1990-026 BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-26
WARREN COUNTY, NEW YQRK c
30q lEr
PERMISSION is hereby granted to Art Mead
OWNER of property located at 27 Thomas Street 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
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2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) rn
( )Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
No. 1,000 gal tank only as per application and plot plan
8. Proposed Use •
Sewage Alteration
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$ 25 00 PERMIT FEE PAID —THIS PERMIT EXPIRES February 12 19 92
(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.) —I
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Dated at the Town of Queensbury this 12th Day of February 19 90
SIGNED BY Ii for the Town of Queensbury •
Building and Zonin Inspector
TOWN OF QUEE-NSf URY
• APPLICATION FOR
cp_.- . /_ 4-_ c•�i %\. � > SEPTIC DISPOSAL ERMIT OWN OF QU EENS BU9 _
RECEIVE _
FEBAM
1 2 1990
DATE ,reh /,. . /9 90 BLDG. et CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: A')7 / , z) Telephone: 79`, `7/ OT 7 "
Address: ; 2 frl a MAT- ` l
Installer's Name: iJrll-/IJI ' r77 /; iIJ.e Telephone: 74,2 2 6-
Number of bedrooms (residential only)
Total daily flow (compute 0. 150 gal per bedroom) 3 o'
Topography: Circle one: Flat Rolling Steep Slope-% of Slope
Soil Nature: Circle one: andLoam clay Other /Depth: Feet
Ground Water: At what depth? Feet,,
Bedrock or Impervious Material:'At what depth? -• Feet .
Percolation test: Circle on-: not required -quired rate min. inch.
Domestic water supply: circle one: 'Iunicipa Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank I COD gal. (minimum size: 1,000 gal.).
TILE FIELD: Each Trench feet/Total system length • 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, '9- • this sheet an_ ree to abide by these
and all requirements of the Town of Qu- -ns ry Sanitary S wage isposal Ordinance.
SIGNATURE OF. RESPONSIBLE PERSON: ALL- `• 1.(//641 ,
DATE: , id , /99 '
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Z _ OVER :M
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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 co 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 unforeseenproblems 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: •
flown of Queeniur,
BUILDING and ZONING DEPARTMENT -/f��
Bay and Haviland Road, R.D. 1 Box 98 1
Oueensbury, New York 12801 J /
(io)
SEPTIC DISSPOSAL SYSTEM INSSPECTION
NAME(.24/ rie&d/OL,/-by./
LOCATION 7� L..kb1'f( (L .
DATE 2 j71/9Q PERMIT NO. 90- l
SOIL TYPE - Sand - Loam - Clay - /
Percolation Test Required? YES - NO /
Percolation rate - Min/Inch _
I
TYPE of SYSTEM:' f,
Absorption field, total length
Length of each trench i
Depth of trenches '
Size of gravel_
SEEPAGE i?ITS4Number of) ' i
Size- __ft. X _ ft. I'
Gravel size /
PIPING: Size ;Type�
Bldg. to tank /I"
Tank to dist. box / .
Dist. boa: to field/p' C
Openings sealed? ` � NO,==''- Partial
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LOCATION/SEPARATI(NS: Ii
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Foundation to tank', e7,5 ft.
Foundation to absc'rption / ft.
Absorption to lot line / ft.
Separation of pits / ft.
LOCATION OF SYSTEM ;ON PROPER `rcle O'Tre)
Front - Rear - Left, side" - ' ht side -
COMMENTS:
/Z) // ,V JA//
/a.23 �Niz / . -,-e�.4.
oitlyY
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SYSTEM USE APPROV D NO
Building Inspector
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•_:),,s,,f4 OF QUEENSBUR
RECEIVED
DEB 1 1990
r BLDG. & CODE DEPT.
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