1988-651 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-651
I/tn WARREN COUNTY, NEW YORK
PER MISSION is hereby granted to Clement Nobert
OWNER of property located at 23 Thomas Ave. Street, Road or Ave.
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in the Town of Queensbury,To Construct or place a Sewage Alterations
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
Same
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
P.O. Box 25
Glens Falls, N.Y. 12801 N
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address rD
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6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( 1 Steel ( )
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7. PLANS and Specifications
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No. existing 1000 gal. tank, distribution box and ±125' leach field 0>
as per plot plan, and application. rt
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8. Proposed Use
sewage alteration rw+
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$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES August 1 19 90
(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 Que y this 29th Day of August 19 88
SIGNED BY for the Town of Queensbury
Building a d oning Inspector -
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Section II ° Septic System In:.p ctions:
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A. An applications for septic system installation,,alteration or repair, as
• •• required by the Town of Queensbury Sanitary Sewage Ordinance, shall
• be submitted tp the Building•Liepartn►ent at least 'Ld hours-before start
of construction and shall iiicludc a plot plan showing:
1.) . the proposed location of the system
2.) location and distance to lot lines
3.) IACation and distance to struct►u•es
•I.) )OCation and ai:.tance to any water supply
5.) size_ and din►ensions of all tanks, distribution
-`boxes, tile fields and/or.drywclls
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 arid 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.
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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.
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I have read the regulations above and agree to abide by these'and all requirements
of the Town of.Queensbury Sanitary S - age Dispo::al Or.lu - ce.
. :Sigr►:►turn of responsible person:
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Date: _ _ __
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. Town of Queensbury •
Building and Cpde_Department -
Ray at'llaviland Road
Queensbury, New York 12801
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(518) ?92-5832
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awn of Q ueenJbury.
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME Les,477 < .f(z'Q- 2- T"
LOCAT ION , 3 17-/-2 977-7 a � -<-_=
DATE,/•-00/011 PERMIT NO. P2: ‘1 5 /
SOIL TYPE - Sand - Loam - Clay -
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Percolation Test Required? YES - NO
Percolation rate - Min/Inch
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TYPE of SYSTEM: i
Absorption field, total length// L
Length of each tr ch 47:2>X/
Depth of trenches
Size of gravel_
SEEPAGE PITS{Number f)
Size- ft. X ' f . •
Gravel size
PIPING: ze Type
Bldg. to tank ' P C•-•
Tank to dist. box// ,'-- /, .
Dist. box to field/pit/ •Lx
Openings sealed? /YES / 0 Partial
LOCATION/SEPARATIONS:
Foundation to tank Z! ft.
Foundation too absorption . ,-3ft.
Absorption o lot line ft.
Separation of pits ft.
LOCATIONT- —SYSTEM ON PROPERTY(circle one) •
Front r R. ar - left side - Right side -
COMMEN .
fr/82/1"- •
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SYSTEM USE APPROVED' YES 1 NO
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Buil9ving Inspector
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SANITARY SEWER SERVICE
LUZERNE RD. GLENS FALLS N.Y. PHONE 792-7257
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P lip -(140/C1 0 tf‘.
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