1989-281 BUILDING PERMIT x
TOWN OF +QUEENSBURY No. 89- 281
-^� WARREN COUNTY, NEW YORK h
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PERMISSION is hereby granted to Mr . Creeden u
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OWNER of property located at � C-�`� Aloonquin Drive 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.
t . OWNE R'S Address is
SAME
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2. CONTRACTOR or BUI LDE R 'S Name a
Action Septic
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.3. CONTRACTOR or BUILDER'S Address n
4_ ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction — (Please indicate by x)
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c ) Wood Frame 1 ) Masonry ( I Steel ( I
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7. PLANS and Specifications
Existing 1000 gal . tank , 200 ' the field as per plot plan and
No. application .
B. Proposed Use
Sewage Alteration
$ ?fi _ Op PERMIT FEE PAID — THIS PERMIT EXPIRES May 10 19 91
(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.)
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Dated at the Town of Queensbury this Day of May 19 89 c
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SIGNED BY - for the Town of Queensbury =
Building and Zoning fnx3ector
TOWN OF QUEENSBUR. Y
TOWN OF QUEENSBURY
APPLICATION FOR
RECEIVED
-=+ ,. SEPTIC DISPOSAL PERMIT i MAY $ _ 19$9
f. BLDG. & CODE DEPT,
DATE
LOCATION OF PROPERTY FOR INSTALLATION r c� , /�+ ✓�' � �cA �/t + iPr
Owner's Name:.,,; ,..---Telephone: .
Address: :7
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Installer's Name: , Telephone:
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom)
Topography: Circle one. Flat Rolling Steep Slope 46 of Slope
Soil Nature: Circle one: ar Loam Clay Other /Depth: Feet
Ground Water: At what depth ? Feet
Bedrock or Impervious Materiel: At what depth ? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: 01unicipal Well Other
If domestic water supply is a well":
Separation: Water supply from septic absorption feet
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PROPOSED SYSTEM : Septic Tank /vve90 ✓ gal. ( minimum size: 1 , 000 gal. )
TILE FIELD: Each Trench .. O feet/Total system length �7, 00 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # /Depth or Thickness �^ ^feet
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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 Queensbury itary Sewa a Disp sal Ordinance,
SIGNATURE OF RESPONSIBLE PERSON:
DATE:
OVER
Septic stem Lnsnections :
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 Deparcnsent at least 24 hours before start
of construction and shall include a plot plan showing :
1 . ) the proposed location of tine 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 ,
till fields and /or drywells
f3 . Nu system shall be covared before inspection and approval by the
iiaiiding Inspuctor . failure to comply with this requirement may
result i¢z the uncovering; of the systell, by the installer and a fine
ut up to � 250 . 00 .
c . An approved copy of the plot plan shall be available on the construction
sitew failure to produce said plot plan at time of inspection may
'- " ult in an immediate work stoppage .
D . Should unforeseen problems during construction prevent proper installa-
tion , alteration or repair of an approved system , a new proposal must
be submitted to the Queensbury Building Department before further
c oni ; t rue t ion
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Town of Queensbury
AUILDTNC and C0DES DEPARTMENT
Bay and Haviland roads
Quvensbury , New York 12804
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road,QueesburY, New YOrkD128011x 98
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /'✓ L.d.. -
LOCATION :
njkTE PERMIT NO.
SOIL TYPE - Sand - Loam - Clay -percolation Test geguired? YES - ND
percolation rate - Min/Inch
TYPE of SYSTEM: total length
Absorption field . ench
Length of each tr
Depth of trenches
Size of gravel
SEEPAGE pITS4Nuxnber ft
Size- ft. X _
Gravel size size , 'Type
P IP : u-'u-� �
Bldg g , to tams
Tank, to dirt_ bO
Dist. boX to fie d nyEse,
NO partial
sealed .
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LOCATION/S'E:PARATI S ! S f�ft.
Foundation to tank I ' f ft.
Founr3ation to absorp on
Absorption to lot In ft.
Separation of pits
LOCATIC7t3 OF 5TEM� ON pi pERTY (circle one)
Front -
ar - Left side
side
CoKmENT
SYSTEM USE APPROVED ES
Building Inspector
01/86 and vl
_ . ROOM . Action Septic Service
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ft Shaw 's Septic ,Service
P.O. Box 1430
Saratoga Road
South Glens Palls, NeY. 12803
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793-2115 7934949 587A444
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