1987-403 BUILDING PERMIT
H
TOWN OF QUEENSBURY �
No. 87-443
WARREN COUNTY, NEW YOR K
PERMISSION is hereby gra
nted to John Herlih
OWNER of property located at 138 Grant Ave .
Ex Street, Road or Ave_ �
N
Sewa a ,Alteration
in the Town of Oueensbury, o Construct or place ardance to application together with plot plans and other information hereto filed and
at the above location in ace
o
approved and in compliance with the Town of O.ueensbury Building and Zoning Ordinance.
t . 0WNERIS Address is 138 Grant Ave .
fqueensbury , N . Y . 12$41
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer
m
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3. CONTRACTOR or SUl LDER'S Address
�C
P . 4 . Box 224
Glens Falls , N . Y . 12841
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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oc
C
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6. TYPE of Construction — (Please indicate by 7C1 r.t
C
( ) Wood Frame ( 1 Masonry ( ) steel
7_ PLANS and Specifications
No, 1440 gallon septic tank, distribution box , 1441 leach field per
plot plan and application .
c
8. Proposed Use
Sewage alteration to one family dwelling a i
$ 15 . 44 PERMIT FEE PAID - THIS PERMIT EXPIRES June 34 ,
19 89
ikling and Zoning inspector of the
(it a longer period is required an application for an extension must be made to the Su
town of Clueerisbury before the expiration date.)
Dated at the Town of Clueensbury this 317th [lay of
June
19 87
for the Town of Queensbury
SIGNED BY Bu Id� r+d zomii6lnsK�ecror ^—'�-
APPLICA110N FOR SEPTIC DISPOSAL PERMIT
er N 2
sUiL.DING `&'CODE DEPT
17
DATE -.- - s_ '� _—� 1 /
LOCATION OF PROPERTY FOR INSTALLATION 77 �� � 1 3 / s�
Telephone:
Owner's Name:
Address: _
Telephone:
Installer's Name:
Number of bedrooms (residential only)
Total daily* flow (compute @ 150 gal per bedroom)
-popogapby: circle one Flat Rolling Steep Slope of slope
Depth** feet
Soil Nature: circle one: and Loam Clay Other De f p -
Groff Water: At what depth?
.�- feet
feet
B eelrock or impervious Material= At what depth?
required rate min. inch.
Percolation test: circle one: of require /
Domestic water suopgly= circle one: unici a Well Other
1 is a Well: "r~ feet
IF domestic water supply
Separation: Watersupply from Septic absorption .__�
( (] ,gal. (minimum size:PROPOSED
gal.} f/V
A Xk
Tank s
PROPOSED SYSTEM: Septic ��� feet I �
TILE FIELD: Each Trench _ feet / Total system length r�
r ..�- feet b'� feet !
�" Sloe each
SEEPAGE PIT(S) : Number of _,_
�„} / Depth or Thickness
feet
Size of stone to be used #
* * * * * * * * * * * * * * * * * *i M P O Et T A N T * * * s * * * * * z e =e
.00Please0aftlAST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * ye * * * * *Arr ( I S¢ PT1 C6 *-j-7'W"- s * * s * s
L?
ID , ,goy
/ G o , 1- e cG..
(over)
��OL�/1t O� �itee►73burt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R .O. 1 Box 98
Ir . Queensbury, New 'York 12801
IC DISPOSAL YSTEM NSPEC ION
NAME SEPT !
40
LOCAT II ON. 4% sr a firm,
/Z
DATE I PERMIT NO . f7
SOIL TYPE - Sand - Loam. - Clay
Percolation Test Required? YES - NO
Percolation rate - Min/Inch _
TYPE of SYSTEM :
Absorption field , total length f
Length of each trench C�
Depth of trenches
Size of grave]_ — —
SEEPAGE P ITSNurnbe�r Qom- -�'-'
Size- ,f���^- �F"- f t.
Grav a z'e
P ING • Size TYp -IZVN4
Bldg . to tank .�4 Z `
Tank to list _ box �-
Dist_ box to field/ it
Openings sealed? ' E NO 'Partial
LOCATION/SEPR
AATIONS :
Foundation to tank. ft.
Foundation to absorption ft - � � -
Absorption to lot line f
ft .
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front - Rear - Left side - Right side -
COMMENTS :
V3 is - - \34c) `tic,.
SYSTEM. USE APPROVED YES NO
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Buil ing Ins ect r
01/86 and V1
J f
6 V,