97-392 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 97392
TAX MAP NO. 21. -1-9
WARREN COUNTY, NEW YORK
MC INTIRE , PHILIP C .
PERMISSION is hereby granted to
2352 RIDGE RD.
OWNER of property located at Street. Road or Ave.
in the Town of Queensbury,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.
'sWifRWelefIns isRIDGE RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
QUEENSBURY SEWER
33.5Wrgorfell or BUILDERS Address
0
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
SEPTIg0ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 July 10 99
$ 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 the
town of Queensbury before the expiration date.)
10 July 97
Dated at the Town of Queensbury this Day of 19
SIGNED BY aLK,_44:tttiv_, for the Town of Queensbury
Building and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No.9 .-3 9 c .
Dept. of Community Development
Building &Codes Office C O
742 Bay Road Fee Paid $a( )
Queensbury, NY 12804
L J
F
Location of property for installation: ( 0 X" o� 3 Z- 6)�t,e t�/sk K v, p,•a,,,, _Rj
0
Property Owner's Nam . P)1 i r. p / /i Cr.-i/ r C.
Property Owner's Mailing Address: '--2-30)( ITS---o2 e e kft7ci pet-, a
Installer's Name: (3)c,..t coe.i:S $z,c,r7 e -r Phone # / ? o 3 V617
Number of bedrooms (if residential): " ' Total daily flow: iS-7)
(residential -compute @ 150 gal./bdrm.)
Topography: )` flat, rolling, steep slope % of slope
► 1. ! 0 1997
Soil Nature: X sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? `',feet
Percolation test: 'V,' not required, required [rate min. per inch ]
Domestic water supply: municipal, X well, other
If domestic water supply is a WELL, water supply from any septic absorption is AZ, v feet.
PROPOSED SYSTEM
Septic tank:/c 1ci gallon (minimum size: 1,000 gal.)
' Tile field: each trench C6 feet I Total system Iength: 2.. D d feet
Seepage pit(s): number of_ / size each: ft. by ft.
Size of stone to be used: # a / depth or thickness l 0 `` feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
CAlarm system and associated electrical work to be inspected by a certified agency.)
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 ., .. _. j
-'fSiature of responsible person: _ Date: 7- - f /
ti TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
/
Name be /N /0
Location 4/o6 4 i
Date / Air7 Permit 97_397,--
SOIL TYPE: `d Loam-C1a .-
Results of' Pe colation est-
(if applicably Rate-M nute/Inch
TYPE OF SYST 7
ABSORPTION FI D: Tot 1 Len tji
Length of each trenc I S
Depth of trenc
Size of stone
SEEPAGE PITS: umb r-
Size - t. x ft.
Stone size _ /
PIPING: S'le Type
Bldg. to Tank ' -t9 y0
Tank to Dist. Boi a S�� 96
Dist. Box to Field '-
Openings Sealed/ No Partial
LOCATION/SEPARI$
Foundation to lank feet
Foundation to Absorption '5 feet
Separation of Pits feet
Conforms as !er Plot k1 an ,, No
LOCATION OF , YSTEM ON rROPER .
(circle 8.:.4
Front Re•4 - - Right Side
Middle ro t - Mialit
'•r
COMMENTS: `
A
(c)&ce-- gip, " — 61(
5
4\
't
SYS USE APPROVED: 0\ NO
P
Arr ved: '
D rted: /,l/1l
` c P
Building Inspector
Este /qhm
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 4Cl ` ''`Q..
Location / O66,
A
Date 7 07 Permit #
SOIL TYPE: Sand-Loam-Clay- CY1 -31
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size .�
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
JC-5 r J�oLC-
3c 475-1- -t
SYSTEM USE APPROVED: YES NO
Arrived: IV
Depar
tiding nsp
/)ó )
TOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name to o%
Location __/Ei QvC
Date 7/z/677 Permit # - 440/4/G
SOIL TYPE: Sand-Loam-Clay- q--1--3e„)
Results of Percolati •n T-
(if applicable) Rate - Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: To ;1 L- .th
Length of each tre
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption _ feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
5,r CHCcK
SYSTEM USE APPROVED: YES
Arrived: /4 :5;5"
Departed:
Building Inspector
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.) ... ? TOWN Or QUEENSBUPY rq1ILDING DEPARTMENT
/ Based on Otlf limited examination,
compliance ;,th our comments shall
not be unstrued as indicating the
plam... and specifications are in full
compliance with the code.
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