1990-197 BUILDING PERMIT y
TOWN OF QUEENSBURY
No. 90-197 z
WARREN COUNTY, NEW YORK °
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PERMISSION is hereby granted to . JOHN HERZOG
OWNER of property located at 12 Greenway 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
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2. CONTRACTOR or BUILDER'S Name
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Steven Sanders
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( I Masonry ( )Steel ( 1
7. PLANS and Specifications w
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No. Sewage alteration to include 1000 gallong tank, 2-6'x8' seepage pits, aq
with #3 stone at 2ft. ground.-as per specifications and application. fD
8. Proposed Use
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Sewage alteration
$ 25.00 PERMIT FEE PAID—THIS PERMIT .EXPIRES April 23 19 90
(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.)
Dated at the Town of Queensbury this --9.3.rd Day of April 19 90
SIGNED BY for the Town of Queensbury
Building and Zo ng Inspector
TOWN OF QULENSBURY
APPLICATION FOR
> SEPTIC DISPOSAL ERMIT yrik %.)'r
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APR 231990
DATE i r,,,I7 �2 ? D BUILDING & COOt.
LOCATION OF PROPERTY FOR INSTALLATION /2 /—reewAiy or
Owner's Name: <i7 Y1, /-ierzo Telephone: 7 7
Address: I2 �rre�y�,.cj,2
Installer's Name: .72-eJa/? Telephone: 7g -.2,775
Number of bedrooms (residential only)
Total daily flow, (compute ld 150 gal per bedroom) "%g—® /
Topography: Circle one: Le Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one:Cnot.required equired rate min. inch.
Domestic water supply: circle one:(Municipi Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption _ feet
PROPOSED SYSTEM: Septic Tank/Qpp " w gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length — feet
SEEPAGE PIT(S): Number of 2 / Size each E' feet by ir feet
Size of stone to be used # /Depth or Thickness Gyor�.n� feet
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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 isposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON:
DATE: Q am./9'7e)
OVER
"''Septic S `stem Inspections:
•
A. All applicationsforseptic system installation, alteration or repair,
. as• required„rrb,yeit,he T�i wn of Queensbury Sanitary Sewage Ordinance, shall
be s$bmitted 'ee!the Building Department at least 24 hours before start
of cons.tr.uctig.n 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. Nu 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
Rilniarks:
•
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_loom o� Queenitrury p 7
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
• Oueensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME (ft. a I Lai E
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LOCATION I . 1,/i.A , L-
DATE / 90 P RM T NO. 9/D-/Q7
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SOIL TYPE - Sand Loam - Clay -
Percolation Test R-. ired? YES - NO
Percolation rate - M n/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each tren h
Depth of trenches
Size of gravel_
SEEPAGE PITS4Numb ' f)
Size- `.Dft. X
Gravel si ze
PIPING: . Size Type
Bldg. to tank �(t /r�'"
Tank to dist. box / (;
Dist. box to fie]d/ t_� if L .
Openings 'sealed? /YES iTO Partial
LOCATION/SEPARAT1 ONS:
Foundation to tank >�4t.
Foundation to absorption f •t/ft.
Absorption to lot line
Separation--of pits 70 ft.
LOCATION(01- XSTEM ON PROPERTY(circle one)
Front , 1R !j,Left side - Riht side -
COMMENTS:ear
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SYSTEM USE APPROVED YES N
e� f
Bui ding Inspector
01/86 and vl
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APR 231990
BUILDING R, e c;
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