1987-484 BUILDING PERMIT �
TOWN OF QUEENSBURY
No. 87-484
4 J WARREN COUNTY, NEW YORK
PERMISSION! is hereby granted to Ruth Barrett 1"
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Rd Burch. . ~
OWNER of property located at � 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
Burch Rd .
Queensbury , N . Y . 12801
2. CONTRACTOR or BUILDER 'S Name t
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a CONTRACTOR or BUILDER 'S Address
4. ARCHITECT'S Name
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5_ ARCHITECTS Address n
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S. TYPE of Construction — (Please indicate by X)
[ ) Wood Frame ( ) Masonry [ } Steel ( I
7. PLANS and Specifications
No. Addition to seepage pit .
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S. Proposed Use m
Sewage Alteration y
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 27 , 1989 p
(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 thiss 27th Day of�% `1a'ily 19 87
SIGNED BY for the Town of Queensbury
RuIldirg and Zoning Inspector
earn of Qee4d4ty
1 60 APPLICATION FOR SEPTIC DISPOSAL PERMIT p^
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BATE '-- 1 c '7 I BUILDING & CODE DEPr
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LOCATION OF PROPERTY FOR INS�TLALLAnON � fid GG/ S
Owner's Name: /�0_ _�A ,¢R ,r^/1G / Telephone:
Address: (,G..p .,J
Installer's Name: / (�dI^/i/S' 3Af1Z Telephone:
Number of bedrooms (residential only) r i
Total daily flow (compute @ 150 gal per bedroom)
Topagaraphy: circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one:_ Sid__, Loam Clay Other / Depth: feet
Ground Water: At what depth? Z5 — feet
Bedrock or impervious Material: At what depth? PG feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one: Municipal Well Other /
oc
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption elle-c '!_ feet
PROPOSED SYSTEM: Septic Tank Z . _e gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of _ / Size each _ feet by feet
Size of stone to be used # / Depth or Thickness _feet
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I M P O R T A N T
,.XIease...L.LST NEW EQUIPMENT TO BE INSTALLED
(over)
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