1987-421 BUILDING PERMIT �
TOWN OF QUEENSBURY No. 87-421
WARREN COUNTY, NEW YOi'RK
PERMISSION is hereby granted to Steve Skel a
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OWNER of property located at C unty Line �- 4 `'�� Suet, Road or Ave_ w
in the Town of Oueensbury, 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-
I- OWNER'S Address is
County Line Rd .
Queensbury , N . Y . 12801
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2. CONTRACTOR or BUILDER''S Name fN
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Walter Graham
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3. CONTRACTOR or BUILDER'S Address ~
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301 Main St . to
Hudson Falls , NI . Y . 12839
4_ ARCHITECT'S Name
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5. ARCHITECT'S Address ^�
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6. TYPE of Construction — (Plasse indicate by X)
I ) Wood Frame ( I Masonry t 1 Steel ( }
7. PLANS and Specifications
No_ 1000 Gal tank , distribution box 200 € t . leach lines .
per plot plan and application .
8. Proposed Use p�q
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Sewage alterations
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10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 1989 0
(if a longer period is requlred 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 6th,, Day of July yg 87
SIGNED BY � �� .0/.>• for the Town of O ueensbury
Building and Zoning Inspector
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* APPLICATION FOR SEPTIC DISPOSAL PER T i L l`" IN
Y `/ 3 JUL 11987
Bi.JILIDiNG & CODE DEPT,
DATE / —_ '� �t 102D P^Wl to
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: ` ti Ca.,�-� .S A�.G.{�- , Telephone:
Address: _-, S ta,,.,,.,.,,.•�
Installer's Name: Oe -�4v�. .� Telephone:
Number of bedrooms (residential only) _ _
Total daily flow (compute @ 150 gal per bedroom) _ 0 1 7
Topography: circle one: Flat Rolli Steep Slope %n of slope
Soil Nature: circle one: Sand oam Clay Other f 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: <RLa ici Well Other _
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank I C*sv — gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench gip feet f Total system length 2 yr p feet
SEEPAGE PIT(S): Number of J Size each feet by feet
Size of stone to be used # __ f Depth or Thickness yf feet
IMPORTANT
,,,Please.,,UST NEW EQUIPMENT TO BE INSTALLED
(over)
7/ 3
BUILDING and ZONING 'DEPARTMENT
Bay and Haviland Road, R . D _ 1 Box 98
Clueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME �/"j� ,"„1,_
LOCAT I ON
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DATE 4 / PERMIT NO._ f G"
SCTL TYPE _ Sand - Loam - clay -_
Percolation Test Required.? YES - NO
Percolation rate. - Min/Inch _
TYPE of SYSTEM: r�
Absorption field , total length L v
Length of each "trench L?
Depth of trenches
Size of gravel_ u 2-
SEEPAGE PITS{Number of)
size- ft. X - ft.
Gravel size
PIPING : Size Type
Bldg . to tank
Tank to dirt . box
Dist. box to field
Openings sealed? 0140
Partial
LOCATION/SEPARATIONS :
Foundation to tank �ft.
Foundation to absorption a ft .
Absorption to lot line ft .
Separatio f Pits ft.
LOCATI STEM ON PROPERTY (ci.rcle one )
Front - ear Left side - Right side -
COMMENT :
SYSTEM USE APPROVE YES NO
Bui ding Inspector
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