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
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at the above location in accordance to application together with plot plans and other information hereto filed and 0
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is Illinois Ave.
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Queensbury, New York 12801
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2. CONTRACTOR or BUILDER'S Name
Hometown Sewer
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name H
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5. ARCHITECT'S Address
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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
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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
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APPLICATION FOR SEPTIC DISPOSAL PERMIT ,
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DATE l( ! 18191 V9 2 3
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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
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IMPORTANT
...Please...LIST NEW EQUIPMENT TO BE INSTALLED
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
(over)
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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.
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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.
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
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