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1987-741 BUILDING PERMIT r TOWN OF +QUEENSBURY No. 87-741 j WARREN COUNTY, NEW YORK Richard Lyons PERMISSION is hereby granted to r'� r ,p } ! F ti✓ kic [, Street. Road car ,Ave. i OWNER of property located at 1 i' 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. t. OWNER'S Address is Same n w 2. CONTRACTOR or BUILDER'S Name � CIA Morning Star Exc . r, Rc c 7 ti 3. CONTRACTOR or BUILDER'S Address Rte 32 Gansevoort , N . Y . 4, ARCHITECTS Name N S. ARCHITECTS Address ro i—� ro cn rt 6. TYPE of Construction — (Please indicate by X) ' ( i Wood Frame ( I Masonry ( I Steel ( 1 7_ PLANS and Specifications to ra No. 1000 Gal Tank, 1 Dist Box 120 ' the field 44 8. Proposed Use y Sewage Alteration m H W rt a $ 10 . 00 PERMIT FEE PAID — THIS PERMIT EXPIRES 0ctobtar 30 19 8c) __,_ (if a longer period is required an application for an extension must be made to the Building and coning inspector of the town of Queensbury before the expiration data.$ Dated at the Town of Queensbury this 30th Day of October 19 87 SIGNED BY r 2L'. 'y or the Town of Queensbury Building and coning Inspector ...II'lf►"�- © +��!'�t+�rl►&d rOiAiiV OF L l APPLICATION FOR SEPTIC pISPOSAL PERMIT OCT 9 1987 iUii_ 33f FG Pie CODEL7EPT. 0 All DATE LOCATION OF PROPERTY FO INSTALLATION / � Owner's Name : 9 'V $ Telephone: 91 Z t3 Yr 3 - - _ Address: Z Z f✓ 5 Installer's Name: J� ��y�%m..ti C+_Y__-1 Telephone: >r 3�A ' ay o Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography& circle one. Flat Rolling Steep Slope % of slope Soil Nature: circle one San Loath 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. unici W ell Other _ IF domestic water supply is a Well: Separation: Watersupply from Septic absorption _ feet PROPOSED SYSTEM: Septic Tank �r r..> _ gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each Trench�,,.'Ir� C5 feet / Total system length j 2O feet SEEPAGE PIT(S): Number of _ / Size each feet by feet a Size of stone to be used # IL , / Depth or Thickness / X 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 plat plan showing: I .) 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, the 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 $2500000 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: T- 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 flown of Quee " it " rY �u BUILDING and ZONING DEPARTMENT Bay and Havifand Road.yorD , IBo� Queensbury. New SEPTIC L7 s'PO� SAL �YS EM 'NSPECT ION ,�ILT NAME L,OCAT I ON 2- DATE Ile $ I - 7 PERMIT NO . - Lc?ari+ - Cla.y SOIL TYPE - Sand Y - l3O Percolation Test Required? Percolation rate - Min/Inch TYPE of SYSTEM= Absorption field , total 1J�h�Tn a tr encY► Length of each Depth of trenches Size of gravel` SESPAGE PIfS(NWnber Size" Gravel size ,Size T�'�'e l PIPIl3G : C+ Bldg , to tank Tank to list . box Dist. box to f ielt]/ No axe ial openings sealed? XES L0 CATI0l3/S.EpICNSx ,�t. Foundation to tank t . Foundation to absorption r17 ft . Absorption to lot line a� ft. Separation of pits one) LOCATION of SYSTEM ON PROPS Front - Rear - Left si de - fight side CC.1414ENTS = SYSTEJ4 USE APPROVED NO Bu i lt3 ing Ins or 01/86 ma vl k R� 1 � � Ip