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1987-354 BUILDING PERMIT � TOWN OF QUEENSBURY NQ 87-354 WARREN COUNTY. NEW YORK C'X t PERMISSION is hereby granted to Homestead Village I OWNER of property located at Lots 101 and 102 Luzerne Road 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_ cc t . OWNER'S Address is pa U . Box 123 Hudson Falls , New York 12839 cL c r✓ 2_ CONTRACTOR or BUI LDE R'S Name ~ N Sanitary Sewer Service oQ M 3. CONTRACTOR or BUILDER"S Address P . 0 . Box 224 Glens Falls , New York o 0 4. ARCHITECT"S Name rs N m rn rt C? t0 .� S. ARCHITECT'S Address w 0 ra 6. TYPE of Construction — (Please indicate by X) { } Wood Frame I I Masonry I ) Steel { } 7_ PLANS and Specifications rn 1000 gallon tank, dtst . box and 2 6 ' x8 ' drywells per appllcatlon No. w M to 9 B. Proposed use Sewage system for lots 101 , and 102 in mobile home park >— � m n w r7 r• 0 $ 10000 PERMIT FEE PAID — THIS PERMIT EXPIRES sane 15 1g8"� (If a longer period is required an application for an extension must he made to the Building and Zoning inspector of the town of Queensbury before the expiration date.) Dated at the Town of Queensbury this 15th Day of June 19 87 SIGNED BY for the Town of Queensbury Building and Zoning Inspector p APPLICATION FOR SEPTIC DISPOSAL PERK 13 - � � � JUN 8 � 987 BUILDING & CODE DEPT, DATE &I LOCATION OF PROPERTY FOR INSTALLATION Owner's Namee / 1 P 1/ I Telephones Address: , lf r`? �_ � Installer's Name: Telephone: Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) Topography: circle one: lat Rolling Steep Slope 40 of slope Soil Nature: circle one: and Loam Clay Other / Depth: feet Ground Water= At what depth? feet Bedrock or Impervious Material: At what depth? i feet Percolation test: circle one: ot required required f rate min. inch. Domestic water supply: circle one 1ylunicipal Well Other IF domestic water supply is a Well: Separation: Watersupply from Sept icy absorption _ feet PROPOSED SYSTEM : Septic Tank V gal. (minimum size: 1 ,000 gal.) TILE FIELD: Each 'french feet f Total system length feet SEEPAGE PIT(S) : Number of / Size each feet by feet Size of stone to be used # Depth or Thickness 2 feet IMPORTANT _..P'Iease...LIST NEW EQUIPMENT TO BE INSTALLED (over) Section II 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 Z.) 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 installation, alteration or repair of an approved system, a new proposal must be submitted to the Queensbury Building Department before further construction. I have read the regulations above and agree to abide by these requirements of the Town of Queensbury Sanit w Disposal e_ Signature of responsible person: Date: Town of Queensbury .Building and Code Department Bay at Haviland Road Queensbury, New York 12801 (518) 792-5832 SETTLE© 1763 . . , HOME OF NATURAL BEAUTY . . . A GOOD. PLAGE TO LIVE