1987-496 BUILDING PERMIT �
TOWN OF C.I UEENSBURY
No. 87-496 a
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Thomas Clary i
OWNER of property located at 'w"0 Reardon Road — Glen Lake 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.
f . OWNER'S Address is R . D . # 1 Box 448
Vaugh Rd .
Hudson Falls , N . Y . 12839 p0
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2. CONTRACTOR or BUILDERS Name �
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Wayne Graham
3. CONTRACTOR or $UILDER"S Address
4. ARCHITECT'S Name fro
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6. TYPE of Construction — (Please indicate by X) �1
( ) Wood Frame t ) Masonry ( 1 Steel ( I
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7. PLANS and Specifications gal
No. 1 , 000 tank 2 seepage pits 6 ' x 8 ' each as per plot plan and
application . Var ( Se tic ) # 1--87
B. Proposed Use
Sewage alteration
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$ 10 . 00 PERMIT FEE PAID - THIS PERMIT EXPIRES July 29 , 89
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (b
town of flueensbury before the expiration date_) R
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Dated at the Town of Queensbury thiis_y�� 29th Day of July ,1g87
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SIGNED BY ///��� +� -- for the Town of Queensbury
Building and Zoning lend Zoning I nspactor ,,,.�/r
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/ APPLICATION FOR SEPTIC DISPOSAL MIT JUL 2 9 198/
1 BUILDING 8c CODE DEPT
PGR. V 11r21 R-� r /p oa ,FG- - PH p
DATE
LOCATION OF -PROPERTY FOR INSTALLATION _ C)b hlCY\ 1�.C7C�A�
Owner's Name: f T1e+�lephones 9 LA
Address: � UK ut4 Yv, F-. "T � C� Q �S �'� �•
Installer's Name. 1 t�y^Y�2 Y � �/�f� h'? 7__ 'Telephone: ��E {�A��'` :1 ---._
Number of bedrooms (residential only) _
Total daily flow (compute @ 150 gal per bedroom) 5l�S c5
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Tarpograph4y.. circle one: Flat Rolling Steep Slope 96 of slope
PC-sii Natiwe: circle one: Sand Loam Clay Other / Depth* feet
Ground Water: At what depth? ry P 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 Oth
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSER SYSTEM; Septic Tank l, oa agal. (minimum size: 1,040 gal.)
LD• Each Trench
SEEPAGE PIT(S): Number of / Size each eet by feet
Size of stone to be used # / Depth or Thickness feet
I M P O R T A N T
ooXleaseo�aLIST NEW EQUIPMENT TO BE INSTALLS
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