1989-239 BUILDING PERMIT '
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TOWN OF QUEENSBURY No. 89_2
39
WARREN COUNTY, NEW YORK
IN a
PERMISSION is hereby granted to James Lois Parrish
OWNER of property located at Big Bay Road 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
Same
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2. CONTRACTOR or BUILDER'S Name +
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Michael B&ackmer
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
S. ARCHITECT'S Address pC
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6. TYPE of Construction — (Please indicate by Xl IN
( ) Wood Frame 1 ? (Masonry I I Steel I }
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7. PLANS and Specifications p
N,, 1000 gal . tank , 2 6 ' x 8 ' seepage pits as per plot plan and
application . o
sy
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8. Proposed use
Sewage Alteration
$ 25000 PERMIT FEE PAID — THIS PERMIT EXPIRES November 1 1989
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbu ry before the expiration data.)
Dated at the Town of Queensbury t 6th Day of, Apr) 1 109 r'�o
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SIGNED BY for the Town of Queensbury
Building and Zon Inspector
TOWN OF QUEEN NSBUR. Y
APPLICATION FOR TOWN CAE 'QUEENSSUR'Y {�
RECEIVED U dO
TO Vov "BUILDINGI?ISTM 'gwr.Y
�1' �� � Ica
BUILDING & 5 ,,,-�tEf�T. APR 1���
REVIEWED BY �'—' 13LDO, & +CODE DEFT.
DATE. DATE ILIke
LOCATION OF PROPERTY FOR INSTALLATION '}�- �j� fS' p � ,� �yy�� 13R yl
Owner's Pi� Telephone: C'Y (C ,3 -
Address:
d c y
Installer's Name: �x i�{ f / _ �'L '`- 2 � ~y- Telephone:
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom) '� d
Topography: Circle one: Flat Rolling ..�Steep Slope % of Slope
Soil Nature: Circle one: and Loam 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 : Municipal Well Other T V1 /✓ Cu f�47�,5 /Z-
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM : Septic Tank V 00 gal. ( minimum size: 1 , 000 gal. )
TILE FIELD : Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of 2/ Size each feet by feet
Size of stone to be used 4. ,3 _/Depth or Thickness � � L,�j r i7 � �� ' p/_5 15 feet
I have read the regulation on the reverse side of this sheet and agree to abide by these
and all requirements of the Town of Queensbupy SaAit$ry .S w e s el 0 dinance.
SIGNATURE OF RESPONSIBLE PERSON : l r ! L'
DATE:
OVER
Septic Systeni 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 hour.: before start
Of construction and shall include a plat 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
5 . ) size and dimensions of all tanks , distribution boxes ,
rile fields and / or drywells
B , Nu system shall be covered before inspection and approval by the
isuilding lnspuctor . Failure to comply with this requirement may
result in the uncovering of tha system by the installer and a fine
of up to $ 2150 . 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 immudiate work. stoppage .
0 . Should unforeseen problems during construction prevent proper installa—
tion , alteration or repair of an approved systetii , a new proposajl must
hu submitted Cc, the Queensbury Building Department before further
cun :: truction .
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
_.foty" of Q"eenjb"ry
BUILDING and ZONING DEPARTMENT
Bay and }iaviland New oad,
R D. 1 Box 98
Queensbury.
01
SEPTIC ISPOSAL SYSTEM INSPECTION
3
LpCATTON -t
DATE _ / I PERMIT NO .sajj � +1�
sand - Loam - clay -
Perc �-- --
TYPE ired? YES - NO
ercolat n Test Required?
rate - Min/Inch ,_
'percolati �
TYPE of SYS EM:
Absorption eld , total length
Length of ea trench
Depth of tree es
Size of gravel
SEEPAGE fPTTS4N a f)
Size-
ft. x ft.
Gravel size si T p
P IP ING :
Bldg • to tank
Tank to disto box y
Disto box to field/per O Partial
openings sealed? ff
LOCATTON/+SEVARATION
Foundation to tank tion fit .
Foundation to abso one t.
Absorption to lot ft.
Separation of Lai � PROPER {circle one)
OE SYST _ Ri t side -
ront Rear - ft side
NTS :
Jam✓ 4 f �1
7
SYSTEM USE APPROVED Y
g Inspector
01/06 and v1 �, f
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