1987-209 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-209
WARREN COUNTY, NEW YORK n
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PERMISSION is hereby granted to Charles Yasko fJ4
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OWNER of property located at 20 Buena Vista Drive Street, Road or Ave.
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Sewage Alteration
in the Town of Queensbury, To Construct or place a
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 _ OWNERS Address is 20 Buena Vista Drive
Queensbury , New York
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2. CONTRACTOR or BUILDER'S Name Sanitary* Sewer Service
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3. CONTRACTOR or BUILDERS Address �•
P . 0 . Box 224 , i
Glens Falls , New York
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4. ARCHITECT'S Name G
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6. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
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} } Wood Frame I ) Masonry i ) steel i 1 E
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7. PLANS and Specifications
6 hole dist . box and 2 6 ' x8 ' seepage pits . W�
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B. Proposed Use 0
Sewage system for dwelling ❑
10 . 00 May 5 19 89
PERMIT FEE PAID — THIS PERMIT EXPIRES
(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.)
5th Day of May fg 87
Dated at the Town of Queensbury this -'dry,, /�
SIGNED BY ! 1 f ( 40 jeAa� for the Town of Queensbury
Building and Zoning Inspector
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APPLICATION FOR 'SEPTIC DISPOSAL PERMWJAPR 2 8 1987
BUILDING & CODE DEPT,
DATE W V V
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: '[,_..-A� S �.h t 7 J j� - Telephone:
Address: a;Z a C3 y�/u l'� ^Installer's Name: [ } /Gt /1,�iISi2� cJ ed(A/e. c- S4::u Telephone:
Number of bedrooms (residential only)
Total daily flaw (compute @ 150 gal per bedroom) r7 d
Topography: circle one: Fla Rolling Steep Slope of slope
Soil Nature: circle one: Sand Loam Clay Other f Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? i feet
percolation test: circle one: 4of require required J rate min. inch.
Domestic water supply: circle one: unicipa. Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank 0 gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of _ / Size each 2 feet by <?� feet
Size of stone to be used -# f Depth or Thickness feet
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALT
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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 U isposal Ordinance_
Signature of responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 79Z-5832
SETTLED ) 763 . HOME OF NATURAL BEAUTY . . A GOOD. PLACE TO LIVE
_Jawn a Q" Ve" J "ry
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
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DATE DATE yy - RMIT NO .
SOIL TYPE - an - Loam - Clay -
Percolation st 'Required? YES NO
Percolation rate - Min/Inch _ r
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
Sang * to tank Wor
Tank to list. box
Dist . box field
Openings sealed?
led? ES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank �ft.
Foundation to absorption ft .
Absorption to lot line ..b- f t .
Separation of pits _3n ft-
LOCATI YSTEM ON PROPERTY (circ1e one)
Front R ar - Left side - Right side -
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SYSTEM USE APPROVED YE NO
Building Inspector
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