1998-741 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY
TAX MAP NO . 114 . - 6 - 11 WARREN COUNTY, NEW YORK
PERMISSION is herebY grant# to RY
Street. Road or Ave.
OWNER of property located at 6 SPRU
in the Town of OueensburY. To Construct or placer 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 Ousensbury Building and Zoning Ordinance.
1. OWNERS Address is
6 SPRUCE COURT
QUEENSBURYr NY 12804
2. CONTRACTOR or BUILDERS Name
CrQNDON SEPTIC & DRAIN: SERVICE
3. CONTRACTOR air BUILDER'S Address
4. ARCHITECT'S Nsme
S. ARCHITECT'S Address
A
$. TYPE of Construction — 1Please Indicate by Xl
SEPTIC
1 1 Wood Frame I I hAssonry i t Steel i I
i
7. PLANS and SpecViQtions
SEPZIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
I
E
8. Proposed Use
SEPTIC ALTERATION
25 December 1 t8 2000
S PERMIT FEE PAID - THIS PERMIT EXPIRES
llf a topper period is required an sppticatlon for an saterajon rnuet be made to the Building and Zonlna irapector of the
town or pueeasbuey bsfore the eepirstion date.l
i 1 December 19 1998
Dated at the Town of Quaensbury this , Day of
i
SIGNED BY for the Town of GueensburY
p r� Zanlno 1 nepacter
I
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Application for SEPTIC DISPOSAL PERMIT
Town of Queecsbury
Dept. of community Development Permit No. 9E:: 7t1
Ridlel ag & Codes Office
742 Pay Road Fee Paid S
QL, emsburr. NY 12804
Location of property for instaUadon:
Property Owner's Name: ,rr_IQ
[Jt�,J�..
Property Owner's Mailing Address: E6 =,,92}^QCC
Instaher's Name:[.,c",, Phone # �.►
Number of bedrooms (if residential): Total daily flow: _ '7
(residential - compute a 150 gal.fbdrrrl.)
Topography: flat, rolling, steep slate 9 of slope
Soil Nature: _Xsaad, Ioam, clay, other f depth:
IA
Ground water: at what depth' , feet f Bedrock or lmpervicus Material: at what dep4A feet
Percolation test: >Lnot required, require; [ rite rain. per inch ]
Domestic water supply: municipal, well, other
If domestic orate: supply is a WELL, water supply =orn any septic absorptioa is feet.
PROPOSED SYSTEM t
Septic tank: &O _ gallon (minimum size: 1 ,000 gi.)
Tile field: each trench _.5� feet / Total system length: Z•-s�o fit
Seepage pit(s): number of f s=.ze each: ft. by ft.
Size of stone to be used: # I de,pth or thickness _ feet
'HOLDD4G TANK SYSTEM: (if required)
Nuornber of tanks: Size of each: Qallons
Alarm system amd associated electrical wvTk to be inspected by a oerdfie3 13CE17.
For yea.: protection, please note that purnuzat to Section 136m29 of the Codo of the 'town of Qowrisbm7 any permit or
approval gn erred which is based upon or is gr3=t*d in LiaMIC. 14Dnc any xaterW rmisregmaectat on or fax7ure to make a
meters fact or circumstaucs lmovv= by or on behalf of am applicant, aba1I be void.
I have —ad the regulations with respect to this application and agr+se to abide by theme and all requmre=e=ts of the Tovru of
Queers"� Samaary sewage Diaposal Ordi s -
Signna:,z.re of responsible person: : Date: ,/��•-
� r
TOWN OF QUEEKSIW f
BUILDING & C742 ODE Road
adRCEf�N i
Queensbury NY 1.2804
ois) 761-8256
5EPTiC DISPOSAL SYSTEM INSPECTION
Name
Location
� Per
Date -� Permit
SOIL TYP a
Cl ay-
es of Percol ati on Test~
Results applicable ) Rate-Minutellnch,, .
( ifTYPE OF SYS'IEMLD : Total Le -r '
,,SORPTION i� trench
Length of ea ches
Depth of t
size of stun ber_
SEEPAGE PITS ft . x f .
Size - ,----
Stone size S i z7e��yp
PIPING: h' A
Bldg . to Tank ►• �'
Tank to Dist . Box ,r
Dist . Box to Field/Pit Partia
Openings Sealed? es
L:0CATIONf SEPpRpTI feet
Foundation to Tank tion� feet
Foundation to AbsarP feet
Separation of Pits Plan o
Conforms as per Plot
LOCATION OF SYSTEM ON pROPE
( circle one) ght Side
Front - Rear eft
Middle Front
e Rea
COMMENTS:
SYSTEM USE APPROVED
YES
8
ArriV
Dep
ui i d g n p+ecta
i
f" AY Aye . C6A4 ary g sf tt� �M we lgt� sF� . c
P� t( N f TOWN F QUEENS RY
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�`— BUILDING & %T
REVIEWED BY
DATE Z
WNW
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