1987-286 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-286
C V i _ WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Bay Ridge Vol . Fire Co . m
OWNER of property located at ` Sunnyside Road Street, Road or Ave. POO
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in the Town of Queensbury, To Construct or place a Sewage Alteration M
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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.
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1 . OVVNERS Address is RD ail BOX 364 ro
Queensbury , New York 12801 c
2. CONTRACTOR or BUI LDER S Name
Walter Stevenson
3. CONTRACTOR or BUILDER'S Address
RD #1
Queensbury , New York 12801
4. ARCHITECT'S Name
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S. ARCHITECT'S Address
fi. TYPE of Construction — (Please indicate by XI
( I Wood Frame I I Masonry I } Steel l 1
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7. PLANS and Specifications E
No. 8rx8 ' seepage pit per plot and application Q
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8, Proposed Use r1
Sewage system for Fire House
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES May 27 1989
{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
")r2']7 th Day ofr May 19 87
/SIGNED BY _ / a� e5 for the Town of Queensbury
Building and Zonin Inspector
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TovvN-! OF i:rL1EE1VSra:..c�'s"
APPLICATION FOR SEP TIC DISPOSAL PE ti ' Ll
MAY z 119$7
DATE / �'ifAJ' 2 T / dQ BUILDING a CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATIONS
Owner's Name : 4Y ��,, t._ I:r� r� Telephone:
Address: y av+ r r'1.,yx,,��r7o•..� la X74p;r ,74r jy i >.p'/ 5' 761
Installer's Name: 41 e ; ./x'Edrrrrr. ' Telephone: 70�
Number of bedrooms (residential only)
Total daily flow (compute Cc) 150 gal per bedroom)
TopogaraphV circle one Fla Rolling Steep Slope °r& of slope
Soil Nature: circle one• San Loam Clay Other / Depth: feet
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Ground Water: At what depth? s' S t feet
Bedrock or Impervious Material: At what depth? !� feet
Percolation test: circle one: not required required / rate 44—
min. inch.
Domestic water supplyt circle one: Municipal rWeW Other
IF domestic water supply is a Well:
Separation: Watersupply* from Septic absorption 2 d d feet
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PROPOSED SYSTEM: Septic Tank g minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of / / Size each d°' feet by A feet
Size of stone to be used # ,�WA ,or / Depth or Thickness feet
I M P O R T A N T
...P'lease...LiST NEW EQUIPMENT TO BE INSTAr_r .rrn
��--�� may_ �_ ,c•�„ � 4W
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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 Z4 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 $Z50.00.
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;Sew]:e Dish Orxlinance.
Signature of responsible person:
Date: 2
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York IZ801
(518) 792-583Z
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD, PLACE TO LIVE
- 20t " a/ Quee" Jiury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
LOCAT I ON �Lr rt +/r t S i rid
DATE 7� / PERMIT NO. X � 4
SOIL TYPE - Sand - Loam - Clay -�
Percolation Test Requi-red? 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{Number of)
Size- eft. X _ 5K f -
Gravel size
PIPING : Size Tvve
Bldg . to tank e,►�-�
Tank to d i st . box 1 r last J�_
Q; m to field/i� it
openings sealed? ES i NO Partial
I.00AT I ON/SEPARATIONS .
Foundation to tank
Foundation to absorption �u-- -ft .
Absorption to lot line aEft.
Separation of pits
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front - Rear - Left side - Right side -
CWMENTS : r ��
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SYSTEM USE APPROVED YES ^f � O
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� uiInspector
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