1988-162 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-162
0
WARREN COUNTY, NEW YORK
(\
o\j 1 / 4% Jack Usher n.'
PER MIS ON is hereby granted to 1--
YI
OWNER of property located at filk Sherman Ave. Street, Road or Ave. 1
V
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 (v
Same
Cl)
co
n
2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
Jay Sweet d
RD #1 Upper Bay Rd. c)
Lake George, N.Y. 12845 hi
4. ARCHITECT'S Name
co
rf
H
W
0
5. ARCHITECT'S Address C
CD
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications N
w
No. 1000 gal tank, trench 60' total system 180' . as per plot plan co
and application y
8. Proposed Use r~t
Sewage Alteration n
w
rt
H.
0
90
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 19 19 xfig
(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.)
19th April 88
Dated at the Town of Queensbury this Day of 19
yy�
SIGNED BY �� / G - .0-GCe/----- for the Town of Queensbury
Building and Zoning Inspector /(--f�
SOWN OF QUEEN; u;_:
.w o Q eeneI,► o L;
APPLICATION FOR SEPTIC DISPOSAL PERMIT APR 18128
\ 1 BUILDING & CODE DEPT.
DATE(, ( / F
LOCATION OF OPERTY FOR INSTALLATION
Owner's Name: ('i (-'l S k`Q ( Telephone:
Address: C- > p -(-12_.V`VV ( k li( U
Scielephone: 2_ �>
Installers Name: (� ‘p �� ��-� .�7 �� �
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: MO Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam 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.
Domestic water supply: circle one: vlunicip&7 Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank 76r7—v gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench 6 0 feet / Total system length / feet _.
SEEPAGE PIT(S): Number of _ / Size each feet by feet
Size of stone to be used # / Depth or Thickness 4) `e- feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(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
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 and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance..
Signature of responsible person:
Date: apA;I) —
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD.PLACE TO LIVE
_Joiun o/ Queiurty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D.,1 Box 98
Queensbury, New York 12801
• SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
•
, LOCATION. �,+,,nrd4 f ! %�L✓2�,�
• DATE. '-// ,c>.-I•. " -PERM'IT_NO.
SOIL TYPE r`Sand)-. Loam - Clay -
Percolation-Test Required? YES• ,',NO�'
. Percolation ra'e - Min%Inch
"TYPE of SYSTEM: i • -- F)
e /
I Absorption fiela, total }leng��
Length of each ,rench i,, y _ ea_-
Depth of trench=s ;2- e;','
Size of gravel 41 ') /
- , SEEPAGE PITS-EN oer of) •
- Size- ft. X f
Gravel size - /
PIPING: / Size Type •
Bldg. to tank / y
Tank to dist. box
Dist. box to fie d •it
Openings sealed, % ES) NO Partial
•
LOCATION/SERA vn TIONS
Foundation t. ;tank c'�,�. ft.
Foundation . !absorpt on
Absorption o lot line
Separation .f. pits ft'. •
LOCATION Or-SYSTEM ON P-OPERTY(circle one)
Front Re=rJ Left sid: - Right side -•
COMMENTS
J
ail : -®k
R •
1.1
_-:- SYSTEM USE APPROVED YES, NO ,
i?Y' it
• Bull'ding. Inspector •
• r;
01/86 and vl
_Joiun of Q ee Pi j Urty
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSA//L SYSTEM INSPECTION
NAME .. tacZ
LOCATION 62/7202
DATE 1//!rj / 9/ PERMIT NO.
SOIL TYPE Sand - Loam - Cla -_
Percolation lest Required? . ES -
. Percolation rate - Min/Inc
TYPE of SYSTEM:
Abso .tion field, total en f 5 D _
Lengt' of each trench -
Depth .f trenches '-
Size of travel $ a2
SEEPAGE • TS4Number '.f)
Size- t. X _ ft.
Gravel size
PIPING: Size Type
Bldg. to tank y
"Tank to dist. :,o
Dist. box to fir d/pit,
Openings sealed' (155P NO Partial
•
LOCATION/SEPA•ATIO .
Foundation to tank a S ft.
Foundation to absorption 3C/ ft.
Absorption t.• lot line l0, ft.
Separation o pits ft.
LOCATION 0- YSTEM ON PRo•ERTY(circle one)
Front "ea, Left side Right side -
COMMENT :
SYSTEM USE APPROVED YES A NO /
L4ALkiti
Buding Inspector
01/86 and vl
TO V1,0 OF Q11.57,,,•
11-13,
PR 181989
. . - . BUILDING & CODE DEPT.
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