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1989-279 BUILDING PERMIT MC TOWN OF QUEENSBURY Iv©. 89-279 ] 4 WARREN COUNTY, NEW YORK C NMI PERMISSION is hereby granted to Gerry Vogel I` OWNER of property located at 23 Dixon Court 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 c S� r 2. CONTRACTOR or BUi LDER 'S Name n Sanitary Sewer 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Narne r t C 5. ARCHITECT'S Address C C r 6. TYPE of Construction — (Please indicate by X) { ) Wood Frame { ) Masonry ; ) Steel ; } 7. PLANS and Specifications No. Existing tank , 2 6 ' x 8 ' seepage pits as per plot plan , and applicati n . 8. Proposed Use n Sewage Alteration a $ r pd[t PERMIT FEE PAID --- THIS PERMIT EXPIRES �( + IE7CXXIX MaY q 19 #� 91 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r town of Queensbury before the expiration date.) Dated at the Town of Queensbury this Day of Kay 19 89 SIGNED BY for the Town of Queensbury Building and Zoning I nspectoY TOWN OF QUEENSBURY APPLICATION FOR41 v� SEPTIC DISPOSAL PERMIT a/ 4� 1 - h 1 DATE LOCATION OF PROPERTY FOR INSTALLATION e��22 rah Owner's Name: O e'6 Telephone: / 9S -Z 1.3 Address: Installer's Name: Telephone: 7 9�2 ZZ Number of bedrooms (residential only)_ Total daily flow (compute (d 150 gal per bedroom) It Topography: Circle an EFat Rolling Steep Slope % of Slope Soil Nature: Circle on 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: unicipa Well Other If domestic water supply is a well: Separation: Water supply from septic absorption feet PROPOSED SYSTEM: Septic Tank gal. ( minimum size: 1 ,000 gal.) TILE FIELD: Each Trench -- feet/Total system length — p feet SEEPAGE PIT(S): Number of t; J Size each feet by C} feet Size of stone to be used # ,3 /Depth or Thickness Z feet I have read the regulation on the reverse de of this s et and agree a abide y these and all requirements of the Town of Que sbu Sanita y Sewage D4 os 1 Or finance SIGNATURE OF RESPONSIBLE PERSON: 6 DATE: u OVER i . . +. Septic System Inspections : A . All applications for septic system installation , alteration or repair , as required by the Town of Queensbury Sanitary Sewage Ordinance , shall bt: SLibmitted 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 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 , tile- fields ant /or drywells BO No system $ hail 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 ut up to $ 250 . 00 . C . Ar, 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 installa— tion , alteration or repair of an approved system , a new proposal must be submitted to the Queensbury Building Department before further construction . Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury , New York 12804 k� luarkS : ._.Jvw►a o� �uBen36etr� ��. BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.Q- i Box 98 Queensbury, New York 12801 SEPTIC ❑ISPOSAL SYSTEM INSPECTION NAM LOCAT ION Z�J 'X e t..'A_r - DATE . ! PERMIT NOO SOIL TYPE - Sand - Loam - Clay Percolation Test Required? _ YES - NO Percolation rate - Min/Inch TYPE of SYSTEM= Absorption field , total/ length Length of each trench Depth of trenches Y, Size of gravel) OVA SEEPAGE PITS#Numb of) _ Size- _ ft. X - ft. Gravel size PIPING : r.' Size TYp � Bldg . to tank Tank, to list. x Disto box to field/ G' Openings sea ed? ES NO Partial LOCATION/S ARATIONS : Foundatio to tank 14 -ft- ONT� * to absorption Z- ft - to lot lineft. of pits ftt F SYSTEM ON PROP RTY (circle one) ar - Left side - .Right side -- SYSTEM USE APPROVED YE NO f Build ng Inspector 01/86 and v1 i Xv bwl.si4 0 tax, oil t5 'Idd t ,,