99-479BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY
TAX MAP NO. 93.-3-7 No. 9947
WARREN COUNTY, NEW PORK
PERMISSION is hereby granted to DURETT, MELISSA
OWNER of property located at 13 EAST DR. Street, Road or Ave.
in the Town of Queensbury, To Construct or place a SEPTIC ALTERATTON
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. OWNERS Address is
13 EAST DR.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUI LDE RS Name
MCGUIRE, RICK
3. CONTRACTOR or BUILDERS Address
4. ARCHITECTS Name
S. ARCHITECTS Address
6. TYPE of Construction — (Please indicate by XI SEPTIC
1 1 Wood Frame 1 1 Masonry ( I Steel 1 1
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
B. Proposed Use
SEPTIC ALTERATION
zs
3
August 3 2001
PERMIT FEE PAID — THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of tIw
town of Queensbury before the expirstion date.)
3 August 1999
Dated at the Town of Oueensbury this
SIGNED BY
of
19
the Town of Queensbury
CERTIFICATE Ol! COMPLIANCE
TOWN OF UUEENSBURY
WARREN COUNTY, NEW YORK
Date August 3 19 99
99479
This is to certify that work requested to be done as shown by Permit No.
has been completed.
This structure may be used as a
Location 13 EAST DR.
Owner DURETT, MELISSA
TAX MAP NO. 93.-3-7
SEPTIC ALTERATION
By Order of Town Board
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
ti
Application for SEPTIC DISPOSAL PERMIT
Town of Quee
Dept. of Com
Building & Cc
742 Bay Road
Queensbury, N .
99479 93.-3-7
DURETT, MELISSA
13 EAST DR.
SEPTIC ALTERATION
47 j Permit No.
Fee Paid $(�95 Oc
Location of property for installation: y� �� � 1 'Drl,L.Q
Property Owner's Name: cc1 fP�
Property Owner's Mailing Address: �3 (o-i1 �
w
Installer's Name: �( 1 1 I tl�i f {' Phone #
Number of bedrooms (if residential): Total daily flow: _3`_�`"` .
�/ (residential - compute @ 150 gal./bdrm.)
Topography: /" flat, _rolling, _ steep slope _ 9 of slope
Soil Nature: A sand, _ loam, _ clay, _other / depth:
Ground water: at what epth? _ feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: _ not required, _ required [ rate
Domestic water supply: municipal, _ well, _ other
min. per inch ]
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
00
Septic tank: gallon (minimum size: 1,000 gal.)
W is
Tile field: each trench jc feet / Totalsystem len;dt feet
ya
Seepage pit(s): number of / size each:. ft. by ft.
Size of stops to be used: # depth or thickness —LL— feet
HOLDING TANK SYSTEM: (if required)
Number of tanks:
Size of each ,gallon
Alarm system pad associated electrical work to be ivspacted by a certified agency.
For your protection, please mte that pursuant to Section 136-29 of the Code of the Town of Qneembury, any permit or
approval granted which is based upon or is granted in reliance upon any material miarepreeadatim or failure to make a
material fad or circumstance known by or on behalf of m 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
Queensburry Sanitary Sewage Disposal Ocdfi a .
Signature of responsible person: Date:
l
I rr)
TOWN OF QUEENSBURY
BUILDING E CODE ENFORCEMENT
742 B' y Rad
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name C _
Location
01
Date C Permit #('�f
SOIL TYP Sand oam-Clay-
Results of Percolati T t-
(if applicable) Rat Minu a/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: otal ngth
Length of a ch tr nch
Depth of tre the
Size of stone
SEEPAGE PITS: umber -
Size - _ ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box „
Dist. Box to ield/P' 11
Openings Sealed? Y s No Partia
LOCATION/SEPARATION .
Foundation to Tank /(' feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan es No
LOCATION OF SYSTEM ON PROPERTY:
(circle��,�
Front -rR"�"- Left Side 1 Right SideMiddle ont - Middle Rear
COMMENTS:
-�v(Lr
SYSTEM USE APPROVED: YES NO'
Arrived.
Departed:
Building Inspector
TOWN OF QUEENSBURY
BUILDING 3 CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name CL-AcpPak-
Locatioon 6-" j lr�)P— _
Date O 'a Permit # L�q
SOIL TYPE. an - oam-Clay-
Results of Percola
(if applicable) R e-Mi
TYPE OF SYSTEM:
ABSORPTION FIELD: Total
Length of each t ench
Depth of trenche
Size of tone
SEEPAGE S: Nr
Size - Stone sizePIPING:
Bldg. to TankTank to Dist. B
Dist. Box to Fi ld/P�'
Openings Seale yYA
Test -
Inch
zp iype
190
It
No artia
Foundation to!Tank 16) feet
Foundation to Absorption - feet
Separation of Pits feet
Conforms as per Plot Plan a No
LOCATION OF SYSTEM ON PROPERT .
(circleDea'
'�Front - Left Side Right Siie
Middle- - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: OYES NO
Arrived:)
Departed: (/v
Building Inspector
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