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BOTH-000456-2016 c au E U N N, `o Ln "Ci O o tip) U so Q GA "CO) o kn 03 0 N OF U o ~ O ❑ N �4 00W W z � o CIO CN u rWrT� o Old g Fr--I '^ 'd r T Q �, � '� •� � O 78 Q' o w o p ¢, c3; p O o �. u 40, o Q .. © a ° x o o b 08, d U � rT� p4 3 ° 0 F-+-� 10 U N U 4-4 o 0 O v q 0 cxo ice ' $,r TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201 Community Development - Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: BOTH-000456-2016 Tax Map No: 309.9-1-4 Permission is hereby granted to: Larry Sweet For property located at: 40 CONNECTICUT AVE In the Town of Queensbury,to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance Type of Construction Owner Name: Larry Sweet Septic Disposal $0.00 Owner Address: 170 Bluebird RD, Lot 27 Total Value $0.00 South Glens Falls,NY 12803 Contractor or Builder's Name/Address Electrical Inspection Agency Plans& Specifications Residential Septic Alteration $ 40.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Monday,July 10, 2017 (if a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Ta of Que bury; Fri a , J y 15 2016 SIGNED BY: for the Town of Queensbury. Director of Building&Code Enforcement SEPTIC DISPOSAL APPLICATION Office Use Only Received DATE: Tax Map ID TAx MAP ID: __90q . q— l — L-f Permit No. jk'1}ti_!1 Sb - ZC i b ZONE: Permit Fee : ,o Inv, aL APPLICANT e. f� PHONE/E-MAIL ADDRESSh0 INSTALLER/ PHONE 1 E-MAIL BUILDER M474/- i OWNER ADDRESS v CONTACT PERSON FOR BUILDING&CODE COMPLIANCE: PHONE/E-MAIL RESIDENCE INFORMATION JiiL P Year Built #of bedrooms X gallons per bedroom =total Daily flow 1980 or older Garbage grinder installed Yes !%Na 1981-1991 Spa or Hot Tub installed Yes _No 1992-Prescnt J• 7r�c•f PARCEL INFORMATION Topography Flat rolling Steep slope %Slope Sail Nature Sand Loam Clay Other Groundwater At what depth: Bedrock/Impervious material At what depth: Domestic Water Supply Municipal Well(if well,water supply from any septic system absorption is ft.) Percolation Test Rate: per minute per inch(test to be completed by licensed engineer/architect) PROPOSED SYSTEM FOR NEW CONSTRUCTION Tank size 101�2_gallons(min.size 1,000 gallons,add 250 gallons to size for each garbage cylinder or spa or hot tub System Absorption field with#2 stone Total length ft.;Each Trench Seepage Pit with#3 stone How many: ;Size Alternative System Bed or other type: j,(Joh (2a.JS ro L f= Holding Tank System Total required capacity? - Tank size #of tanks Notes: 1)Alarm system&associated electrical work must be inspected by a Town approved electrical inspection agency;2)We will no longer allow systems to be covered until such time as an As-Built plan is received&approved. The installed system must match the septic system layout on file—no exceptions. Declaration: Any permit or approval granted which is based upon or is granted in reliance upon any material representation 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 and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. PRINT NAME: t! Sv e e DATE: SIGNATURE: DATE: Town of Queensbury Building&Codes Principal Structure Application Revised September 2014 SEPTI-C PLOT PL6N I HAVE SEEN OR OBSERVED ALL OBJECTS SUCH AS HOUSES, WELLS, TREES, FENCES, ETC SHOWN ON THIS DOCU T.I PERSONAL(Y MEAS HE ANC E 0 flN IAGRAM. 2 f SI NATURE DAT€ I t.0 I _ jN _ ..., tr "Y FILE COPY I I TOWN OF QUE R_ BUILDING & E . Reviewed By- Date: 309.9-1-4 BOTH-000456-2016 Sweet, Larry 40 Connecticut Avenue 11 Residential Septic Alteration M .iul_ i 2016 �V • � P�`I�..I�Lt���LA�I � - I HAVE STEN OR. OBSERVED ALL OBJECTS SUCH AS HOUSES, WELLS,TREES, FENCES, �TC SHOWN ON THIS ROCU T.I PERSONAL f MEAS''HE IANC E 0 ON -DIAGRAM. - I .,� SI NATURE DATE Ai ,17 J� L -S BUILT -a ........... NV FILE COPY TOWN 4F Q J _ R �a � BUILDING & E r Reviewed By: _ Date: a • I - 309.9-1-4 BOTH-000456-2016 - Sweet, harry ,:. .., .. a 40 Connecticut Avenue Residential Septic Alteration JUL i I