88-216 BUILDING PERMIT
TOWN OF QUEENSBURY No. 88-216
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David B. Pine
OWNER of property located at Sunnyside Road North Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewage Alteration
at the above kocation 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 lv
RD#1 — Box 301 — Sunnyside Road NOrth
Glens Falls, New York 12801
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2. CONTRACTOR or BUILDER'S Name
Walt Stephenson
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( 1
7. PLANS and Specifications
No. 1000 gal. tank, 1— 8' X 8' seepage pit
8. Proposed Use
Sewage Alteration
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 1990 O
(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 11 th Day of May 19 88
SIGNED BY 7"7ad� a • a0-,9_,6// i for the Town of Queensbury
Building and Zoning Inspector R,��
c� TO`.:ail OF QUEENS U
Crilrit of(ae,,z.dgait
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^),,-\.) APPLICATION FOR SEPTIC DISPOSAL PE T Iiiii'.Y 1 1988
4.�i BUILDING & CODE DEPT.
DATE in R) /t / /9(fk Y
'LOCATION OF PROPERTY FOR INSTALLATION SuNnue�/J/De NeX7df /oA,D
Owner's Name: cf)A U/p g. e//t/,E Telephone:// _793 —�7�/
Address: f, D- f/ -4eic3o/ ,SGNNP/.I/J//' /yw,/ repo - ,,:c.u' erica-6/U.y 12d0/
Installer's Name: W, -L1- Sre4a l'N £-e N Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope % of slope IO 2
Soil Nature: circle one Sand Loam Clay Other / Depth: _ feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? _ feet
1
Percolation test: circle one: not required required / rate . inch.
Domestic water supply: circle one: Municipal Other 00
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM:: Septic Tank (a gal. (minimum size:. 1,0,00 gal.)
TILE FIELD: Each Trench feet / Total system length feet
(� �/R n'+ TG2 CC) Co v eiz
SEEPAGE PIT(S): Number of / Size each0 feet by < feet SKr !
Size of stone to be used # _ 7 / Depth or Thickness _ feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
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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.
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I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance
Signature of responsib person: ,L)- el
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
;f . ;-i I'. :,C,,; ;i, "il;'.A;- EF.!:TY . . . .' OOD . LA IvC
Jown o/ Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
37. fl( 3o f
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME j
LOCAT I ON ,S'(1�t/e4' s/2>e- �"vpp2 7-27/
DATE o7//g PERMIT NO. ( -�J
SOIL TYPE - Sand oam Clay -
Percolation Test Re•bired? YES • G)
. Percolation rate - Min/Inch 160
TYPE of SYSTEM:
Absor ion field, tal le'gth
Length of e rench
Depth o enches
Size • avel_
SEEPAGE PI' S-Number or _a/ •
Size- p X _R rtj>
Gravel size (2j ", G, 3
PIPING: Size Type
Bldg. to tank -"/l f'/'C
Tank to dist. bo - 1
Dist. box to fi- d . /1
Openings seale.. a) ' NO Partial
LOCATION/SEPA' ,TIONS:
Foundation t. tank • /2 ft.
Foundation t• absorption .571..,°7ft.
Absorption .o lot line .Q ft.
Separation .f pits
LOCATION • SYST u Fa "IPER'Y(circle one)
Front - - Left side - Ri%ht side -
COMMENTS:
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SYSTEM USE APPROVED ® NO
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Building fnspec or
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