1988-838 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-838
WARREN COUNTY, NEW YORK 0
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PERMISSION is hereby grante to Dan Morrell
OWNER of property located at 17 Lynnfield 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.
1. OWNER'S Address is
SAME
2. CONTRACTOR or BUILDER'S Name 0
Sanitary SEwer
3. CONTRACTOR or BUILDER'S Address d
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4. ARCHITECT'S Name
5. ARCHITECT'S Address 0
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6. TYPE of Construction—(Please indicate by X) t7
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( I Wood Frame ( ) Masonry ( ) Steel ( ) - -- -- (o
7. PLANS and Specifications
No. Destribution box, 2 6' x 8' dry wells as per plot plan and
application.
8. Proposed Use
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Sewage Alteration
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 25, 19 90 rt
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the co
town of Queensbury before the expiration date.)
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Dated at the Town of Queensbury this
25th Day of October 19 88
SIGNED BY � for the Town of Queensbury
Building and Zoning nspector
.J.rtv/6 of auuirdi
/ . DA'I'
APPLICATION FOR SEPTIC DISPOSAL PERMIT 201iIItG S. UL1.)0 CL ULS ULJ'I.
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MN OF(1UE Jt::UUUY
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LOCATION OP PROPERTY FOR INSTALLATION BUILDING & CODE DEPT.
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Owner's Name:T/q /3 , _O( f.c- C/ Telephone: 79c) -/
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Address: /-7 LI/Urt1 FI�.�T� •U l g rc``-
Installer's Name: \TApc/ 17 fewer Telephone: 2Q - /Ja d 7
Number of bedrooms (residential only) _& •
Total daily flow (compute e 150 gal per bedroom) _ 11-6""v
Topography: circle one Rolling Steep Slope 9 of slope
Suil Nature: circle one:alp Loam Clay Other / Depth: feet
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Ground Water: At what depth? — feet ,
Bedrock or.lmpervious Material: At what depth? _ feet .
Percc.datiou test: circle onenot require required / rate thin. inch.
Domestic water supply: circle one: alb Well Other .
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption . feet
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PROPOSED SYSTEM: Septic TankA / ,'J
gal., (minimum size: 1,000 ;►1.)
TILE FIELD: Each Trench feet / Total system length - feet
SEEPAGE PIT(S): Number of ) / Size each 6 feet li'y r feet
Size of :.tone to be used U
/ Depth or Thickness 1i feet
♦ 4 4 4 4 • 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 ♦ 4 - 3 4 4 • * ♦ 4- 4 4 4 4 4
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IMPORTANT
...Please...LIST NEW 1:QUu'MEN'1"1'O BE INSTALLED
• 4 4 4 4 4 4, 4 4 4 4 4 44 4 4 ♦c 4 4 4 4 4 4 4 4 ♦ 4. 4 4 4'4 4 V 4 4 4 • 4 4 4 3
. 1St� ( hv�i0� . arc
.2 - . G x ? ' D 2 cv-e_ L f--
(over)
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Section II Septic System Inspections:
A. All ahl►lications for septic system installation, alteration or repair, as
;• required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted LP the Building Lepartment at least 24 hours before start
of construction and :.hall include a plot plan showing: •
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I.) the proposed location of the system
2.) location and distance to lot lines •
3.) location and distance to structures
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•I.) location and distance to any water supply
5.) si:e and dinnunsions of all tanks, distribution
boxes, tile fields and/or.drywells
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B. - No systent 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 $25U.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.
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I have read the regulatioas above and agree to abide by these•and all requirements
of the Town of Queen:.bury S:u►it a ge Di::po:.al O in utce. .
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.Sigr►:►ture of responsible person:
Date: /o -23 --OPT - - - -
- Town of Queensbury
Building and Code_Department
Bay at Haviland Road
Queensbury, New York 12801
(SIR) 792-5832
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..ocun of Queen3tur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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` U SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /(2Q 7. 1 z. ,
LOCATION (;e/: (..,,,,_4?". //ca.-) .
DATE 0���p/ PERMIT NO. g- �3,�
SOIL YPEr - Sand - Loam - Clay
Percol tion Test Required? Y - NO
Percola ion rate - Min/Inch
TYPE of STEM: •
Absorptio field, total le gth
Length of ch trench •
Depth of tr ches •
Size of gray
SEEPAGE PITS* umber of) • 14-- .
Size- ft. ems'ft .j-- ,7L-
Gravel size `.,
PIPING: / Siz T Type
Bldg. to tank J , i/tir
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Tank to dist. box _ �I /�,'2iiY(
Dist. box to field/ it L7/ ,/ -
/G"'1
Openings sealed? c, NO Partial
LOCATION/SEPARATI�S:
Foundation to to /k L X .ft.
Foundation to absorption L/0 ft.
Absorption to lot line ' 1 -ft.
Separation of pits {) ft.
LOCATION Oj_SYSTEM-ONN-PROPER Y(circle one)
Front -CRI CW eft a side - Ri ht side -
COMMENTS• 1 J
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SYSTEM USE APPROVED YES ,' NO _ •-
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Building Inspector
01/86 and vl
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