1988-715 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-715 0
WARREN COUNTY, NEW YORK
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PERMISSION is herebygranted to Ron Shaw e
OWNER of property located at 10 Lynnfield 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.
1. OWNER'S Address is
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2. CONTRACTOR or BUI LDER'S Name
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address
P.O. Box 224
Glens Falls,N.Y. 12801
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( 1 Masonry ( )Steel (
7. PLANS and Specifications
No. 1000 gal tank, 2 6x8 dry wells
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8. Proposed Use
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Sewage Alteration
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 11 1990 r-r
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(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensb// 'rtiii _ 11th Day of , Octs ber 19 88
SIGNED BYla ", for the Town of Queensbury
Building and Zoning In pector
'APPROVED •
J ri 1 o iQuez 1,4 tr & •• ,.1, /�/ // , .
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APPLICATION FOR SEPTIC DISPOSAL PERMIT • NA& L I l.Itl-f ikS u[J'f. •
. 1owh 0t QUELW.:11UkY
DATE 7 c Q - P?'/ . . . .
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LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: _F____, s�f11 /.t ��1 Telephoner / (P'- .39 r/
AdhlresS: _I 0 ((/JN)L)V- ('e.,L`I)
. - Installer's Name: rrq-/J / / , " ) z� Telephone: 7 -7)-�5 7
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. Number of bedrooms (residential only) _c
Total daily flow (compute @ 150 gal per bedroom) .4�-7) •
Topol;rapby: circle on Rolling; Steep Slope i, of slope -
Soil Nature: circle one: Loam Clay Other / Depth: feet
Ground Water: At what depth? feet
Bedrock or.lmpervious Material: At what depth? --- feet
feet
Percolation test: circle ►e: not required • uired / rate min. inch.
Domestic water supply: circle one:• unicipai Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption . feet
• . PROPOSED SYSTEM: Septic Tank /700D Lag. (minimuni size: 1,000•c: l.)
TILE FIELD: Each Trench ---. • feet / Total system length '� feet
SEEPAGE PIT(S): Number of , / Size each • 6 feet by d' feet
Size of stone to be used .II , / Depth or Thickness feet
• 4 4 i 4 ♦ 4• 4 ♦ 4 4 4 i * ♦ 4 * * * * * * * * 4 * * * * * * 4 ♦ *5* Y * Y * *
' IMPORTANT
...P1ea.sc...LIST NEW EQUIPMENT TO 1tE INSTALLED
a Ili * 4 ; * * 4 ♦ ♦ i ♦ s ♦ ♦ ♦ * ♦ i * ♦ 4r * f 1 ♦' s * ♦ * 4 ♦ i 4i ♦ s * * *
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Section II Septic System Inspections:
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A. All 'applications for septic system installation, alteration or repair, ;►s
required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be sut,u►itted tp the Building l)epar•tment at least 24 1►oura before start
of construction and shall include a plot plan bowing:
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1.) the proposed location of the system
2.) location and distance to lot lines •
3.) location and distance to structures
•I.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution
boxes, tile fields and/or arywells •
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 $2.50.00.
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 agr to abide by thesc'and all requirements
of the Town of Queen.sLury Sanit Sewa a Dispu:::al Ordu -
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.Signature o_f_responsible_per-son:-- __ - __ - -- — - - - --- - - - -
Date:
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Town of Queensbury
Building and Cpde_Department
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hay at Havilund !load
Queensbury, New York 12801
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(518) 792-5832
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awn of Queeniur,
. 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
NAME i�1, ./... a%e..2
LOCATION l/ �71/Y7-1 4
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DATE ��,;�//r� PERMIT N0. W. 70'
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SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO '''
Percolation rate - Min/Inch - j
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TYPE of SYSTEM: "'
Absorption field, total length'.
Length of ach trench <<'"+
Depth of t nches p'''
Size of gra 1 I .
SEEPAGE/PITS umber .of) ,f A
Size- (li ft. 'ft_s" ; G'
Gravel size . , 11 a
PIPING: N ' Size Type_
Bldg. to tank ' /-/"
Tank to dist. box( 4 1--T ' +''
Dist. box to field/ it l%%' /','f,'
Openings sealed? 'ES / NO Partial
LOCATION/SEPAATIONS:
Foundation t/ tank 7'
" 1 Zft.
Foundation o absorption*� /l' ft.
Absorption/to lot line `,, j'W ft.
Separatio q of pits '`' _%ft.
LOCATION (F—SYSTEM ON;PROPE Y(circle one) •
Front - ear Left side)- Ri-ht side -
COMMENT 1-----' .
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SYSTEM USE APPROVED --YES. ) NO /
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Building Inspector
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