1987-529 BUILDING PERMIT
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TOWN OF +QUEENSBURY No. 87-529 �
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Betty Stewart
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OWNER of property located at 16 .Tune Btive Street, Road or Ave. N>
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in the Town of O.ueensbury. 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
16 June Drive �
Queensbury , N . Y . 12801 rd
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2. CONTRACTOR or BUILDER'S Name us
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Morning Star Excavating w
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3. CONTRACTOR or BUILDER'S Address.
Route 32
Ganesevoort , N . Y . 12831
4. ARCHITECT'S Name
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5. ARCHITECT'S Address �
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6. TYPE of Construction — tPlease indicate by X)
l ) Wood Frame t ) Masonry t 1 Steel I )
7. PLANS and Specifications
No. 1000 gal tank , 2 seepage pits 8 ' x 8 '
8. Proposed Use w
Sewage Alterations
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES August 12 , 1989
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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
town of Queensbury before the expiration dada.)
Dated at the Town of Queensbury this 12th, /Day
,.o-ff August 19 87
SIGNED BY _ GG *✓tC _ _ r', .r�.� fe? x/ for the Town of Queensbury
Building and Zoning inspector
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. AP IAGATION FOR SEPTIC DISPOSAL PERMIT TrJ49r, 1 ��1-_�{..� 1_R
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' AUG 101
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DATE BUIL-DIN & CODE DEPT
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: "71,�hh., . , Telephone:
Address:
Installer's Name: 4*0� 0
� Telephone: -� 7
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Fla Rolling Steep Slope 9Ix of slope
Soil 'Nature: circle one*. ( Sa 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 AXrate min. inch.
Domestic water supply- circle one: Mung i> Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM : Septic Tank MU 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 CC7 a
Size of stone to be used # _ J 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 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
Be 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 persj
Date:
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
fOU/IZ fl� �e.l[ ¢¢Il3blll'L�
�� 11 Ii DING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Sox 98
Clueensbury. New or Q
SEPTIC DI AL SYSTEM INSPECTION
NAME
LOCATION
DATE 4�C PERMIT N0 a I J 'r
SCIL 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
SEEPAGEPI S.(Numbe
Size- ft, X ft . 7 �-
Gravel size -
PIPING :PIPING : S1 T� moo'f'
'Bldg , to tank — `�-� -- -�
Tank to dist , box
Dist_ box to field/p,,���G,,�
Openings sealed? n) NO Partial
L }CAT'ION/SEPARATIONS- ft. e�X7�
Foundation to tank
Foundation to absorption
Absorption to lot line ! s f't.
Separation of Pits fc
ION OF SYSTEM C" PROPERTYfcirCle one)
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- Rear - Left side - Right side NTS :
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SYSTEM USE APPROVED ES NO
Build n Inspector
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