - Clay - Other Depth ft .
Ground water -At what depth? ft .
Bed-rock or impervious material - At what depth? ft _
Percolation test - Not required - Required - -Rate min- inch .
Domestic water supply - Municipal - Well - Other
Separation - Watersupply ( if14) from Septic absorption fvc .
Proposed System : Septic tank d;d , gal . ( Minimun size , 1000 gal . ]
Tile Field - Each trench f t _ 'Total system legnth f t _
Seepage pits ) Number of !_ Size each ft x S ft
Size of stone to be used # Depth or thicknessft _
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 .
T _heave read ,.the regulations on the reverse side of this sheet and agree
to abide by these and all requirements of The Town of Queonsbury
Sanitary Serfage Disposal Ordfnance .
Signature of responsible person
Date
05/ 86 and/ vl
r
Section IT Septic System Inspections :
A , All applicationd for ' septic system installation ,
alteration or repair , as required by the Town of
4ueensbury Sanitary Sewage Ordinance , shall be
submitted to the Buildina 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 , the fields and/rear dryw+ells
B , NO system shall be covered before inspection and
approval by the Buildings inspector . Failure to
comply with this recruirement may result in the
uncovering of the system by th+e installer and a
fine of up to $ 250 . 000
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 .
t Iao should unforeseen problems during construction
Prevent proper .installation , alteration or
repair of an approved system , a new proposal
must be submitted to the Oueensbury Building '
Department before further construction ,
_locals of Queivnsfacer�
BUILDING and ZONING DEPAnTMENT
Bay and Haviland Road. R, D- 1 Box 98
Queensbury, New York 12801
eSN Gr r00"rcc�A► ►p ,a&q�dacrs
SEPTIC DISPOSAL SYSTEM INSPEC ION
KWE
LOCATION s / !�/ J J� IJ�'+OFr c
del
DATE Ik -( / 5S2Z PERMIT N0a
SOIL TYPE - and - Loam - Clay
Percolation Test Required? YES - NQ
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption fief" dotal length��
Length of trench�_7�, 'r
Dept trenches=�
e of gravel
SEEPAGE PITS4VIimber of) _ -
Size- --Cft. X ^rft .
Gravel size '
PIPING : Size 'type
Bldg . to tank
Tank to disc . box
Dist. box to fielnp
Openings sealed? NO Partial
LOCATION/SEPARATIONS :
Foundation to tank f Foundation to absorption ft •
Absorption to lot line ft .
Separation of pits f t-
LOCATIQN OF SYSTEM ON PROPERTY (ci.rcle one)
Front - Rear - Left side - Right side -
CCMMENTS :
SYSTEM USE APPROVED ES NO
Bui ding Inspector
01/86 and vl
_. - -
i qo
- c- �
y' Id
Af f
f 1/'