1987-445 BUILDING PERMIT
TOWN OF QUEENSBURY No. 87-445 �
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Steve Kounbis �-
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OWNER of property located at #4364 West Mountain Rd . Street, Road or Ave. r!,
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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 Oueensbury Building and Zoning Ordinance.
t . OWNER'S Address is
#364 West Mountain Rd .
RD # 2
Queensbury , N . Y . 12801 rr,
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2. CONTRACTOR or SUI LDE R"S Name ro
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Morning Star Excavating o
3. CONTRACTOR or BUILDER'S Address
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Frank Shaw °0
Route 32
{Gansevoort N . Y . 12831
4_ ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction - (Please indicate by X) t!s
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I ) Wood Frame ( } Masonry ( } Steel 1 I
7. PLANS and Specifications
No. 1000 gall septic tank, seepage pits ( 2) each 6 ' x 8 ' per plot plan
and application .
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B. Proposed Use
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Sewage Alteration , rrD
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES July 14 , 3S 89 03
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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 D
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 14th pay of July 79 87
SIGNED BY3'. a!G for the Town of Queensbury
Building and Zoning Inspector �Y
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APPLICATION FOR SEPTIC DISPOSAL PERMIT M
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JUL 14 1987
4,00
HATE j _ BLPL'bIN' Q %, _ "EP'T.
LOCATION OF PROPERTY FOR. INSTALLATION 3G`7 Lys . /fO
Owner's Name: w,, �r�*} �r Telephone:
Address:
Installer's Name: r .^� .. `r _ f r�s .,. tr 1 Telephone: 2Z_32 ,;t 'ICJ
Number of bedrooms (residential only) 7�> _
Total daily flow (compute @ 1. 50 gal per bedroom)
Topographyo. circle one: ( ;* Rolling Steep Slope % of slope
Soil Nattire: circle one: 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 suppYly&. circle one: unici al Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM : Septic Tank ydee : gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet j Total system length _ feet
SEEPAGE PIT(S) : Number of �r�_ / Size each _ feet by feet
Size of stone to be used # _ / Depth or Thickness 2� 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 Z4 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 $Z50.00.
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 Qneensbutry Sanitary Sewage Disposal Oxxtivance,
Signature of responsible person:
Date. I X?
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Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 1Z801
(518) 792-5832
SETTLED 1763 . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE
BUILDING and ZONING DEPARTMENT
Bay and Hawiland Road, R. D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
1]ATE / <EEJ:: PERMIT NO. EZ.1
SOIL TYPE pbnsl:�
- Loam - Clay -
Percolatio Required.? YES N
'Percolation rate - Min/Inch �-
TYPE of SYSTEM:
Absorption field , total length
Length of each trench
Depth of trenches
Size of gravel_
SEEPAGE PITS{Numb x of) —
Size- - £t. X < £t.
Gravel size '
PIPING : Size Type
Bldga to tank —
tiC t
Tank to diet. box `' l/�;�
Dist. box to field
Openings sealed? YES NO Partial
LOCATION,/SEP.ARATION S :
Foundation to tank 1 f ft.
Foundation to absorptionft .t , +7 +
Absorption to lot 11ne 0 v. ft • r
separation of pits aft.
LOCATI�TEM Ofil de Right side one)
Front �Rear���/j Left side - Right side -
C C HMENTS :
SYSTEM USE APPRC)VE YES Cl
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Building Inspector
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