97-558 BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 No. 97558
TAX MAP NO. 26 . -2-10 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HARRIS, FLORA
OWNER of property located at 1727 RIDGE RD. Street, Road or Ave.
in the Town of Oueensbury,To Construct or place a SEPTIC 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.
1. OWNER'S Address is
1727 RIDGE RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
HARRIS , KEITH
3. CONTRACTOR or BUILDERS Address
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
1 Wood Frame ( I Masonry ( )Steel 1
7. PLANS and Specifications
SEPTIe°'ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID -THIS PERMIT EXPIRES September 29 19 99
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
Dated at the Town of Queensbury this 29 Day of September 19 97
SIGNED BY
3A J for the Town of Oueensbury
Building and Zoning Inspector
c .pput;zttlutt Wi ..)1:.r 1 I' . 1J1.7r'J )! L1 t-.Z.M.UV111
y 7 Town of Queensbury Permit No. --
Dept. of Comm=ununity Development
Sor
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: /742 7 //tap /at/
Property Owner's Name: 1/Q4,y K' ////fi S
Property Owner's Mailing Address: /7d°? 2t Sr' ieo.1 ✓L27' /d-,POk
Installer's Name: --lei . A <( tCI5 Phone # `71-Jty'
Number of bedrooms (if residential): 02 Total daily flow: 3°_
(residential -compute @
Topography: - flat, rolling, steep slope 90 of slope ti
aD
SEp29i9
Soil Nature: 'sand, `"loam, � clay, other /depth: w, O 9�
fit:+ C
r� �!�LI�IN•
Ground water: at what depth? /Dafeet / Bedrock or Imperrcus Material: at Wh G C`COFi r
Percolation test: Viot required, required [rate min. per inch ] .
Domestic water supply: municipal, V well, c=e
If domestic water supply is a W'FTL, water supply from any sec absorption is /b, feet.
PROPOSED SYSTEM
Septic tanIc /ea° gallon (minimum size: 1,CCO gel.)
Tile field: each trench co ' feet / Total system in ath: ``t' feet
Seepage pit(s): number of / size each: — ft. by it-
Size of stone to be used: # / depth or thick` s ,,1 fee rfeet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: -- gallons
Alarm system and associated electrical work to be inspected b7 a certified agency.
J
For your protection, please note that pursuant to Section 136-29 of the Code of±e Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance known by or on behalf of an applicant, shall be acid.
I have read the regulations with respect to this application and agree to abide b7 these and all requirements of the Town of
Queensbury ssmirary Sewage Disposal Ordinance.
Date: q l9 A2
Signature of responsible person:
fre
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSSPECTION114-4
Name
Locationo a e4317l
Date /011/1W/4 -7 Permit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate- ' to/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: To al L ngth
Length of each trenc
Depth of trenches
Size of stone
SEEPAGE PITS: Numb -
Size - ft. x ft.
Stone size
PIPING: Size ype
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption 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:
SYSTEM USE APPROVED: YES NO
Arrived: k 1 5
Depart
B lding Ins c or
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 4AI?JS
Location _ QtOCDC gc)
Date fS Permit #
SOIL TYPE: ' a Loam-Clay-
Results of Pie col .tion Test-
(if applicable R. te-Minute/Inch
TYPE OF S 1,-
ABSORPTION FIELD. Total Length
Length of each tre.ch
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone 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 feet
Foundation to Absorption 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:
ALL Cao2 .cC( /d4) S — 0 IC
SYSTEM USE APPROVED: bYESNO
Arrived: , .Q',
Departed: jrb.
Building Inspector
TOWN OF QUEENSBURY 'ssz*
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ���, x(<- \ ) `C \O(
Location \ink \&. C.,44.1,
Date % C -c\ -rmit # 1 '9.S-1
SOIL TYPE: Sani-Loam lay-
Results of Pe olation Test-
(if applicable Rate-Minute/Inch
TYPE OF 1YSTEM.
ABSORPTII FIEL' : Total Length (fQ
Length of ea. i kr- chi 5V
Depth of trenche )^
Size of stone //
SEEPAGE PITS: 'er-
Size - ft. x ft.
Stone size
PIPING: S'fie JType
Bldg. to Tank • `jib 7D
Tank to Dist. Box so. 4
Dist. Box to Field/P h a C7
Openings Sealed? No Partia
LOCATION/SEPARATII .
Foundation to Tank ` feet
Foundation to Absorption (0 feet
Separation of Pits _ feet
Conforms as per Plot Plan No
LOCATION OF SYSTEM ON PROPER .
(circle one) ----r,
Front - Rear - eft Sid: Right Side
Middle Front - - 'ear
COMMENTS:
l57�&._ &JO co
Co p& L 4TG R4 -
Cvl- L(AJ&-s efi.ex - dfL
Vic. 6- ply
SYSTEM USE APPROVED: YES ok
Arrived: -
Departed: AMMO
Buil 9� Inspector
P
TOWN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Af6
Location _ Po.b(c,C
Date /Dig/91 Permit #97"55)
SOIL TYPE: Sa -Loa Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: ".ta ength
Length of each tr.
Depth of trenche-
Size of stone II
SEEPAGE PITS: mber-
Size - t. x ft.
Stone size
PIPING: Size vale
Bldg. to Tank 144 54i0 D
Tank to Dist. Box h
Dist. Box to Field/Pit
Openings Sealed? Yes Ncyartia)
LOCATION/SEPARATIONS:
Foundation to Tank 0'1 feet
Foundation to Absorption feet
Separation of Pits _ feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear -d . • - Right Side
Middle Front - .. • Rear
COMMENTS:
•P -fzT► q-L', (ttNv ItoL.6.1- OOrit=l
n<< ')Pp°ol2T ou-rLc i 1./AJ& of
SE-q,_ Fov,uo , P P c
SYSTEM USE APPROVED: YES NO
Arrived: /
Departed: l r(O
VPc>
Building Inspector
J
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S41 -7. e/�2.
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3.14 A ORES+ \ N o
( TO BE CONVEYED J Q
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( TO BE CONVEYED
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persr rwad free was ut Iorth on the
SIGNATURE � DATE
I TOWa BUIZY
° PT.
NOTE ALL BUILDINGS NOT SHOWN I
MAP OF A SURVEY MADE FOR — SEP
91997
� x REVIEWED BY
HENRY M. 8 FLORA K. HA RR/S a N of o x DATE
S � � -TO
TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK
SCALE : I" = 50' DATE : JULY 29 , 1986
VanDusen 8 Steves PICKLE HILL ROAD
LAND SURVEYORS , GLENS FALLS , NEW YORK w
z
N.Y. STATE LIC. NO. 35617 �°, Q
TOTAL ACREAGE - 9.14± �.f Q . A41r-r1L FcAJL. f--70 sr