1987-754 BUILDING PERMIT
TOWN OF QUEENSBURY No 87- 754 �
WARREN COUNTY, NEW YORK c'
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PERMISSION is hereby granted to Alex Alexander t
OWNER of property located at 'Chestnut Ridge Street, Road or Ave. ~
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. `w
1 . OWNE WS Address is Box 546
Chestnut Ridge �0 S
Queensbury , N . Y . 12801 m
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Z. CONTRACTOR or BUILDER'S Name
Andy Scargellino
3. CONTRACTOR or SUI LDER'S Address
4 Seward Ave .
Glens Falls , N . Y . 12801
a. ARCHITECT'S Name
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5. ARCHITECTS Address rt
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S. TYPE of Construction — (Please indicate by X)
f ) Wood Frame ( 3 Masonry ( } Steel I i
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7. PLANS and Specifications
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No. Existing 1000 tank 40 feet each trench , total system length 250 ' y,
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S. Proposed Use ri
Sewage alteration
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$ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES NOvember 6 , 19 89
(If a longer period is required an application for an extension must too made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.I
Dated at the Town of Queensbury this ' �.6th Day of November 19 87
SIGNED BY �'/ / for the Town of Queensbury
OuIId ing and Zoning Inspector �p
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APPLI+CA77ON FOR SEPTIC DISPOSAL PE MIT NOV 1987
4 � ,R
DATE
LOCATION OF PROPERTY FOR INS VALLATION Q 5z, t6 �
Owner's Name: f+ Telephone:
Address: _ ►��x '�}L7 c '�"� Wit, 1 / '�' �� /
Installer's Name: J jV ,K +� Telephone: 7 2;0 ' F '5 Cff
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) 6 .4 f
Topography: circle one: Flat Rolling Steep Slope % of slope
Soil Nature: circle one: Sand Loam Cla Other / Depth: fee✓t
Ground Water: At what depth? � feet
Bedrock or impervious Material: At what depth? M feet ge,, 9rp�J l
Percolation test: circle on not required required / rate min. inch.
Domestic water supplye circle one: Municipal ell Other
IF domestic water supply is a Well: 674, � �
Separation: Watersupply from Septic absorption _ / Z10 feet
PROPOSED SYSTEM : Septic Tank ��G � gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length 495�0 feet
SEEPAGE PIT(S) : Number of / Size each feet b feet
Size of stone to be used ## / Depth or Thickness feet
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
otesse 0�5-6) er= Z�eee/ /�." 40411
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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:
Is) 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 $254.40.
CO. 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 QQueensbtary Sanitary Sewage Disposal Ord` ce,
Signature of responsible person:
Date:
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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
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D_ 1 Box 98
Queensbury, New York 12801
14Z,,G Sz. C-%j A,10 6- .Ve,,
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION CA ��� +� �- 'i I n r b�
DATE I �+ 7 PERMIT NO . 5 '] — '2 5 `f
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total jength
Length of each trench
Depth of trenches -
Size of grave]
SEEPA(IP 'S#Nxmtber of)
Size- ft. X _ ft.
Gravel size
PIPING . Size. Type
Bldg . to tank
Tank to disc. boss
Dist . box to field/ /l f'•R' lIIEC',e s/y`
openings sealed? E NO Partial
LOCATION/SEPARATICINS : � Z:
Foundation to tank ft.
Foundation to absorption ft. e�-
Absorption to lot line ft.
Separation of pits ff ft.
LOCATION Cp SYSTEM ON PROPERTY (circle one)
Front -<;!m - 7�ft side - Right side
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SYSTEM USE APPROVED ES NO
Build ' g Inspector
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