1986-346 • BUILDING PERMIT
TOWN OF QUEENSBURY No. 86-346
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to
Myrtle Lilly
OWNER of property located at 66 Main St. 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.
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1. OWNER'S Address is 66 Main St. r,
Glens Falls, New York ~'
2. CONTRACTOR or BUILDER'S Name
Jay Sweet
3. CONTRACTOR or BUILDER'S Address
RD #1
xxxxx Lake George, New York
4. ARCHITECT'S Name 0
rt
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
En
( 1 Wood Frame ( 1 Masonry ( )Steel ( ) $
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CM)
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7. PLANS and Specifications
1000 gallon tank, dist. box and 160 ft. leach field per m
No. n
plot and application submitted. ¢;.
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8. Proposed Use
Sewage system for dwelling
$ 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 24 19 88
(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 24th Day of June 19 86
SIGNED BY —Me./ for the Town of Queensbury
Building and Zoning Inspector G
TOWN OF QUFFNSURY
BUILDING & ZONING DEPARTMENT
SEWAGE' DISPOSAL P _IT APPLICATION _
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1. Owner ' s Named, j� MyYflc , ...eje
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Address r.��► )
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Telephone Jo GEC 6
( nr-- 7 ?i �9� ZiJ12l�2)g.,
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2. Propertylocation s
3 . Name of person or firm responsible for installing system
3-(...( E. e iJS `� �w .., —. Telephone No. �7 ,2 4%c<
Address "�� 7 l 72).
4. Number of bedrooms (residential buildings only) 2
5. Daily flow' ZrV gallons/day
6. Septic tank capacity /' —tea gallons
7 . Topography: am rolling, steep
\% of slope '
8. Nature of soil and depth ..S- ---„..--Al
9. If ground water, bedrock or impervious material is apparent at what
depth does it 'begin? ft.
10. Percolation test: A r! is required
B is not required
C If required what is the rate minutes/inch
11. Water supply: (municipalD well, other
12. Type of system proposed: drywell,(tile field), other
Any contractor, corporation, individual, etc. engaged in" the construction
of a sanitary sewage disposal system who covers the same before inspection,
does not have an approved permit, or varies from the approved application
will be subject to a penalty of $250 as provided for in Section 6 .010 of the
Queensbury Sanitary Sewage Ordinan -
Date (0 Z
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si nat'"e'o applicant
On separate sheet of paper submit a diagram of the proposed septic system
with all dimensions, including distance from any structure, distance from
property line and domestic water supply, etc. Include all dimensions of
the system itself.
Form 3-82
-A.1SL ]
_loom of Que?nJur/
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801
`j hi;7o41" ('l f 9
SEPTIC� DISPOSAL SYSTEM INSPECTION
NAME t4 y'i LW
LOCATION (p iAiSt— �ZvGrp �.1.410
�G - 31f6
DATE L(lq / 0 PERMIT NO. - .
SOIL TYPE - and J Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length /&>01
Length of each trench ;7O, (c O, �r
Depth of trenches ' ( •
Size of gravel `?
SEEPAGE PITS*Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to dist. box
Dist. box to field/pit
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank /D ft.
Foundation to absorption ?Oft.
Absorption to lot line
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY- r-cle- )
Front - Rear - Left side -�ght side
COMMENTS:
/00o G i -�/�-
n'(.:ri- ,ox
/ = /J-c4rre
SYSTEM USE APPROVED YE NO
Building Inspector
01/86 and vl
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