1987-224 BUILDING PERMIT
TOWN OF QUEENSBURY No 87-224
i jj l WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Richard Collin ;
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OWNER of property located at 10 Carlton Drive Street, Road or Ave. �
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in the Town of Queensbury, To Construct or place a Sewage Alteration �—
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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 10 Carlton Drive
Queensbury , NY 12801
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2. CONTRACTOR or BUILDERS Name
Rusty Graham
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X)
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[ I wood Frame ( ) Masonry ( I Steel { } rrt
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7- PLANS and Specifications w
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8n �tgt seepage pit and bull valve per plot and application
8_ Proposed Use
Sewage system for dwelling,
$ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES May 8 19 89
(If a longer period is required an application for an extension must be made to t h a Building and Zoning inspector of the
town of Queen sbury before the expiration date.)
Dated at the Town of Queensbury this 8tM`--}r�,� �Daay of May 19 $7
SIGNED BY / / ! " � for the Town of Queensbury
Building and Zoning I ntspector
W WTOWN OF . ia r ,'vSLsqtaw earn of"e4nd4fV NP
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APPLICATION FOR SEPTIC I3ISPOSAL PERMIT
APR z is 1987
BUILDING & C DE DEPT.
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LOCATION OF PROPERTY FOR 1N5TALLATIQN L.. '1-1[2- . (�ItiJ ,
Owner's Name N Telephone: r - c 0/
Address:
Installer's Name:�T�J ]Q.�1 3 1ti/� Telephone: i
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Clay Other / Depth: feet
Ground Water: At what depth? W feet
Bedrock or Impervious Material: At what depth > _ feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one Municipal Well Other
IF domestic water supply is a Weil:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank — gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet �^�
SEEPAGE PIT(S) : Number of / Size each 5' feet by _ (.p l �feet DDi 0"£i
Size of stone to be used # `�'� _ / Depth or Thickness (P — i�� t feet Y 7
IMPORTANT
...Please.o.LIST NEW EQUIPMENT TO BE INSTAI.I
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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 and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ckilinance.
Signature �of responsible person: cul
Date: 7 `. c 6 7
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SE rTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A {;ODD.. PLACE TO LIVE
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" suILDING and ZONING DEPARTMENT i
Bay and Haviland Road. R. D. i Sox 98
Clueensbury, New York 12801 i
SEPTI DISP SAL SYSTEM INSPECTION!
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NAME
LOC A r I ON
DATE / / 5 7 PERMIT NO .
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES-
Percolation rate - Min/Inch -
TYPE of SYSTEM :
Absorption field , total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS-(twluinbe]S of)
size ^ft. X rJ ft.
Gravel size
PIPING : s- Type
Bldga to tank
Tank to list_ box
Dist_ box to field/ 40
Openings sealed? NO Partial
LOCATION/SEPARATION S
Foundation to tank fE'T� f t.
Foundation to absorption / t .
Absorption to lot line ft.
separation of Pits l ft.
LOCATI{7N OF SYSTEM ON PROPERTY (circle one )
;Front Rear - Left. side - Right side -
CoMMEIg s :
SYSTEM USE APPROVE YES NO
Building Inspector
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FLUID HANDLING DIVI