1987-609 BUILDING PERMIT
TOWN OF +QUEENSBURY No. 87-609
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Lee Reeves w
OWNER of property located at 1+ Upper Sherman Ave . Street. Road or Ave.
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In the Town of Queensbury. To Construct or }glace a Sewage Alteration rn
at the above location in accordance to application together with plot plans and other information hereto filed and rn
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance,
1 . OWNER'S Address is
192 Upper Sherman Ave .
Queensbury , N . Y . 12801
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2. CONTRACTOR or BUI LDE R'S Name
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Morning Star Excavating
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3_ CONTRACTOR or BUILGER "SAddress
Route 32
Gansevoort , N . Y . 12831 r`Aa
4. ARCHITECT'S Name *�
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S. ARCHITECT'S Address r{
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G. TYPE of Construction — {Please indicate by X) ro
i ) Wood Frame f y Masonry I ) Steel t I
7. PLANS and Specifications
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No. 1000 gal existing tank , 1 seepage pit 8 ' x 10 ' per plot plan �
and application
B. Proposed Use y�
Sewage alteration m
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$ lfl . QD PERMIT FEE PAID — THIS PERMIT EXPIRES Sept . 15 8919
Ilf a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of ttueenshury before the expiration date.}
Bated at the Town of Queensbury this pay of Sept . 15 19 87
SIGNED BY /�, /� 4Q X for the Town of Queensbury
Building and Zoning Inspector ���
Yf +..+ow1L "Cend6wy TGNiN £7F C}UEEfti5Bi3F2Y
APPLICATION FOR SEPTIC DISPOSAL PERJ T
SEP 1 o 1%7
BUILDING & CODE DEP L
w DATE tg_
LOCATION OF PROPERTY FOR INSTALLATION _ �/ � mid .--. � - 'Ar c
Owner's Name: -huh. eramp,zo/e%5 Telephone:
Address: _
Installer's Name: / Telephone:
Number of bedrooms (residential only) 2 _
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Rolling Steep Slope % of slope
Soil Nature: circle one: an Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or Impervious Mater al: At what depth? _ feet
Percolation test: circle one: not required required / rate min. inch.
Domestic water supply: circle one Munici al Well Other _
IF domestic water supply is a Well:
Separaticux: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank ,Ooo^ gal. (minimum size: 1 ,000 gal.) 19w�:
'PILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number of / Size each __`feet by _ ,/C? feet
Size of stone to be used # � / Depth or Thickness „ � feet
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
(over)
F �y
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 showings
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 antld agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal. Ordinance.
Signature of responsible persons
Date
-...'Jazz ea � >c
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Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New York 12801
(518) 792-5832
SE fTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD 'PLACE TO LIVE
01 Quee" 31 urey
�l BUILDING and ZONING DEPARTMENT
1 Bay and Haviland Road, R ,D. 1 BOX 98
C)ueensbury. New York 12801
SEPTIC DISPOSALSYSTEM INSPECTION
NPME ■ '
�LOCAT I ON � rn t k
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I4` V0^nTE J] b0 / r I PERMIT NO*
-/ SOIL 'TYPE - Sand - Loam - Clay
Percolation Test Required? YES - NQ
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total length
Length of each trench
Depth of trenches
Size of gravel —�
SEEPAGE S4Nuiabe- yr. 1 11
ft. _�..-....
Size- x ---
Gravel size
Size TYlie
PIPING :
Bldg - to tank
Tank to disc. box _—
17ist . box to field
openings sealed? YES
NO Partial
LOCATION/SEPARATIONS a ft.
Foundation to tank s S ft .
Foundation to absorption
Absorption to lot line ft .
Separation its
LOCATION SYS EM ON PROPERTY (circle one)
Front
Rear - eft side - Right Side -
CCiMME S :
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SYSTEM USE APPROVED? � YES NO
Building Inspector
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