1988-117 BUILDING PERMIT
TOWN OF QUEENSBURY ro
No. 88-117 0
WARREN COUNTY, NEW YORK
01r1'1 � I - �fo
PERMISSION is hereby granted to Robert Hickey5
OWNER of property located at Morgan Drive Street, Road or Ave.
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.
1. OWNER'S Address is
Box 247
Morgan Drive
Queensbury, N.Y. 12801 rt
2. CONTRACTOR or BUILDER'S Name •
Same x
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address pq
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel (
7. PLANS and Specifications
No. Existing 1000 gal tank, tile field 40' total system 200' as per
plot plan and application. cpa
8. Proposed Use
Sewage alteration
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10.00 April 7 90
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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 7th Day of April 19 88
SIGNED BY .Z 'U for the Town of Queensbury
Building and Zoning Inspector , .
.Tc�tU9L or TOWN OF QUEENS i it d.-
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a '\ APPLICATION FOR SEPTIC DISPOSAL PERMIT APR 5 1 i
)Avi E UILDING & CODE DEPT.
DATE fr►Asa�4 Z /
LOCATION OF PROPERTY FOR INSTALLATION f4O1"1C. cJ ORivi`:
Owner's Name: R 13L=RT L ( l C `f Telephone: -7 aj 0�
Address: Y •Z,47 M aREAN, pR PALLS,jL1'f (2 t1 Z
Installer's Name: S C Lis" Telephone:
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) 46'D
Topography: circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam_ Clay Other / Depth: 10 feet
Ground Water: At what depth? •ZZ feet
Bedrock or Impervious Material: At what depth? feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: 61--luniElp.0 Well Other
IF domestic water supply is a Well: Ni3T I iv 'SL
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank gal. (minimum size: 1,000 gal.) > LSTI hi 6 Mar-:
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TILE FIELD: Each Trench Li.R feet / Total system length ZOO feet EJEIA/
SEEPAGE PIT(S): Number of / Size each feet by feet
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Size of stone to be used # 11?� / Depth or Thickness I feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
... le ... ST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
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0NI BLDG CODES DEPT,
TOWN OF QUEENSBLIRY (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
O 3.) location and distance to structures
4.) location,and distance to any water supply 0
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
O Inspector. Failure to comply with this requirement may result in the
O 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 00
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 Disposal Ordinance.
Signature of responsible person:
Date:" 31 Id 8-
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Town of Queensbury
, .
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
1763 . . . HOW- 7:RAL P A GO ' II,F
A/ �. 0 awn ot Queeni urtij
J. BUILDING and ZONING DEPARTMENT
I Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
072
SEPTIC DISPOSSAL SYSTEM INSPECTION
NAME G' 0 Gke
LOCATIO �d1
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DATE ��/ [SS�'/ PERMIT NO. � /`/2(
SOIL TYPE - and y Loam - Clay -
Percolation est Required? YE. 76(12
Percolation rate - Min/Inch
TYPE of SYSTEM: •
Absorptio field, total l-•ngth />
Length o' each trench
Depth of trenches 3 '
Size of gavel • _
SEEPAGE PI S4Number of
Size- f . X f .
Gravel size
PIPING: Size Type
Bldg. to tank perc_
Tank to dist. ..x Ay la //
Dist. box to fi- ./pit y"
Openings sealed? al NO Partial
LOCATION/SEPARATiO .
Foundation to t.•nk A% ft.
Foundation to . .sorpt .on C7.49ft.
Absorption to of line IQ ft.
Separation of sits ft.
LOCATION OF SYSTEM ON PROP"•TY(circle one)
Front Rear r Left side - R side -
COMMENTS:
SYSTEM USE APPROVED 411, NO
Bu lding Inspector
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