1987-342 BUILDING PERMIT
TOWN OF +QUEENSBURY No. 87~342
WARREN COUNTY, NEW YORK o
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PERMISSION is hereby granted to N 1
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Moor Drive �
OWNER of property located at 3 Street, Road or Ave.A
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 3 Moorwood Drive
Queensbury , New York 12801
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2. CONTRACTOR or BUILDER'S Name Morningstar Ex .
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3. CONTRACTOR or BUILDER 'S Address
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4. ARCHITECT'S Name
6, ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by X) o
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l ) Wood Frame ( ) Masonry ( } Steel
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7. PLANS and Specifications
Dist . Box and 2 6 ' x8 ' seepage pits with 2 ' stone per plot and
No. application
8_ Proposed Use
Sewage system for dwelling
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$ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES June 11 19 89 {°
(If a longer period is required an app I!cat ion for an extension must be made to the Bui Ming and Zoning inspector of the ice•
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this 11th Day of June 19 87
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SIGNED BY for the Town of Queensbury
Building and Zoning I nspector
ammome
�JI'ffft of (+ OWN OF QUEE�VSFL. :av
!" APPLICATION FOR SEPTIC DISPOSAL PERMIT M � � � U L+' N 101
JUN 9 1987
r+ BUILDING & CODE DEPT_
DATE
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ns0�c3 R�!� Telephone:
Address: r 3 rz_ ,rF�-
Installer's Name: : r . - T�L.�- Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) _
Topography: circle one: Flat Rolling Steep Slope % of slope tom"
Soil Nature: circle one: (Sand j ,oam 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.
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Domestic water supply: circle onek'lMunicipa Well Other
IF domestic water supply: is a Weil:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM : Septic Tank , + gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of / Size each . feet by 115P feet
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Size of stone to be used # / Depth or Thickness feet
IMPORTANT
...P'lease..OLIST NEW EQUIPMENT TO BE INSTALLED
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Section II Septic System InMectionse
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 $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 a.nd all requirements
of the Town of Queensbury Sanitary Sewage Disposal C ordinance,
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Signature of ��� .
g responsible person"—
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SE I- TLED 1763 HOME OF NATURAL BEAUTY . . A GOOD PLACE TO LIVE
._,/nwn of Queen 'll"ry
BUILDING and ZONING DEPARTMENT
Say and Haviland Ftoad, h-0. 1 Box 98
Queensbury, Now York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
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LOCATION r7 ■�
DATE / PERMIT NO . !
SOIL TYPE - an Loam - Clay
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Percolation est Required?
percolation rate - Min/Inch _
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TYPE of SYSTEM:
Absorption field total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS{Plumber af)
Size_ 69
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Gavel sze Size Type
P TP IP3G :
Bldgo to tank
Tank to list. box
Dist* box to field/ NO Partial
Openings sesealed? ��/.,'YES IJ
LOCATIONN/SEPARATICNS : ft.
Eoundation to tank. ft . �
Foundation to absorption
ft.
Absorption to lot line ft.
Separation of Pits
LOCATI£3R3 STEM ON PROP (circle one)
Front ' ear Left side - Right side -
CCMMEN S .
SYSTEM USE APPROVED YE 140
Bu4131.ng Inspector
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