97-256 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 97256
TAX MAP NO. 147 . —1-32 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to DE MARSH, CLIFTON &
OWNER of property located at 457 STEVENS 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
JUDITH STEVENS RD. , R. D. #2
QUEENSBURY, N. Y. 12804
2. CONTRACTOR or BUILDER'S Name
CONDON SEPTIC & DRAIN SERVICE
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
(' )Wood Frame ( )Masonry ( )Steel ( 1
7. PLANS and Specifications
SESUIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES May 22 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 Queensbury before the expiration date.)Dated at the Town of Queensbury this 22 Day of May 19 97
SIGNED BY \ _ for the Town of Queensbury
Building and Zoning Inspect-
. = Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury oi Dept. of Community Development ermit No. 75 ,t2
Building &Codes Office C 0 D
742 Bay Road Fee Paid $
Qi' nsbury, NY 12804
J
Location of property for installation: 3 ? 8-it V e&`S hO /1'_q—
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Property Owner's Name: �/Q� (���l C / 01.01t '� tib, ll, (
Property_Owner's Mailing Address: g 7 S 1 E VrevS L aiv E.
Installer's Name: p N�O/L S' c rp--/-t c '3Va/Iv Phone # Ng--FS—'IL--
Number of bedrooms (if residential): Total daily flow: 7 3
(residential - compute @ 150 gal./b
Topography: X flat, rolling, steep slope % of slope \I
SID
Soil Nature: �( sand, loam, clay, other /depth. 4a%�9�1 00
Ground water: at what depth?A feet / Bedrock or Impervious Materi : at what�l�ep .. et
Percolation test: Knot required, required [rate min. per ' eh m
Domestic water supply: X municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
02E /4J- 74.114T 0014/4esEd.- PE,/.1 c /,40 iG '
PROPOSED SYSTEM ffaoKiii, U _frd ex(S4 /'y .)1 �jt?J-!Lid
Septic tank: 10ed gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system length: feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # / depth or thickness feet
•
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
(Alann system and associated electrical work to be inspected by a certified agency. 1
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 reliance 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. �`
��� j -- 2 0
Signature of responsible person: Date:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT I I '
742 Bay Road [ (J
Queensbury NY 12804
(518) 761-8256
SEPTIC DI OS,A,,LMSYSTEM� SPECTI.N
Name Uv-L \'Y-e 6 eritc-;//
Location \`�� S 4EAmA,0 (I`�(
)
1:, D� _
Date ���;` 7�' I Permit # � ',-7 "0251P
SOIL TYPE: rSand-Loam-Cl ay-
1
Results of 'ercolation Test- 0
(if applicable) Rate-Minute c ;
TYPE OF SYS EM: ,'
ABSORPTION -IE : T t gth•
Length of eah tre
Depth of trench
Size of stone I f G] ff.
SEEPAGE PITS: ; Number- 'T ►r.'
Size - \tr-,55 ,;',' f .
Stone size t
PIPING: E , ., Size Type
Bldg. to Tan to .,6 C -
Tank to Dist. Box J-f .1\f_ T� F i6
Dist. Box to Fie\i d/Pit i tw
Openings Sealed? No Partial
LOCATION/SEPARATIe. :
Foundation to Tanls4i•
t 171 feet
Foundation to Absorption feet
Separation o; Pi tsl feet
Conforms as per Pil of Plan es o
LOCATION OF SYSTEM PROP .
(circle one) s
Fron %( Sii de Right Side
Middle Front - "Middl e ear
COMMENTS: i
\ ______
SYSTEM USE APPROVED: ..-11 0
Arrived. c <,
Depa ed: %,
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TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
compliance with our comments shall
not be construed as indicating the :.
plans and specifications are in full compliance with the code.
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REVIEWED nrf
DATE 5 -
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