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1987-343 BUILDING PERMIT TOWN OF QUEEN5BURY � WARREN COUNTY, NEW YORK No. 87--343 PERMISSION is hereby granted to Kenneth Blackmar o OWNER of property located at 00 15 Buena Vista Drive Street, Road or Ave. cc cc 1 N in the Town of Queensbury, To Construct or place a Sewage Alteration _ 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. x. OWNEROS Address is 15 Buena Vista Drive Queensbury , New York 12801 ra 0 2. CONTRACTOR or BUILDER'S Name rmr Morning Star Ex , Fa w 3. CONTRACTOR or BUILDER'S Address �s 4. ARCHITECT'S Name 5. ARCHITECT'S Address , Ln tsi C ro 0 6. TYPE of Construction — ;Please indicate by XI w C H• I I Wood Frame Masonry { ) Steel { } on w 7. PLANS and Specifications ty 1000 tank , disc , box and 120 ' leach field per plot and No. application m w S. Proposed Use p Sewage system for dwelling sn w to _1,0 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES June ll 1989 it a longer period is required an application for an extension must be made to the Building and Zoning inspector of the [n town of Queensbury before the expiration date.) rn w Dated at the Town of Queensbury this 11th -Day of June 19 87 y. SIGNER] BY )14&41 "' • for the Town of Queensbury m Building and Zoning inspector Iv rt H• d ^J APPLICATION FOR SEPTIC DISPOSAL PERMIT Q E % N H 'l1 N J UN 9 1987 �,r� BUILL]Il3G qEk0 C/►E DE DATE 1 j LOCATION OF PROPERTY FOR INSTALLATION Owner's Name: ;�� ram'- Telephone: Address: 4al40#g', Installer's Name: L26 Ly a Telephone: 2E3 2- Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: Flat Rolling Steep Slope % of slope _ Sail Nature: circle one: San$j Loam Clay Other / Depth: _ feet Ground Water: At what depth? 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 Wells Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM: Septic Tank _ gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length 0 feet SEEPAGE PIT(S) t Number of / Size each feet by feet Size of stone to be used # _� / Depth or Thickness � Air Z� feet IMPORTANT f ...Please...I.IST NEW EQUIPMENT TO BE INSTALLED s� 0 `'N' I d a Q t k (over) Section II Septic System Ins ections: 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 Be 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 Sewage 13isposal. Qrdinaxace. Signature of responsible person �� a Date: Town of Queensbury Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-583Z 5EfTLED 17631 HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE _lUW DSPAFtT B1l1LC]►NC' and ZO N't4 ; gox 98 rk as+d Ha�iland Road. 0,% Oueensbury. tdew Yo � 2g41 Bay INSPECTION 15PQ5AL- ►C a V, j c�EPT I C w NAME r- 0 rQ . LOGA1ION pE4tMt� NO * TYS,� Sand Re�N ed� YES SCIL Percola tivn ratie Pexcola I*YFE pf SYSfjeldr to tax le th��--�� pbsoxPtion c]n -Length of each t s rieptY► of tr enche � _--- ��--� of gXavel'r size E PXT'rJcN e� SEEPNG Gravel size It y' t~ j ` plPxN� 'to Manx to r--- Tank tGist. Pa a- - 1 boX o .f ield/ YES "0 rii5t. sealed? ppenitr3 s I.QCA,TTOrit/S£ 'I'+RF''atCkS► Te cauxrdation j:' absorPtios' f t. Foundation �`� line circle one) E `c� Absorption to lot Sp prati� Q ' SYS�ts 7L,.,bt sine i €t side rl Front _ Rear r• !/ CCWILNTS = r At;)t� y� 13Q SYS.ro, +t3S'S APPRC1uEt? Buildin3 Inspector C11/$6 and vl e7© eeeenJhursy _Jsun O BUILDING and Zpr11NG DEPAFt- 88 Bay and Haviiand Road. R.L). i Box ()ueensbury. New York 12801 SEPTIC DI/SSpOSAL SYSTEM INSPECTION 11 NAMEui Le.) LpCAT WN n PERMIT DATE <e l� percola SOIL iOn TYPE - Sand - SJoam - Clay percolation Test Required? YES - I30 rate - Niin/Inch r" TYPE of SYSTEM: total length Absorption f fi tot eld , I,engtYx of each � fNDepth of trenches . Slze of gravel SEEPAGE PI S414uimber ft) Size- ^�- - Gravel size size TYPL PrpxKG : Bldg . to tank. Ta1k. 'todisc. box box to field/� Dist_ NO partial Openings sealed'' ESQ} LICCP,TxC7"/SF A11ATIC]I3Sc �C t. Foundation to tankft . Foundation to absorption �ft. Absorption to lot line ft. Separation of pits PROP_ER (circle one) iKCATION OF SYSTEM - Right side 'Front - Rear NNINNIN Left side GCEUIENT'S : 1 SYSTEM 17SE Y ROVED ES NO Build n�3 Inspector 01/86 and v1 Q ' �. r ,�63 �. � rCt, y --- -� --___ , .