98-024 TOWN OF QUEMSBURY
WARREN CCIUTITY , NEW YORK
19 __9$_
98024
This is to certify that work requested to be done as shown by Permit Nov
has been completed .
This structure may be used as a
SEPTIC ALTERATION
Location 4 EDGEWOOD DR *
Owner PUTNICK , LAWRENCE & -
By Order of Town Board
TAX. 14AP NO . 65 . - 2 - 3 / TOWN OF QUEEN BURY
� � ' - - -' Director of Building code Enforcement
BUILDING PERMIT
VALUE $ m TOWN ()F QUEENSSURY No.
TAX MAP NO . 65 . - 2 - 3 WARREN COUNITY. NEW YORK
PERMISSION is hereby granted to FUTNICK
Street, Road or Ave.
OWNER of property located at 4 EDGEWOOD D
in the Town of Clueensbury, To 'Construct or place a
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 Oueensbury Building and zoning Ordinance.
t. OIIVNE R'S Address is
DEBORAH 4 EDGEWOOD DR .
QUEENSHURYr NY 12804
2. CONTRACTOR or BUIt,I Name
CONDON SEPTIC & DRAIN SERVICE
3. CCOMTRAC Oil or BUILDERS Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
$» TYPE of Construction — (Plea" lydicote by %) SEPTIC
} wood Frame f 1 Masonry < I Steel 11
7. ,PLANS and Speclfloltions
SEPTIa ALTERATION AS PER. PLOT PLAN SPECIFICATIONS
S. Proposed Vae
SEPTIC ALTERATIC)N
25 February 3 2000
Is PERMIT FEE PAID - THIS PERMIT EXPIRES
19
(if a lunaer period is retiuired on apptication for an rxtensl+on "Wet be Ada to the Building and Zoning inspector of the
town or CN~Sbury before the expiration deee.l 14
Dated at the To
g Februarywn of f]ueertsburry this
Day Of 19
,y for the Town of Queensbury
SIGNED f3Y Boiwina and z ninp iruperxaar
Application for SEPTIC DISPOSAL PERMIT
JLI
Town of Queeosbury Fee
a. _ J
Dept. of Community Development t
Building & Codes Office
742 Bay Road
Queensbury, NY 12804
Location of property for installation: �"� + ' � ` -73
property Owner's Name:
Property Owner's Mailing Address: ' / ur no c 7 R
Installer's Name: 09 ,'Vd1d rr� S S • c - I-4z>j A1ry Phone
Number of bedrooms (if residential): Total daily fio'= 7 5 0
(residential - compute 0 1.50 gal.lbr dm.)
Topo phy; �' flat• rolling, steep slope 5€+ of slop RECEIVED
Soil Nature: sand, loam, clay, other f ,depth: FEB 02 1M
Ground water: at what depth? feet I Bedrock or ImperNious Material: _T p G� p
~-.—
Percolation test: not required, required [ rage - Per in
Domestic water supply: E. municipal, well, ocher
If domestic water supply is a WELL, water supply from any sepac absorption is feet.
PROPOSED SYSTEM l
Septic tank: 1��- gallon (1(xnimmum size: 1 ,O00 gal.)
Tile field: each trench feet 1 Total system 1en."b: L7 4 feet
Seepage pit(s): number of I size each: ft. by ft.
Size of stone to be used: # -- 1 depth or tbiclmess feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Aln�rm e5'etem sood associated eteetrical vxwk to be aaspected by a oeatiEwd a -
For your protecki0a, please now that pursuant to Section 13&29 of the Code of thv TOwn of iQueensbusy, any pew or
or is m reliame upon any or faffilm to In a
qVro .,al, granted vAnch is based upon granted
material fact or c=cznm.stanae imn by or on behalf of an applicaOt,
be vm&
1 bave reed the regulatuxw with respect to this application and agree to abide by tbooe and all regtriremuenta of the Town of
Queensbury Sanitary' Sewage Disposal O"14 nce.
