1987-638 BUILDING PERMIT
H
TOWN OF QUEENSBURY No. 87_638 �
�r.., WARREN COUNTY, NEW YORK
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iKim
PERMISSION is hereby granted to Kost}'a1 n�
N
OWNER of property located at 16 Cherokee Lane rj
Street, Road or Ave.
rn
in the Town of Queensbury, To Construct or place a Sewage Alteration ti
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 Cherokee Lane
Queensbury , N . Y . 12801
x
2. CONTRACTOR or BUILDER'S NamePq
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Byxgxiix D Granger & Sons
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3. CONTRACTOR or BUILDER 'S Address
4. ARCHITECT'S Name
Mr
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ti
5. ARCHITECT'S Address p
ro
tic
ra
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su
G. TYPE of Construction — (Please indicate by X) tic
i I Wood Frame I ) Masonry I I Steel ( I
7. PLANS and Specifications
No' 1000 gal tank (existing) — Leach field 50 ft .
to
r[o
8. Proposed use Sewage alteration
M
Iq
Pt
10000 Sept . 22 , 89 rt
19 r�.
IIf a longer period is ng sp o
g required an application far an extension musk be made to the Building arxl Zoni �n attar of tfie �
town of Quaensbury before the expiration date.)
Dated at the Town of Queensbury this �y^y22nd Day of Sept 19 87
SIGNED BY for the Town of Oueensbury
Building and Zoning Inspector __� f!
-{''fl►NiV OF QU� 1EE1f1Sij3�urt4v
f APPLICATION FOR SEPTIC DISPOSAL T SEP 2 119$7
BUjt�pJj !% 3G 8c COOE DEPT.
DATE
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: t 1rY1 !"► t"'} ~S [ Telephone.
forAddress: / 6 Z 0. V
Installer's Name: . Y _ Telephone: ?t 0 'Q('n 1
Number of bedrooms (residential only)
Total daily flow (compute (0,ZP 150 gal per bedroom) f b
Topography*. circle one: Flat Rolling Steep Slope 3b of slope _
Soil Nature. circle one: and Loam Clay Other / Depth: 20� feet
Ground Water*. At what depth? feet
Bedrock or Impervious Material*. At what depth? _ ryC feet
Percolation test*. circle one: not required required / rate . min. inch.
Domestic water Supply. circle one: Municipal Well Other _
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet r
PROPOSED SYSTEM: Septic Tank / 66b gal. (minimum size: 1 ,000 gal.) e )0 '
TILE FIELD: Each Trench ��6 feet I Total system length �Z t3 C] feet
SEEPAGE PIT(S) : Number of / Size each feet by feet
Size of stone to be used # Depth or Thickness feet
IMPORTANT
...Please...LIST NE'VYr' EQUIPMENT Tt] BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * as * 7k
(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 above7D77
d all requirements
of the Town of Queensbury SanitSignature of responsible erson:
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
�lcrurrt of �ueen3nur �f
BUILDING and ZONING DEPDARTmE T
98
Bay and 1 lavifand N w York 12801
pueensbury.
BUILDING INSpECTOR ' S REPORT
NAME
LOCATION
Permit- NOV
Dat
* * * * _ YES NO
Jr * * * * * * �/ APPROVED
F700tinq/Pier Forms
Foundation
Waterproofing
Backfill
Framing
R,Cxo f ing
Siding
asonrY Veneer
Rough Plurnbinc3 -.-_-----^
Relief Valves - -- --- ----
Ext . Porches
Finished Floors
Interior Trim
Stairs & Railings --
ellar Drain Tile
Concrete Floors
11 1pjbq - Fixtures
` Gar . Fireproofing
Door Clcsers�
V 'smoke Detectors
himncy
sNSD1,A'rTON
Fo un rla t i on
Fltrors
Walls
Ce i 1 inq INSPECTION
�---
. CTRI L
FINAL EL AL
R'iVEF1AY APPR
Final Buildi Survey
d inspection (Call when ready )
Next sched"
Remarks-
od l .
Iiuildin Inspector
6/86 mci-vl
�r� �' ati,,/r_Jour�: o �ueen s u ► y
BUILCSING and ZONING DEPixR
gay and Haviland Road, R 0. Box 98
4 / Queensbury, New York 12801
SEPTIC DISPOSAL SYSTe4 INSPECTION
mow„ Cc� 5 k A �—
LOCAT IONJ C Or-& 12 4
DATE ��G PERMIT NO *,
SOIL 'TYPE San - Loam - Clay
Percolation Test Required? YES - NO
Percolation rate - Min/inch
TYPE of SYSTEM-0 total length "1�
Absorption field ,
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS#Nn�°e .-�'y Size- X -��
Gr size � -Size e
p ip:[NG : �C..
aidg . to tank
Tank to aist . box t
Dist& box to 'field/ . a Partial
Openings Sealed? 5
LOCAT T Oi3/S EPARAT I C"S : t o
Foundation to tank Foundation to absorption
t _
Absorption to lot line ft_
Separation of pits PROPERTY
(circle one)
LATION _S]i~- SYSTEM Cyt3 - Right side
Front Rear Left side
COI!4MENi 1 000 6 A i
SYSTEM USE APPROVED lYBS NO
��.---�
Building Inspector
01/86 'md V1
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