1988-911 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 88-911 •
WARREN COUNTY, NEW YORK
106 ` �`
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PERMISSION is hereby granted to Stanley Wood
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OWNER of property located.at 9 Kiley Lane Street, Road or Ave. o
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 d
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Queensbury Sewer
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3. CONTRACTOR or BUILDER'S Address ro
RD#1 Upper Bay Road
Lake George,New York 12845
4. ARCHITECT'S Name
5. ARCHITECT'S Address
H.
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( I Masonry ( I Steel ( ) -
7. PLANS and Specifications
No. 1000 gal. tank, 1 6' x 8' seepage pit 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 November 21 19 90
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(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.) 11)
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Dated at the Town of Queensbury t ' 21st Day of November 19 88
SIGNED BY L9 , for the Town of Queensbury
Building and oning Inspector
TOWN OF QUEENSBURY C
y,,1 i� TOWN OF QUEENSBURY
t. �� APPLICATION FOR RECEIVED
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t�{i�'��y. v 5 - ..,t4' SEPTIC, DISPOSAL PERMIT NOV r', 1 1988
,;.._ BLDG. & CODE DEPT.
DATE /00 ... ,,,, l- �0
LOCATION OF PROPERTY FOR INSTALLATION q d C
Owner's Name: 51f,4.)Qd Telephone:
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Address: q
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Installer's Name: ePe ix g,./- �0--/5 - Telephone: 7/72"--Z3o-fif
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Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) ,_16 0
Topography: Circle one4110 Rolling Steep Slope % of Slope
Soil Nature: Circle on 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:_cOrmici_p . Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank/t�--b-U gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length feet
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SEEPAGE PIT(S): Number of / / Size each feet by t� feet
Size of stone to be used # g /Depth or Thickness 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 Queens y Sanitary Se ge Di posal Ordinance.
SIGNATURE OF,RESPONSIBLE PERSON:
DATE: /(ZOZ ' -2 �' . 04 i j_
OVER o/r
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Septic System Inspections:
All'vapplerations 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,
tile fields and/or drywells
•
B. 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 of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads •
Queensbury, New York 12804
•
Remarks: •
•
_Awn or Queeniur,
BUILDING and ZONING DEPARTMENT •
• Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM - NSPECTION
NAME (/ c'/
LOCATION/ /if/ ( 1/ %Je
DATE/ t r--/- PERMIT NO. J d ` //
/
SOIL TYPE``-7 Sand - Loam - Clay' -
Percolation Test Required? YES - NO
Percolation\ rate - Min/Inch /\
TYPE of SYST
Absorption fild, total length
Length of each\trench •
Depth of trench s . /'�
Size of gravel:
SEEPAGE PITS4N en of)//'
Size- Sj ft. X 1 ft! ' j ( ___._ -
Gravel size , \ / -
PIPING: \ /Size Type
Bldg. to tank
Tank to dist. box /
Dist. box to field/pit
Openings sealed? XES NO Partial
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LOCATION/SEPARATION :
Foundation to tank fi.{. ft.
Foundation to abso ption . 2 .
Absorption to lot line 7-7- ft.
Separation f pits/ f-t.
LOCATION? F YST ,ON-PR•PERTY(circ e one)
Front Rear - e t 'sid 1- Right sid -
COMMENTS:
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) . ) a 1
/2,0, )
SYSTEM USE APPROVEEDfIYES f NO
6 -4 -----• • •
uilding Inspector
01/86 and vl
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