1987-105 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-105
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WARREN COUNTY. NEW YORK
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PERMISSION is hereby granted to Gordon Ogtrander
51 � Road Street, Road or Ave.
OWNER of property located at ,y
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in the Town of Queensbury, To Construct or place a Sewage Alteration a
at the above location in accordance to application together with plot plans and other information hereto filed and
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
F2, CONTRACTOR
ER'S Address is 51 Kensington Road
Queensbury , New York 12801
or BUl LDER'S Name Sanitary Sewer
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3_ CONTRACTOR or BUILDER'S Address
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P . O . Box 224 rt
Glens Falls , New York o
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d. ARCHITECT'S Name
5. ARCHITECT'S Address
8_ TYPE of Construction — (Please indicate by x)
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) Wood Frame 1 ) Masonry f } Steel l ) w
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7. PLANS and Specifications :°`
1 — 6 hole dist . box and 180 ' leach field per plot and ram,
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No. application submitted .
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8. Proposed Use o
Sewage system for dwelling
$ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES March 31 19 89
(If a longer period is required an application for an extension must he made to the Building and Zoning inspector of the
town of Queensbury before the expiration date_)
Dated at the Town of Queensbury this 31st Day of March 19 87
SIGNED BY _ - �- ' for the Town of Queensbury
Building and Zoning Inspector
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ay ' ae"W6WP TOWN OF QUErE.NSuu 'r
APPLICATION FOR SEPTIC DISPOSAL PERMIT M
M U V M
MAR 311987
BUILDING & C DE DEEM
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LOCATION OF PROPERTY FOR INSTALLATION A olu ,-sw � �p� Pd ,
Owner's Name: �elephone:
Address: C5�1 ,/ I A/ S' / ^0 7-0 .-r ^�7 r
Installer's Name: / (,tJ Telephone: / / Z '%
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) C?
Topography_ circle one(::Fla Rolling Steep Slope % of slope _
Sail Nature: circle one• San Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ "� feet
Percolation test: circle one: not require required / rate min. inch.
Domestic water supply: circle one<Ejun ci i al Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank _ gal. (minimum size: /1 ,000 gal.)
6 TILE FIELD: Each Trench V feet j Total system length / k o feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # _ j Depth or Thickness / feet
IMPORTANT
...PleaseaevMST NEW EQLIIP'MENT TO BE INSTALJ_sin
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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 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.
I have read the regulations above agree to a ide by these all requirem is
of the Town of Queensbury Sani Sewage D' r)rr-dinance..
Signature of rqkponsibl person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . HOME OF NATURAL BEAUTY . . A GOOD. PLACE TO LIVE
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BUILDING and Zf7 Ftoaa D'E O RTBox ge
BaY and Haviiand N York 1280i
QUeensburY.
SEPTIC DISPCISAL- SYSTEM INSPE.CTIC"
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IlATE _
SOLT� TYPE Sand - Loan, _ C1Y S NO
at
Percolion Test Rewir/Inch
ed? YES
Percolation rate. _ Min
TYPE of 5`3 5 3'E s 'total length 1
pbsorptian field : {C '
Length of each trench
Depth of trenches -~ �--
Size of gravel_
SEEPAGE, PITS4,41, r of)
ft. X _ ft.
Size- Type
Gravel size Size
PxP sNG : -- --.
Bldg m to tan1�
Tar►'k to dist. box ----
Dist- box to f ieldl .00 Partial
Openings sealed? Es
LJOCATION/SEPARAT1ONS ' /C) ft.
Foundation to tank �-ft .
gounclati.on to absorption CL 0 f t.
Absorption to lot line ftft
of pits Circle onel
Separation STEM ON PROPERTY {
z,oCATzo Left side - Right side
Front Rear
COK"ENTS =
SYSTF
USE APp'ROVED NO
YE
Building Xnsliector
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