1987-836 BUILDING PERMIT �
TOWN OF QUEENSBURY �
No. 87-836 �
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to S . Weiner
OWNER of property located at _ 12 Northrup Dr . Street, Road or Ave.
Sewage Alteration
in the Town of Queensbury, To Construct or place a
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
Same
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2. CONTRACTOR or BUILDER'S Name N
Condon ' s Septic
ro
ry
3. CONTRACTOR or BUILDER'S Address
17 Grant Ave .
G&ens Falls , N . Y . 12801
4_ ARCHITECT'S Name r
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rs
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S. ARCHITECT'S Address �
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6. TYPE of construction — (Please indicate by X)
i ) Wood Frame ( I Masonry I ) Steel f )
7. PLANS and Specifications
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No. 1000 Gal existing tank , 50 ' trenchs p'
as
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pt
8. Proposed use Sewage Alteration r*
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10 . 00 Dec . 8 , 7989
$ PERMIT FEE PAID PERMIT EXPIRES
lIf 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_)
Gated at the Town of Queensbury this $th Da ram, Y of December 19 87
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SIGNED BY / / / e�? '�` for the Town of Queensbury
Building and Zoning I nspector ,r'
yown
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f APPU CA17ON FOR SEPTIC DISPOSAL PERMI 81987
DATE -" 1 ��
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name. !✓i,/ ,r'�'/ A149 Telephone:
Address: // 4 r [ ,►
Installer's Name.[�,,,d I'll '�• C Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: Flat Rolling Steep Slope�,rr�� ���yy° of slope
Soil Nature: circle one: and Loam Clay Other45l°y�'• / Depth. T feet
Ground Water: At what depth? Q feet
Bedrock or Impervious Material: At what depth? O feet
Percolation test: circle one: not require required / rate min. inch.
Domestic water sugplya circle one: Municipal Well Other
IF domestic water supply is a Well.
Separation: Watevsuppiy from Septic absorption . feet
106 0 +8 4-4llll
PROPOSED SYSTEM: Septic Tank,�6<1&,� gal. (minimum size: 1 ,000 gal.)
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TILE FIELD: Each Trench feet / Total system length . C? feet
SEEPAGE PIT(S) : Number of / Size each _ feet lay feet
Size of stone to be used # �'- / Depth or Thickness .!or feet
I M P O R T A N T
...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
so) size and dimensions of all tanks, distribution
boxes, tile fields and/or drywelis
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 Oxxtinance.
Signature of responsible person: cL�
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
�irreeres6ure�
o ur re o/
'�'� 4�- UILDING and ZONING DEPARTMENT
Bay and Haviland Road. R.0 • I Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
DATE f 1 E PERMIT NO.
ay
SOIL TYPE - Sand - LoamClays- - NO
Test Requi ec??
Percolation rate - Min/Inch
TYPE Of SYSTEM: co)
Absorption field , total length
Length of each each
Depth of trench
Size of gravel
SEEPAGE PITS#Nvanbe of)
Size- ft. X _ tW
Gravel Size S . e
PIPING : }
Bldg . to tank
Tank to dirt. box
Dist. box to field/DES No Partial
openings sealed?
LOCATION/SEPARATI S : AEI S 'f .
Foundation to t k
£t.
Foundation to a sorption £t.
Absorption to t 11ne �.
Separation of its
LOCATION OF S STEM CAI PROP TY (circle one)
Front -
ear Left side - fight Side -
CCMMENT
1 ^ 1 <)
YL
SYSTEM USE APPROVE YES
Build g Inspector
01/66 znd vl
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AJY , 21
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