1987-351 BUILDING PERMIT
TOWN OF QUEENSWRY No. 87-351
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Homestead Village ri
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OWNER of property located at Lots 103 and 103 — Luzerne road Street, Road or Ave. lam•
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 Queenshury Building and Zoning Ordinance.
t_ OWNER'S Address is homestead Village rD
P . 0 . Box 123
Hudson Falls , NEw York 12839 I'''
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2. CONTRACTOR or BUILDER'S Name Y
Sanitary Sewer Service F
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3. CONTRACTOR or BUILDER'S Address
P . 0 . Box 224
Glens Falls , New York
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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B. TYPE of construction — (Please indicate by X)
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1 ) Wood Frame C I Masonry i 1 Steel C 1 NN
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7. PLANS and Specifications r6
No. 1000 gallon septic tank, da.sto box and 2 6 ' x$ ' drywells
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per plot and application '
8. Proposed Use
Sewage system for two lots in mobile home pLxxjtk park,
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$ 10 . 00 PERMIT FEE PAID — TMISPERMIT EXPIRES June 15 1989 �
(if a longer period is required an application for an extension must be made to the Building and Zoning inspector of the r
town of Queensbury before the axpiration d ate I �
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Dated at the Town of Queensbury this 15 th Day of June 19 87
SIGNED BY /' // . for the Town of Queenslaury
Building and Zoning Inspector
TOWN OF QUF-Et: NSd�L
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APPLICATION FOR SEPTIC DISPOSAL PERMIT JUN 8 0 98
BUILDING & C00F, DEFT.
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LOCATION OF PROPERTY FOR INSTALLATION
Owner's Name: b 04S /144� t Telephone:
Address: I � /
Installer's Name* Telephone: ��2>—
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: circle one: 1 Rolling Steep Slope of slope _
Soil Nature: circle one: San Loam Clay Other / Depth: feet
Ground Water; At what depth? feet
BMe frock or Imperrvious Material: At what depth? feet
Percolation test: circle on not re re uirr required / rate min. inch.
Domestic water supply: circle oner&1Municipa:L> Well Other
IF domestic water supply is a Well:
Separation: Watersupply from Septic absorption _ feet
PROPOSED SYSTEM : Septic Tank gal. (minimum size: 1 ,000 gal.)
TILE FIELD: Each Trench feet / Total system length 1 feet
SEEPAGE PIT(S) : Number of Size each feet by feet
Size of stone to be used # 3 f Depth or Thickness Z,,,n feet
IMPORTANT
.._p'lease...LIST NEW EQUIPMENT TO BE INSTALLED
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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.
Co 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 agme to abide by these all requirements
of the Town of Queensbury Sanit w Disposal. Ord." ce.
Signature of r spa Bible person:
Date: 1619' f
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