1987-830 BUILDING PERMIT �
TOWN OF QUEENSBURY No 87--830 �
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Ed Ewald 00
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OWNER of property located at Sunset Street, Road or Ave. Co
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.
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1. OWNER'S Address is
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2. CONTRACTOR or BUI LDER'S Name
4tteensbury Sewer Service
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3. CONTRACTOR or BUILDER'S Address RD # 1 upper Bay Rd .
Lake George , N . Y .
4. ARCHITECTS Name '
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5. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X)
I Wood Frame I I Masonry I I Steel I T
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7. PLANS and Specifications f°
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No. Distribution Sox 2 b ' x 8 ' Drywells r°°o
8. Proposed Use
Sewage Alterations
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$ 10600 PERMIT FEE PAID — THIS PERMIT EXPIRES Dec . 8 19 89
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury thisy-8th Day of / ,Dec . 19 87
SIGNED BY / / / _ - L-". Gam'.. 9"v� for the Town of Queensbury
Building and Zoning Inspector
T-OWN OF
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APPLICATION FOR SEPTIC DISPOSAL PERMITr' I -,
r. 21987
ri3JIL .`. 'f" FCC .". _-
DATE
LOCATION OF PROPERTY FOR INSTALLATION sC S c ---
Owner's Name: t Telephones
Address: `}� C + L e i � *� .� ; ✓ �i
Installer's Name: ��� c � -v- v 1 Telephone: d
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Tcgx p aphy: circle on la ' Rolling Steep Slope % of slope _
Soil Nature: circle one: and Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedresck or Impervious Material: At what depth? _ feet
Percolation test: circle onet of req required / rate min. inch.
Domestic water supply: circle one*^ unicipa Well tither
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM: Septic Tank t/ =� gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length feet
SEEPAGE PIT(S) : Number Of _ :2 _ / Size each
.- feet bar 4 feet
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Size of stone to be used # / Depth or Thickness feet
IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
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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:
1 .) the proposed location of the systern
Z.) 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 $Z50.00.
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 Queeasbtu•y ary Sewage Disposal Ordinance.
Signature of responsible person:
Date:
Town of Queensbury
Building and Code Department
Bay at Haviland Road
Queensbury, New "York 128ol
(518) 792-5832
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD- PLACE TO L3VE
' _.,Town �►� �'"ueen .s� ur�
8U1LC71NG and ZONING DEPi R-TMENT
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Ft.C7 . 1 BOX
Bay and 4-lavifand R 12801
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Queensbury. New Yark 9S
SEPTIC DISPOSAL SYSTEM I SPECT�(��
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LOCATION
W I'Y NO * �s 1
Dp�TE
Loam - clay
TYPE - Sand YES 430
SCII, Test Required -
Percolation Mi
rate - n/Inch -
Percolation
TYPE of 5YSTEM
taYal lengt
Absorption field 0 h
Length of each trench
Depth <)f trenches
Size of gravel of)
SEEPAGE pIT rivmb
Size_ Type
Gravel size S .
PIPING
Bldg -
to tank
Tank to disc- bo L%
Dist- 'box to fief S NO partial
openings sealed? -
DNi SEPAT S : f t-
Foun�7ation tp t
sorpti.o - �f to
Foundation t4 of line f t.
Absorption ON one)
o pits _ i"`.�rcTe
Separation P
Y5TEM RO ght side -
ICp.'� IC�L3 Iie fC. sidle
Fronk. - ea
CGWENT
'SYSTEM t}SE ,APPROVED YE o
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ing Inspector
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