1987-350 BUILDING PERMIT
TOWN OF QUEENSBURY 87-350
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to
John Dalesandro
Ave .9 Westmore Street, Road or Ave. °O
OWNER of property located at i
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in the Town of Queensbury, To Construct or place a _ Sewage Alteration 00
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 9 Westmore Ave . cti
Queensbury , New York. 12801
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2. CONTRACTOR or BUI LDER'S Name Sanitary Sewer Service N
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3. CONTRACTOR or f3UILDER'S Address P . 0 . Box 224
Glens Falls , New York
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A. ARCHITECT'S Name
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5. ARCHITECTS Address tt
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6. TYPE of Construction — {Please indicate by X} ,
1 } Wood Frame ( } Masonry f ) Steel I }
7. PLANS and Specifications
No. 8 ' x8 ' pre-cast seepage pit per plot and application
8. Proposed Use
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Sewage system for dwelling £
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$ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES June 15 19 89
(if a longer period is required an application for an extension must be made to the Building srnd Zoning inspector of the n
town of Queensbury before the expiration data.]
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Dated at the Town of Queensbury this 15th Day of June l9 87
SIGNED BY ~.C��I.aL= for the Town of Queensbury
Building and Zomng Inspecro
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APPLICATION FOR SEPTIC DISPOSAL. PERMIT JUN 8 )987
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BUILDING & CODE DEPT.
DATEc� IJ (P r �/ -
LOCATION OF PROPERTY FOR I�NSTALLATION
Owner's Name: V F/ 1� J }-SLf �1 Pi) Telephones
Address: }
Installer's Name: ( C�l u�1C Telephone: 7q )L — ;off 1�
Number of bedrooms (residential only)
Total daily flow (compute (,a 150 gal per bedroom)
Topograpphyx circle oneM Flat Rolling Steep Slope % of slope
Sail Nahmc: circle one• San Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Material: At what depth? i feet
percolation test: circle one: not required required / rate m in. inch.
Domestic water supply: circle one: Municipal ell Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank I Coo gal. (minimum sizes 1,000 gal.)
TILE FIELD. Each Trench feet / Total system length �y feet
SEEPAGE PIT(S) : Number of / Size each tR feet by 6 feet
Size of stone to be used # � / Depth or Thickness _ feet
IMPORTANT
___Please...LIST NEW EQTJIPMENT TO BE INSTALLED
(over)
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 to abide by these requirements
of the Torun of Queensbury Sanit Sewage "
Ordi
Signature of r spore ible person:
Date: Q
Town of Queensbury
Building and Code Department
Bay at 13aviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . A GOOD PLACE TO LIVE
*30
7own 01
Q"ee" itury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R,D, 1 Box 98
Oueensbury, New York 12801
SEPTIC
�^.DISPOSAL
� SYSTEM INSPECTION
LOCAT I ONN '�'�- AL
DATE f PERMIT NO *
SOIL TYPE - Sand - Loam - C1aY -
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#Nu e —
Size- '%_ft. X _Air.,ft. E� -,4924A 4-
Gravel size
PIPING : Si C; TY
Bldg , to tank.
Tank to disca box
openDist box ea ed?ld O artial
Openings sealed?
LOCATION/SEPARATIONS : 7-zf to
Foundation to tank t .
Foundation to absorption Pzft.
Absorption to lot line
Separation of pits �ft`
OF SYSTEM ON PROPERTY (circle one)
ront - ear - _Left side - . Right side -
C TS :
SYSTEM USE APPPJDVED 'YES NO
Bui din Inspector
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