1987-083 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-83
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to lames R . Putnam rn
44- 4r Stone ate Drive Street, Road or Ave.
OWNER of property located at �
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in the Town of Queensbury, To Construct or place a Sewa a Alt
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 ,ill
Queensbury , New York 12801
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2. CONTRACTOR or BUILDER'S Name Dick Lee
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name C
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5. ARCHITECT'S Address
S. TYPE of Construction — (please indicate by X)
i 1 Wood Frame i 1 Masonry i 1 Steel i 1 cn
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7. PLANS and Specifications [so
# 3 & 4 stone around existing concrete seepage pit per plot and a
No. application . H
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S. Proposed Use
Sewage system for dwelling o
13 . 00 March 24 19 89
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PERMIT FEE PAID — THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Buiding and Zoning inspector of the
town of Queensbury before the expiration date.)
Da of March t9 87
Dated at the Town of Queensbury this 24 th Y
SIGNED BY 0' for the Town of Queensbury
Bulling and Zoning Inspector
Tr3WN OF
APPLICATION FOR SEPTIC DISPOSAL PERMrW
987
47
BUILDING & CODE DEFT.
DATE
LOCATION OF PROPERTY FOR INSTALLATION �t���rx . a L32
owner's Name: � T`Qrr2f-s r_._ pss n, "arv, Telephone: 293
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Address: cyH LEPY5 LdEe
Installer's Name: Pt �_K 1. Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) i �5
Topography: circle one: Flat Rolling Steep Slope 9 of slope
Soil Nature: circle one. and Loam Clay Other / Depth: feet
Ground Water: At what depth? y rblm feet
Bedrock or Impervious Material: At what depth? prs 01 feet
Percolation tests circle one: not required required / rate min. inch.
Domestic water supplps circle one: Municipal eI Other
IF domestic water supply is a Well:
Separations 'Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank �v _ gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of 1 I Size each _ 1 _ feet by `� feet
Size of stone to be used # / Depth or Thickness _ '� feet
IMPORTANT
...Please.._LIST NEW EQLiIPMENT TO BE INSTALLED
(over)
,7ouln 0/ Queen .3laury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R-0. i Box 98
Dueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME_p..S .
LOCATION. I(1r �.� ?� L�
,,ATE � s7i 3 �� PERMIT
SOIL TYPE - Sand - Loam - Clay
Percolation Test. Required? YES - NO
Percolation rate - Min/Inch _
TYPE of SYSTEM:
Absorption fieldr 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
Bldgo to tank
Tank to list. 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 -
CCMMENTS :
SYSTEM USE APPROVED fYFS NO
Building inspec .or
01/86 Md vl
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 ve,gulations above and agree to abide by these and au requirements
of the Town of Queensbury Sanitary Sewage Dispo� Ordinance.
Signature of responsible person: -'
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.Date:
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Town of Queensbury r
Building and Code Department +
Bay at Haviland Road
,Z t.j rs r Queensbury, New York 12801
(518) 792-5832
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SETTLED 1763 . . HOME OF NATURAL BEAUTY . . .! A GOOD. PLACE TO LIVE