1987-522 BUILDING PERMIT
TOWN OF QUEENSBUR`1!' No. $ 7-522 �
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Tri—County Kitchens
OWNER of property located at 15 Corinth Road. 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
Frank Cottone y
RD #4 Corinth Rd .
r•
Queensbury , N . Y . 1
n
c
2. CONTRACTOR or BUl LDE R'S Name
rt
Paulin Construction
w
3. CONTRACTOR or BUILDER 'S Address ter
C
CD
22 Sugar Pine Rd . U
queensbury , N . Y . 12801
4. ARCHITECT'S Name
C]
5. ARCHITECT'S Address a
r-
r
a"
S. TYPE of Construction — [Please indicate by X) 0
I Woad Frame i ) Masonry I I Steel I )
7. PLANS and Spacificatiorw
No. 1000 gal tank , 2 Seepage Pits 6 ' x 8 ' each as per plot plan and
application .
8. Proposed Use rn
ro
Sewage Alteration
as
m
n
$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES August 11 , 19 89
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Irt
town of Ousensbury before the expiration date.) p'
to
Dated at the Town of Queensbury this y l lth Day of August 19 87
SIGNED BY �» ^mm�,7 //G[ -'� for the Town of Queensbury
Building and Zoning Inspector X T
µetrrts oV��� T
APPLICATION FOR SEPTIC DISPOSAL PERMIT
l IA!AUG 7 1981
t� CAS- ID,C] CJi`PT-
f DATB4 /
LOCATION OF PROP, ,RTY FOR INSTALLATION
Owner's Name i ,�+'/ JJ�oyt , _ _.I��► i , Telephone:
Address:
Installer's Name: v " '�+1g _ I x r k Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Tcpog%tpphV. circle one: Fla Rolling Steep Slope % of slope
Snit 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 anew. Municipal Well Other
IF domestic water supply is a Wells r
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank '. gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of / Size each (a feet by feet
Size of stone to be used it / Depth or Thickness _ feet
IMPORTANT
...Please...1AST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
IL
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 Queensbtwy Sanitary Sewage ce.
Signature of responsible person:
Date. _
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-583 2
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD. PLACE TO LIVE
��` _..locum o� �ueYns6cerc�r
BUILDING and ZONING DEPARTMENT
S.. Bay and Haviland Road. R. D. I Box 98
Ouu}eensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 12 ( - kf!� S
LOCATIONa t �,►`�[- ;F+ti�y 4
DATE PF
2r7 PERMiT NO . i" Z 4,;? 40f
SO" TYPE - Sand - Loam - Clay -
Percolation Test Required? YES _ NO
Percolation rate - Min/Inch
- TYPE of SYSTEM:
Absorption field , total length
Length of each trench
Depth of trenches
Size of gravel_
SEEPAGE PITS{Nvinber ,o€)
Size- ---Lf't. X
Gravel size
PIPING : Size Type
Bldg . to tank
Tank to dirt . box
Dist . box to field/
Openings sealed? (YESN NO Partial
LOCATION/SEPARATIONS :
Foundation to tank Qft.
Foundation to absorption 7 O ft .
Absorption to lot line ft ,
separation of pits irft.
LOCATION S STEM ON PROPERTY (circle one )
Front ear - Left side - Right side -
COMME
11 71Z
SYSTEM USE APPROVED YES NO
Sui i gInspector
01/86 and vl
f
_Journ 0 Queei" .3Esury
8UILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
New York 12801
EPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION �^
DATE // / PERMIT NO.
SOIL TYPE - Sand - Loam - Clay
Percolation Test Required? YES - NO
Percolation rate - Min/inch
TYPE of SYSTEM:
Absorption fieldr total length
Length of each trench
Depth of trenches '
Size of gravel _
SEEPAGE PITS{Number of)
Size- ft. X _ ft.
Gravel size
PIPING : Size Type
Bldg . to tank
Tank to dist . box
Dist. box to field/pit
Openings sealed? YES NO Partial
r
LOCATION/SEPARATIONS
Foundation to tank ft,
Foundation to absorption ft .
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY (circle one)
Front - Rear Left side - Right side
CCJMMENTS :
v °e7f_
SYSTEM USE APPROVED YES NO
Bu ' nspector
01/86 and vl
r.
tl
rt
i
PiK�
t -
�t
4�'S•q.:N•ErLAa'.ti�R L4N S7�.{. •� � � - � �
[0..F a{K]C.I•rC/FA7lk.'v Kr r'
cc
DOOKluva:cv cgr�c&.vru.aa.-"cr
iov set Mrs),
Fµ . .. 4$_� AEtri 3anr•5 !akfE f.
c. t.5.�r CaGK
5uRr nr�-ACti?1�_ _
i
_ r T-Er'-..?�-¢.F.MavL CcC••'d'-S-�i.��' S..F; - .. J
lop
F¢.en a.u.4,a2Si �` 1 p s
C6
15
-
i
1 +�
-
5iYt� PirA. N