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1986-803 BUILDING PERMIT TOWN OF QUEENSBURY No. 86-803 WARREN COUNTY, NEW YORK. PERMISSION is hereby granted to Frances and Margaret Russell 9-4Illinois Ave. OWNER of property located at Street,Road or Ave. Sewage Alteration cn in the Town of Queensbury,To Construct or place a w at the above location in accordance to application together with plot plans and other information hereto filed and 0 a, approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is Illinois Ave. Sv Queensbury, New York 12801 PzJ -1✓ 2. CONTRACTOR or BUILDER'S Name Hometown Sewer H H 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name H H H r• 0 0 N• CO 5. ARCHITECT'S Address • 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications 1000 gallon tank, dist. box and 150 ft. leach field per U, No. plot and application submitted. 8. Proposed Use 0 Sewer System for Dwelling CD n Iv rt $ I-i• 10.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Nov. 14 19 88 0 (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 14th Day of November 19 86 SIGNED BY ,c.,G&A) Of-424-WL2; for the Town of Queensbury /�eTi n y Building and Zoning Inspector • *5:1141. laaftedeftly TOwN APPLICATION FOR SEPTIC DISPOSAL PERMIT , (. .. f t-0 DATE l( ! 18191 V9 2 3 poi 56 LOCATION OF PROPERTY FOR INSTALLATION £U �_GG% .el5 ,Z/ Owner's Name: f Rluii12/55 74,./ 7- /0- 660a---Telephone: ga/ 53 Jf� Address: 7301/l_ Installer's Name: / 6'TOz-0A( E j,9/Z Telephone: Gr,t - Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) 3v-L, Topography: circle one CO Rolling Steep Slope % of slope Soil Nature: circle on : Sand Loam Clay Other / Depth: feet Ground Water: At what depth? N/4- feet Bedrock or Impervious Material: At what depth? /(///4- 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 /VOD gal. (minimum size: 1,000,gal.) TILE FIELD: Each Trench 67) feet / Total system length ?sO feet SEEPAGE PIT(S): Number of pf//� / Size each DV//� feet by feet Size of stone to be used # (� ( / Depth or Thickness a feet * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IMPORTANT ...Please...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 _ 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 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 and all requirements of the Town of Queensbury Sanitary Sewage Disposal-Ordinance. Signature of responsible person: Date: ////7/15 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 OLD ,S STEwl TD 31 sty I /dof Sfl )01 201 p Ya' D c A AO. T LLi,fo/S AVE