1988-584 BUILDING PERMIT
TOWN OF QUEENSBURY No. 88-854
��, �^ �� WARREN COUNTY, NEW YORK o
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PERMISSION is hereby granted to Frances & Margaret Russell
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OWNER of property located at 1-k%(Illinois Avenue Street, Road or Ave. o0
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
Morning Star Excavation ' �
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3. CONTRACTOR or BUILDER'S Address C)
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4. ARCHITECT'S Name i..l
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5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications 0
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No. 1000 gal tank and 150' tile field as per plot plan,and application
8. Proposed Use
Sewage Alteration
$ N/A PERMIT FEE PAID —THIS PERMIT EXPIRES ER MINN November 12 19 US XX
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 04
town of Queensbury before the expiration date.) m
Dated at the Town of Queensbury this „--1 th Day of Novem 19 X(86 fD
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SIGNED BYL for the Town of Queensbury o'
Building and Zoning Inspector 0
L.7:44t. Ofiettailify
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APPLICATION FOR SEPTIC DISPO' L PE; MIT 4 v E ,
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DATE l/ /y �� 1'. il9a 40
LOCATION OF PROPERTY FOR INSTALLATION /C y
Owner's Name: f/Q/4 2 55 // / /1fd-2G/S/ C--Telephone: q-9 3-3
Address: 5 , v/
Installer's Name: —'� - Telephone: -
0`tO twt,v(, d51-/+t ,C!c t•Afpfot -tem/ 793—Z
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) 36 )
Topography: circle one CO Rolling Steep Slope % of slope
Soil Nature: circle on : Sand Loam Clay Other / Depth: feet
Ground
ound Water: At what depth? / 4- feet •
Bedrock or Impervious Material: At what depth? A//A feet
Percolation test: circle one: .of required required /rate min. inch.
Domestic water supply: circle one: icipal Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption feet
PROPOSED SYSTEM: Septic Tank /OD gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench Ej(9 feet / Total system length /5 0 feet
SEEPAGE PIT(S): Number of Ay//� / Size each feet by feet
Size of stone to be used # 1 \ / Depth or Thickness 3. feet
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
IMPORTANT
...Please...LIST NEW EQUIPMENT TO'BE INSTALLED - {-
* * * * * * * * * * * * * * * * * *.* * *_* * * * * * * * * * * * * * * * * * * *
/000 6*
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Section II. Septic System Inspections:
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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
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 dry.wells
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. '
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I have read the regulations above and agree to abide by these and all requirements
of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
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Signature of responsible person: - ` �
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Date: //////ic.
Town of Queensbury . "
Building and Code Department
Bay at Haviland Road ,_
Queensbury, New York 12801
(518) 792-5832
SETTLED 1763 . ..-HOME OF NATURAL BEAUTY . . . A GOOD,PLACE TO LIVE
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awn of QueenJhury
. BUILDING and ZONING DEPARTMENT
y Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME 'Vi'l; /,1--,2(Pel
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LOCAT QN 4 9
DATE// \/J(- PERMIT NO. Jv
SOIL TYPE - Sand - Loam - Clay -
Percolation est Required? YES - NO
Percolation r to - Min/In
TYPE of SYSTEM: J/ •
Absorption field total/ length / SZ
Length of each tnch , ,c,V •
Depth of trenches \ Pip"
Size of gravel \/'?,.
SEEPAGE PITS{Number,NT)
Size- ft. X / f
Gravel size /
PIPING: size- Type „
Bldg. to tank , 11/6
Tank to dist. box "� ////(
Dist. box to f'eld/p �t_ t/\ hl%(�
Openings seals.? çY
YES NO Partial
\LOCATION/SEP'RATIO :
Foundation o tank / ;'ft.
Foundatio to absorption %Z ft.
Absorpti. to lot line /f f :,
Separat'on of pits ---ft.
LOCATI.._(OF-SYSTEM ON• PROPERTY(circle one)
Front(= ear)Left side - Right side -
COMMENTS i:_�-�
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SYSTEM USE APPROVED YES NO
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Building Inspector
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