—� Date•
Signature of responsible person: 5 �"^" -
i
TOMM OF QUEENSBURY
'--WILDING CODE ENFORCEMENT
742 Say Road
Queensbury NY 12804
(519) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name A x 7.x At o+--.G ' w
Location 1 cc)
Date
, _ Permit # �
SOIL 6: Sand- Loam Cl ay-
Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM: 4'
ABSORPTION FI D : a 1 Ler �] tfi
Length of each tre c
Depth of trench s
Size of stone
SEEPAGE PITS : N er-
Size - ft . ft .
Stone size
PIPING : ize Type
Bldg . to Tank -'>t/� �/ ✓�'
Tank to Dist . Box {�3:5
Dist . Box to Field/P * u �
Openings Sealed ? Yes No Partial
LOCATION/SEPARATION /
Foundation to Tank / feet
Foundation to Absorption u feet
Separation of Pits feet
Conforms as per Plot Plan
es No
LOCATION OF SYSTEM ON PROPER
( circle one )
Front - Dear Keft Side Right Side
Middle Front - Mi ear
COMMENTS :
SYSTEM USE APPROVED : YES NO
Arrived:
Departed :
Bulling inspector
: her 5111011! Der 0U9Kv4U0 W yJ1411 _ I smovkWaft Ott
all objects such as ipdh6 tMK f4@0W gk ►
shown on this ft a l t l aW pga-1 "01hoo
personaft mess i A tM that#An a* fwa oo the diagram."
95NATU� DATE
PLOT PLAN
SEPTIC SYSTEM
Notice : The following statement must be " stamped " on your plot
Plano This sheet of paper may be used for purposes of drawing your
plot, plan . ,After drawing such plot plan , please read the statement
and sign it . If you choose to use other paper for Your plot plan ,
the office will stamp those plans for your signature .
CEIV
FEE 98
TOWN Ct:EEN RY
� C r B ING AND CC3
t`} n �^
r
RECEIVED
r
ova 4'S
�e
CURY
T fit
C11f1ih1 OF �. j Lc)Im
Lz
•� ] AND C?DE I
,M BUILDING
L7
lee
Cf,Z ,rp� -,/yr //♦�J
�. ( ,/� f/.ram"
I
TOWN OF QUEENSBURY
BUILDING 5 CODE ENFORCEMENT
742 Say Road
Queensbury NY 12804
(518) J761-8256
SEPTIC 'DISPOSAL- SYSTEM INSPECTION
Name _ LG' L
Locati on ■ r` / ��//-
Date �- y Permit # 4 t---
SOIL TYPE : Sand- Loam Clay-
Results pplicable ) Rate�
n Test-
( ifa
o Minutellnch�_
( f Pp
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Length
Length of each trench
Depth of trenche
Size of stone ----
SEEPAGE PITS : Num r ft .
Size ft . x
Stone size Size ype
PIPING:
Bldg . to Tank ------
Tank to Dist . Box �--
Dist . Box to Field/Pit
openings Sealed? Yes No artsa
LOCATION/SEPARATIONS : feet
Foundation to Tank Absorption feet
Foundation to Aibsorp feet
Separation of Pits — fifes No
Conforms as per 'Plot Plan
LOCATION OF SYSTEM ON PROPERTY :
( circle one ) Right Side
Front - Rear - Left Side - Rig
Middle Front - Middle Rear
COMMENTS :
SYSTEM USE APPROVED - YES NQ
Arrived : pu
Departed =
Building nspector
TOWN OF QUEENSBURY 20
BUILDING & CODE EMFORCEPOMT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name „
�.
Location / we
Date .2 Permit #�
SOIL TYPE : Sand- Loam-C ay-
Resul is of Percolation Test.
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIEL : To
tal Length
Length of each renc
Depth of trench s
Size of stone
SEEPAGE PITS : er-
Size - ft . ft .
Stone size
PIPING: dd Size TyFe
Bldg . to Tank
Tank to Dist . Box
Dist . Box to Field/Pit
Openings Sealed ? Yes"'R!o arti a
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan —T�es 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 : ,u
Departed :
Building Inspector