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2000-684 TOWN OF QUEENSBURY 742 Queensb ury,� Bay Road,Q ury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20000684 Application Number: A20000684 Tax Map No: 523400-147-000-0001-004-000-0000 Permission is hereby granted to: ARTHUR ALMY . For property located at:' 3 PINELLO Rd in the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: ARTHUR ALMY Septic Alteration Residential 14 GIBSON Ave ,,IHUDSON FALLS,NY 12839 Total Value Contractor or Builder's Name/Address Electrical Inspection Agency I.B.S. SEPTIC 2 LOWER WARREN STREET QUEENSBURY, NY • • Plans & Specifications 2000-684 LOT 7 PINELLO ROAD SEPTIC ALTERATION AS PER APPLICATION $25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Wednesday, September 18, 2002 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town eensbu ; Monda , September 18,2000 SIGNED BY 11 for the Town of Queensbury. Director of Building& ode E orcement Application for Permit Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 • 1. OWNER INFORMATION: . Location of installation: . Li '.- 3 Office Use ed File Permit No.C:.2--e)(50— (.0 01 - Tax Map No. / /- Fee Paid cas Owner's Name: /9/417 ti '11 (4. Address: e LC ° 0- 6 vo.t, avit, 2. INSTALLER'S NAME : • PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate #bedroom(s)and multiply# of bedrooms with applicable gallons per bedroom to equal total daily)low) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdnn = 00h 1980- 1991 - x 130 gal/bdrm 1991 —present : x 110 gal/bdtm = ' 1 2000 • Garbage Grinder Installed yes / no LLP-EllViEb Spa or Whirlpool Installed yes / no hi 4. PARCEL INFORMATION: (circle applicable information &indicate measurements) TOw OFBUILDi CkIENS BURY AND cOOF oporaphv S9i 1 Natureground Water Bedrock Or lirnitivious Material Dom_estic WaterSupplY sand at wilco depth at what municipal Rolling oam lIi feet i feet well: Steep slope - clay: if well; water supply " %slope other from any septic-system : depth: absorption is ft.- ' other Percolation Test: (lb be completed by licensed pty)fessional engineer or architect) Rate:. 1 minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the sin of the septic tank and leach field for each.Garbage Grinder; Spa or Whirlpool Tub. Septic Tank: p,51-14) gallon (min. size 1,000 gal) Tile Field: each trench ft. Total System Length: - Seepage Pits): number of . 2- . ske of each: 6 ft. by •g 2 P Size of Stone to be used: II / depth or thickness Bed System Size: • - x . ,• Alternative System: " length and/or size 6. HOLDING TANK SYSTEM: (if required) . Number of tanks / Size of each gallons /TOTAL Capacity: gallons - Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection,please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or approval granted which is based upon or is granted in roliance upon any material misrepresentation or failure to make a Material-fact or circumstance known by or on behalf of an applicant, shall be void. „ - I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance gf. Signature of responsible person Date t.V 3l 5CS :id/5 ,J icod °.Jd cm, 7 v i -' v 9/?14'Q --- f , 91 Sa/-7 -11201 I,46%1 ,,'&,"1 d ryo'1 ) 07 !,'-0,X3 "to. .r'°,i j for Cr 11 .2.1vet --1 P lM/ i 3 al NV I (3E/ axe J t 04OW • area q A8 03M31A321 J d3 G 2G03 & oNIC]ifle NMU1 -. { Z0 39tld SS —.�- EtZE86L 0b:0t 000318I/60 Gsv�2f Jdfa TOWN OF QUEENSBURY - . BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 • SEPTIC DISPOSAL SYSTEM INSPECTION Name . I hp„.,„ Location ?j e\(16,1 0 Date I �‘2%.1t" Vk Permit #(90a)-(Ogil SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate- . ute/Inch. TYPE OF SYSTEM: ABSORPTION FIELD: Total ength Length of each trench Depth of trenches Size of stone SEEPAGE PITS Nurnberg., Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank_ Tank to Dist. Box • Dist. Box to Field/Pi ' Openings Sealed? Y:;s No :Partial LOCATION/SEPARATIONS: .,,Foundation to Tank feet • Foundation to Absorpti •n . .feet . . Separation of Pits feet Conforms as per Plot P an Yes No LOCATION OF•SYSTEM ON •'ROPERTY: (circle•one) Front - Rear - Left Sid- - Right Side Middle Front - Middle R-ar COMMENTS: . . . • • • r • .1 �r • E 1°' /61. • SYSTEM.USE APPROVED: 'YES NO Arrived: M v Departed: (4— • . Building Inspector TOWN OF QUEENSBURY \ ItiJ�J BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 • (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Q 36 r0 V, ,J Date Permit # 0 U ' l�.0 4 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench 1 1 Depth of trenches / ) Size of stone I / SEEPAGE PITS: Number- ( / Size - ft. x ]/ ft. Stone size PIPING: f1 Size Type Bldg. to Tank — Tank• to Dist. Box Dist. Box to Field/Pit Openings Sealed? Ye No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorpt'on feet Separation of Pits _ • feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: *1(1 Sh•- If\ CA cI SYSTEM USE APPROVED: YES NO Arrived: Departed: Building Inspector 3 0 y TOWN OF QUEENSBURY . BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 • (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 4-rt /641^- Ac- Location /?qua R=4 Dateq_WOO Permit # Oefa - P' SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Tot. Length Length of each trenc Depth of trenches Size of stone SEEPAGE PITS: Numbe Size - ' ft. x ft. Stone size PIPING: Size Type Bldg. , to Tank Tank. to Dist. Box Dist. Box to Field/P't Openings Sealed? Yes No Partial LOCATION/SEPARATION. : Foundation to Tank feet Foundation to Abso ption feet Separation of Pits' _ • feet Conforms as per P of Plan Yes No LOCATION OF SYS, . ON PROPERTY: (circle one) Front - Rear - eft Side - Right Side Middle Front Middle Rear. COMMENTS: &if!7 c tit re cheJ Oat I /Veto iv J76" /.(iy,‘-§e e, eit, 01 47 62a)I SYSTEM USE APPROVED: YES 6,w Arrived: 2-)( •¢g,► f uJ� Departed: o��y Building Inspector ape 9 ' t TOWN OF QUEENSBURY . `c'y BUILDING_ &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 �y�� j�� (518) 761-8256 e'"`{" S PTIC DISPOSAL ,SYSTEM INSPECTION ve hi ex 56 Name A-7- A 142_ jzJ ,. Location `-f r�.e(.4 Date .. eD.) Permit # P ,d1 Ajv SOIL TYPE: Sand-Loam-Clay- -. �� Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches r Size of stone } SEEPAGE PITS: Numbe Size - ft. x ft. Stone size PIPING: 1111,Size Type Bldg. to Tank Tank. to Dist. Box Dist. Box to Field/'it Openings Sealed? Yes No Partial LOCATION/SEPARATION` : Foundation to Tank feet Foundation to Absorition feet Separation of Pits _ feet Conforms as per Pl o+ Plan Yes No LOCATION OF SYSTEM IN PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Midd e Rear COMMENTS: 4)0 4 cr (‘- 'owe SYSTEM USE APPROVED: YES NO ,) Arrived: Departed: t_7_2,6 Building Inspector