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1986-790 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-790 q,96 L0 ) ARREN COUNTY, NEW YORK PERMISSION is hereby granted to Marie C. Hayes OWNER of property located at 11 Bonner Drive Street, Road or Ave. n 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 c� approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. M 1. OWNER'S Address is 11 Bonner Drive Queensbury, NY 12801 2. CONTRACTOR or BUILDER'S Name Sanitary Sewer Service F-' 3. CONTRACTOR or BUILDER'S Address P. 0. Box 224 o Glens Falls, NY1-1 4. ARCHITECT'S Name d CD 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) cn m ( )Wood Frame ( I Masonry ( )Steel ( ) ou CD 7. PLANS and Specifications y No. 1000 gallon tank and 1 8'x8' seepage pit for washing machine only per plot and application submitted. w rr 8. Proposed Use p Sewage system for dwelling $ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 10 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 10th Day of November 19 86 SIGNED BY V2:& for the Town of Queensbury Oct e Building and Zoning Inspector a awn of Q4 ,3i1Ury APPLICATION SEPT'arc�. P S ',�u_TA,� BUILDING and ZONING DEPARTMENT 10. 10EOVED Bay and Haviland Road. F3.D. 1 Box 9E3 • 1 Owensbury,• �: New. `'ork 12801 a1! • l �/ • DA1 / Cc--kB .r/ } i LOCATION OF PROPERTY FOR INSTALLATION • / � ��A a� N4. I Ina - C, G R A°Ta'� - ' l ,I, , y J •OWNER' S NAME• �} `� (— ADDRESS \ ` V TI`' 1� - .�j I' TEL:7 --se/ 7 INSTALLER' S NAME ,S7/] �,c4',- a(A),./c TEL 5)- D.- Number of bedrooms (residential only) Lvi\ cCNIL., 013E Total daily fiow(compute @ 150 gal per bedroom) Topography: (la - Rolling - Steep slope - (circle one) % of slope Soil nature: Sand Loam - Clay - Other Depth ft. . Ground water -At what depth? 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(if well) from Septic absorption ft. Proposed System: Septic tank .\ QC) p gal. ( Minimun size, 1000 gal. ), Tile Field - Each trench .— ft. Total system legnth . ft. (N ) Seepage pit(s) Number of 1 . Size each (, ft X cr ft Size of stone to be used r Depth or thickness 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 lak-e, streaim,pond or wet-lands. Include all dimensions of - . the system, itself . * * * * • * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I hac>c read the rc:o: 7at ions on the reverse side of this sheet and agree to abide by these and all requirements of The Town of Queensbury Sanitary Sewage Disposal Ordi.nanc . • • • Signature of responsible p-erson !' 05/86 and/vl See m p1 cr, J ',1 • Section II Septic System Inspections: A. All applications for sept'id system installation, alteration or repair, as required by the Town of Oueensbury 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 M 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. Y Jown of Qu ?enatur/ BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME `( 6,`7 — LOCATION DATE I( I� 7 /Vo PERMIT NO. (r6 _ 7 'to 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 trenche Size of el SEEPAGE PITS4Number of) 1 Size- ft. X ?- ft. Gravel size PIPING: Size Type Bldg. to tank 4 Tank to dist. box _ Dist. box to field/ it U�. Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank Z j Foundation to absorption L(v ft.f-- Absorption to lot line ft. OI-. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - - Left side - Right side - COMMENTS: 10bCA--L \A.'J SYSTEM USE APPROVED ES 0 /tew Building Inspect 01/86 and vl Down of Queen u ry BUILDING and ZONING DEPARTMENT • e...t� . Bay and Haviland Road, R.D. 1 Box 98 /n Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME /4_74 LOCATION 6,, !Y DATE if t / PERMIT NO. U V - `f D 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 _ SEEPAGE PITS{Numbe of) 1 Size- 0 ft. X t 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: J U� itq (© �rj tw - (cut IvorY?G�farrG Wt LL ( UW-- SYSTEM USE APPROVED YES NO Buil ing Insp for 01/86 and vl SANITARY SEWER SERVICE LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257 .� C_