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1987-726 BUILDING PERMIT � TOWN OF QUEENSBURY No, 87_726 � WARREN COUNTY, NEW YORK • ( q — �`� TX-MX UiiK#A Tom Murphy PERMISSION is hereby granted to �rKci OWNER of property located at Street, Road or Ave_ w in the Town of Queensbury, To Construct or place a Sewage All;eratlon ' 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_ G" 00 1 . OWNER'S Address is Same 2. CONTRACTOR or BUILDERS Name Morning Star Exc . r< 3. CONTRACTOR or BUILDER'S Address `G 4. ARCHITECT'S Name 0 0 r'! R 6_ ARCHITECT'S Address rt r� 6. TYPE of Construction -- (Please indicate by XI ( ) wood Frame I ) Masonry R I Steel l 1 7. PLANS and Specifications No_ 1000 gal tank, 2 seepage pits each 8 ' x 10 ' per plot plan and application . m 8_ Proposed Use w Sewage Alteration a M ro r� 10 . 00 Oct . 28 , 89 19 , {If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of C]ueensbury before the expiration date.) Dated at the Town of Queensbury this [ 28th Day of October 19 87 SIGNED BY 7 �" / e �t � ac for the Town of Queensbury Building and Zoning Inspector X if {r� : t [/ APPLICATION FOR SEPTIC DISPOSAL PERMIT 4CT 9 1987 �y DATE LOCATION OF PROPERTY FOR INSTALLATION Zee..t".+G G• Ap Owner's Name: ,r. .�¢ ,, / Telephone: _ /� 3 2 ? 7 jr Address: _ � /�/ ! Ago z .. Installer's Name: � � F--�W / ^,�[ Telephone: 2.1 V Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: Rolling Steep Slope % of slope Soil Nature: circle one: San 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 one: Municipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Septic absorption feet PROPOSED SYSTEM : Septic Tank e4� � gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench feet / Total system length feet SEEPAGE PIT(S) : Number of / Size each S feet by feet Size of stone to be used # — 3 / 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 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. Signature of responsible person'�� 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 r- fowa o ueen spur y BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL. SYSTEM INSPECTION rL NAME_ L_C3CAT I C t14 DATE �/� PERMIT NO. ?. _ SOIL TYPE - an - I,©am - C Percolation Test Required? Y Percolation rate - MIn/Inch TYKE of SYSTEM: Absorption field , total length Length of each trench Depth of trenches size of gravel SEEPAGE PI.TS4NUmber of) _ Size- AAKft. Xft . Gravel size � PIPING : Sip? Type - Bldg _ to tank Tank to dist . box L Dist . box to field/ Openings sealed? jYES No Partial LOCATION/SEPARATIONS : Foundation to tank Cv" Foundation to absorption ft. Absorption to lot Line t- Separation of }wits ft. LOCATION OF SYSTEM ON PROPE TY (circle one ) Front - Rear - Lett side - Right side - CC bV4ENTS : f - Y SYSTEM USE APPROVE YES O D ing Inspector 01/86 and vl FA a <v 1