1989-366 BUILDING PERMIT
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TOWN OF QUEENSBURY
No. f24_ RF.F.
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� WARREN COUNTY, NEW YORK �-- 4*
PERMISSION is hereby granted to
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OWNER of property located at Eor Corinth A Terri tt- Roads Street, 'Road or Ave.
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.
1 . OWNER'S Address is
Sallie its
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2. CONTRACTOR or BUILDER 'S Name �p
Condons Septic
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3_ CONTRACTOR or BUILDER 'S Address
Glens Falls , h _ Y_ 12801
4. ARCHITECT'S Name
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6_ ARCHITECT'S Address .�
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S. TYPE of Construction — (Please indicate by X) s
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I ) Wood Frame ( I Masonry I } Steel I }
7. PLANS and Specifications
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No. 1000 gal _ tank , 1 6 ' x 12 ' seepage pit as per application and plot pl n e+
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B. Proposed Use
Sewage Alteration
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$ 25 0o PERMIT FEE PAID — THIS PERMIT EXPIRES MKM Maur 26 19 91
Ilf 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.I
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Dated at the Town of Queensbury tlyis� Day of May 19 89 r`+o
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SIGNED BY C for the Town of Queensbury p
Building and Zoning Inspector N
TOWN OF QULENSBURY e5v / '4zz
TOWN OF QUEENSBURY
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�y..-- , �_ APPLICATION FOR. RECEIVED
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SEPTIC DISPOSAL PERMITgY 2 6 19$9
BLDG. & CODE DEPT.
DATE
LOCATION OF PROPERTY FOR INSTALLATION
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Owner's N//am__e: iq h wf ,y� 1 ►T�ye�leephone:
Address: �-- Q Q ��[' qfq Z/ "'��42 64AR
Installer's Name. 01 /?1 ' ^ ! Telephone:
Number of bedrooms (residential only) �--
Total daily flow (compute fa 150 gal per bedroom) 1G
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: E35
Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? & N fv Feet
Percolation test: Circle one : not required required rate*VA—min. inch.
Domestic water supply: circle one: Municipal Well Other
If domestic water supply is a well:
Separation; Water supply from septic absorption feet
PROPOSED SYSTEM : Septic Tank &ifa gal. (minimum size: 1 ,000 gal.)
TILE FIELD : Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of _ / Size each 6 feet by f Meet
Size of stone to be used # /Depth or Thickness 2, r 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 Queensbury Sanitary Sewage Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: L
DATE : � f(.'
OVER
Septic System 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 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 ,
the fields and /or drywells
Be 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 $ 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 .
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 ❑ f Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
Remarks
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