1988-199 BUILDING PERMIT
TOWN OF . QUEENSBURY
No. 88-199
WARREN COUNTY, NEW YORK o
• GC). William Garyo0
PER MISS ON is hereby granted to
OWNER of property located at X$.XXxxxxnu txxx. 31 Lynfield Dr. Street, Road or Ave. '—
P P tY
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
Same
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2. CONTRACTOR or BUILDER'S Name
Condon's Septic
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications cn
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No. Existing 1000 gal tank, New D Box, each trench 50' , total system
200' as per plot plan and application.
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8. Proposed Use ~'
Sewage alteration
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10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 1 19 fl90
(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 this 29th Day of April 19 88
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector /�
/ TOWN OF QUE NSEURY
..7011 o Que 4i9
APPLICATION.FOR SEPTIC DISPOSAL PERMIT APR 2 71988
,
DATE 9fi
LOCATION OF PROPERTY FOR INSTALLATION
l.0 C1`}A Telephone: 7?- 1/
Owner's Name: (1�(d1�-17 U/ p
Address:ems` L�IU/-/E/cj TP ' UP&Us' 01'
Installer's Name:AYUD6 rd S S Ef LLI L. Telephone: 7?g'- a-S" Z-
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) y -0
Topography: circle one: 410 Rolling Steep Slope % of slope
Soil Nature: circle one: .and Loam Clay Other / Depth: feet
Ground Water: At what depth?.
40 feet
Bedrock or Impervious Material: At what depth? '1/,/4 feet
Percolation test: circle one: not required required /rate 4/Ai4 min. inch.
Domestic water supply: circle one:(Municipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption . feet
0C t S iin/
PROPOSED SYSTEM: Septic Tank I°"6'+4� gal. (minimum size: 1,000 gal.)
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TILE FIELD: Each Trench J0 feet / Total system length 7--60 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # Z / Depth or Thickness / 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.
ecoineytenp\___
Signature of responsible.person: ar---Z
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Date: i( '" ( o u •
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Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832 •
•• v iirlur" r , A • '1 PI Arr
�/.. Jown o f Queen.ibur y
(f BUILDING and ZONING DEPARTMENT
ay nd Haviland Road, R.D. 1 Box 98
, ueensbury, New York 12801
014
//� S IC DISPOSAL SYSTEM INSPECTION
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NAME 4(�,, 1„,! ')? /VIC/ g(/
LOCATION 3/ ` ei 1
DATE s7-9 4 PERMIT NO. , - I1°l
SOIL TYPE - Sand - Loam - Clay - 1
Percolation Test Required? YES - NO
. Percolation,rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length ,2 '
Length of ach trench t C'p
Depth of tr .ches 7- �j
Size of gra ,e 0'2
SEEPAGE PITS4Ne ber of)
Size- ft. X ft.
Gravel size
PIPING: Si•e Type
Bldg. to tank yi/C
Tank to dist. box c{ /i
Dist. box to field/p' , ct LI
Openings sealed? 00 NO Partial
LOCATION/SEPARATION.:
Foundation to tank /5ft.
Foundation to abs.rption c25ft.
Absorption to to line •0 ft.
Separation of pi s ft.
LOCATION OF SYSrEM ON PROPER'Y(circle one)
Front - Rear ) , eft side - Right side -
COMMENTS: 7
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SYSTEM USE APPROVED�ES>N
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