1986-587 BUILDING PERMIT
- TOWN OF QUEENSBURY No. 86-587
WARREN COUNTY, NEW YORK
301 , 11--A
PERMISSION is hereby granted to
/ LeRoy Reeves
rRoiOWNER of property located at� Upper Sherman 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.
1. OWNER'S Address is RD 3 Box 192 L'.
Glens Falls, New York o
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2. CONTRACTOR or BUILDER'S Name same C
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3. CONTRACTOR or BUILDER'S Address
same
4. ARCHITECT'S Name
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5. ARCHITECT'S Address to
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6. TYPE of Construction—(Please indicate by X) C
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( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No. 1000 gallon tank and 1 — 5'x8' drywell per plot and application
8. Proposed Use cn
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Sewage system for dwelling — for use with toilet in basement m
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Sept. 17 1988 m
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rt
town of Queensbury before the expiration date.) H.
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Dated at the Town of Queensbury this 17th Day of Sept. 19 86
SIGNED BY l/'d, a_ 0. - 1 for the Town of Queensbury
Building and Zoning Inspector 04
t OWN OF QUEE+.✓BURY
of11
Qs re 5 uy FOR SEPTIC DISPOSAL PERJ1 I •
BUILDING and ZONING DEPARTMEN tPNCITI
Bay and Haviland Road. R.D. 1 Box 9- SEP 12 IL;
Oueensbury, New York 12801 � RM.,� 'DATE l /./o /24
LOCAL ON OF PROPERTY FOR 17 k:L1i1`1=0�1 1 5i6
� • V)�ek - i4- I� a�-
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OWNER'S NAME LE Rod EE\/E-S c� -
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ADDRESS
` 1:2i 1)3 oY f G. E-rVS FILLS }I O j TEL 7 9 "s53
INSTALLER' S NAME TEL
(0E. /�S 9 .0\)E • TEL
Nurrcber of bedrooms(residential only)Y0(L' qL/3/4-77-{ //tl T/SSE/vr For t-1Jr
��ITt3 pC_i+ygao(vLCC i;e-6 `2)
Total daily flow(compute @ 150 gal per bedroom) /_r0
Topography: Flat - Rolling - Steep slope - (circle one) % of slope
Soil nature: Sand - Loam - Clay - Other Depth >'f 0 ft. •
Ground water -At what depth? :3ST ft.
Bed-rock or impervious material - At what depth? > ' ft. .
Percolation test - Not required - Required - -Rate min-inch.
Domestic water supply - Municipal Welt - Other
Separation - Watersupply(if well) from Septic absorption /66 ft.
Proposed System: Septic tank (ObO gal. ( Minimun size, 1000 gal. )
Tile Field - Each trench ft . Total system legnth ft.
• Seepage pit (s) Number of I . Size each Sr ft X R ft
Size of stone to be used ¥ Li Depth or thickness I 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 .
* * * * * * * * * * * * * '*' * * * * * * * * ' * * * * * * * * * ♦ * * * * *
1 is i 2'f l ;:c 2.e _. 1 .. , : one an IC ciGF Of 0:is s cc c :.: ac2'ce
to cbi. g c- L'y Lr. sc and a 7 Z recut rerrent. Of The Tot n of Queensbz-ry
. Sanitary Sei,'OCc iiispcsc7 Ordinance.
S i o r c t✓r c: of ri-rronpler` oLe-'-illo7 // c'i
6�l OTf;` rl Fn W i5�-
t �-���� J v O a G/�L. ��E r'i►�� ( D lL;�WELL ��y��C TL!�. 6�n1 r'�:�i�n�T� � .. 64.�
-Tilts- ,iPPLICATI;;,J For( /1CUIT )nr/ii._. 4��5l rti
0 5/8 6 and/v l -Fu 2 U S cr-i.-k t o Ai As:EA'I,Eh±T•_
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Section::II Septic System Inspections:
A. All -applications .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 t)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 Oueensbury
.Building.
Department before further construction.
_loran o/ Queeniburty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NE L
AM eG1.- R U6S
LOCATION W-6'37M I Al (\( Jt--
DATE _/ PERMIT NO. '6- 7 "7
SOIL TYPE 1- 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 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 -
COMMENTS:
l_ S(.7 N:„.f (4)(17-/A--
AI DIA\Of- .- q t2 v�rC
SYSTEM USE APPROVED YES NO
/
- � !_41_
Building Inspectr l
01/86 and vl
awn-4 QueenJtury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME LeJe- , 11 P -e 1/e_Y
LOCATION /gyp eta _SA E%n7 as /c7.,
DATE / / 86 PERMIT NO. 8 fo r- X
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 CLA Nf-u v _
SEEPAGE PITS{Number of) _ I
Size- S ft. X ft. 47
- J
Gravel size
PIPING: Size Type
Bldg. to tank V"
Tank to dist. box _
Dist. box to field/.'
Openings sealed? NO Partial
LOCATION/SEPARATIONS:
Foundation to tank d2. ft.
Foundation to absorption TO-ft.
Absorption to lot line /0 ft F
Separation of pits —ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front GOLeft side - Right side -
COMMENT
SYSTEM USE APPROVED YES 0
601/6",
Building Inspector
01/86 and vl
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