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97-254 BUILDING PERMIT TOWN OF QUEENSBURY VALUE $ 0 No. 97254 TAX MAP NO. 46 . —2-34 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to RIDGE RD. WESLEYAN- CHURCH OWNER of property located at S 4 3 RTDGE RD. Street,Road or Ave. in the Town of Queensbury,To Construct or place a SEPTIC SYSTEM 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. OWNERS Address is 543 RIDGE RD. QUEENSBURY,NY 12804 2. CONTRACTOR or BUILDER'S Name JONES, DAVID O. 3. CONTRACTOR or BUILDERS Address 4. ARCHITECT'S Name 5. ARCHITECTS Address 6. TYPE of Construction—(Please indicate by X) SEPfTIC ( 1 Wood Frame ( I Masonry ( )Steel 1 7. PLANS and Specifications SEPtITC SYSTEM ALTERATION AS PER PLOT PLAN AND SPECIFICATIONS 8. Proposed Use SEPTIC SYSTEM $ 35 PERMIT FEE PAID -THIS PERMIT EXPIRES June 2 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 2 Day of June 19 97 SIGNED BY 1D_ for the Town of Queensbury Building and Zoning Inspector —"" Application for SEPTIC DISPOSAL PE ti Town of Queensbury q O Dept. of Community Development MA$e Building &Codes Office 742 Bay Road TC Fee-Paid Queensbury, NY 12804 B ALDINE,ANf COOK Location of property for installation: .113 t e_ Rd , q 510i , uk, 7,1 _3 I Property Owner's Name: [3 es P (ICY`C' -�— Property Owner's Mailing Address: 5 ) RI 0 Rcrd Installer's Name: D c;r C). Phone # 713 a (o J0 5' Number of bedrooms (if residential): 17/ Total daily flow: 6,2 0 0 (residential - compute @ 150 gal./bdrm.) Topography: X flat, rolling, steep slope % of slope Soil Nature: sand, loam, X clay, other /depth: Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet Percolation test: not required, required [rate l D min. per inch ] Domestic water supply: X municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: JZ5°gallon (minimum size: 1,000 gal.) Tile field: each trench qz feet / Total system length: j 3 Co feet Seepage pit(s): number of / size each: ft. by ft. Size of stone to be used: # 3 / depth or thickness feet HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: /2 5O gallons 1 Alarm 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 res application and agree by these and all requirements of the Town of Queensbury Sanitary Sewage al . Signature of responsible person:1 a lie Date: TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name 4f2C— A. 416s �dGr/aGu1 Location s-18 , g06 G A . Date 6/4d/y-7 Permit # 97 - 75- SOIL TYPE: Sand-Loam-Clay- Results of Per.ol ati . -st- (if applicable) 'at!M to/Inch TYPE OF SYSTEM: ABSORPTION FIELD. 'ot Length Length of each tr:' 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 st. Box to Field/P. Openings Sealed? No Partial LOCATION/SEPARATION Foundation to Tank feet Foundation to Absorption _ feet ;eeparation of Pits Elpeet Conforms as per Plot Plan No LOCATION OF SYSTEM ON PROPER (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: /4)9/ 6e- 6ti0 C,4-00 S e ,44_4_ 247 cS -> CY\ ___ 14,-- 6utt_f-r cA) -f---It_ 6-- . .- SYSTEM USE APPROVED: 0 NO Arrived: - ; 00 Departed: Afij/ Building Inspector i a.: 3o TOWN , BUILDING & CODELtNSBURY ENFORCE ) 1)4) Bay Road 742 ENFORCEMENT Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name fir 1 Location Date 0 t_ r Permit # -J___:::____3,4S11 SOIL TY and-Loam Clay- Results of Per . . ion Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Le gtL �j6.b i Length of each tren hi. :5" Depth o t -nche�yr Size sto - S SEEP E PITS: 'umbe S ' e �'ft. x ft. ze tone si PIPING: — Si. T p Bldg. to Tank ---y Tank to Dist. Box U Dist. Box to ield/Pit /, Openings Sealed? Yes fp Parti 1 LOCATION/SEPARATIONS: r Foundation to Tank /0 feet Foundation to Absorption 'feet Separation of Pits f Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle Front Re - Left Side - Right Side Middle ront - Middle Rear COMMENTS: -i44 le (- 10C-0 , /it)Sr, -.,,t_,Io p5 e 4g 1_4T '.5 vvvi i Ah-- £ u,Lr PutA) SYSTEM USE APPROVED: YES N Arrived: _ Gi Departed: Building Inspector (518) 761-8256 7„ fY TOWN OF QUEENSBURY =x-' BUILDING & CODE ENFORCEMENT 742 BAY RD., QUEENSBURY NY 12804 INSPECTOR'S REPORT: ARR I DEPART!' INT ::E INSPECTRECEIVED:( r r f !' P).• LOCATION `�- DATE -1 1_ J PERMIT I TYPE OF STRUCTURE: I -' ;')6('( RECHECK APPROVED N/A YES NO FOOTINGS/PIERS MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR S RESPONSIBLE FOR PROVIDING PROTE TION FROM FREEZING FOR 48 HOURS FO •NING THE PLACE- MENT OF THE CONC' LTE. MATERIALS FOR THI• PURP', E ON SITE _ FOUNDATION/WALLPOU' REINFORCEMENT IN P E ._ FOUNDATION/DAMPP'""FING BACKFILL APPROVAL PLUMBING VENT/VENTS IN PLACE ROUGH PLUMBING PLUMBING UNDER SLAB FRAMING: JACK STUDS/HEADERS BRACING/BRIDGING JOIST HANGERS JACK POSTS/MAIN BEAM AIR INFILTRATION BARRIER HEATING ROUGH-IN INSULATION: FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WALLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED SPACES R- C l -- r,.✓s�nlEo /T' ��Aar �/i_f�'l 1L�o P fi a. p,.✓6 e ti • ' I t / r \ • f r r s 1 P 4' f+ELFOfI'rCI A+C fir.---1,}�---� %•,yEay...0 HA) . CdP.2 %ie W FT O `.' F+ �p+�t'�" " - -_� - -- ...� 1 30 - - _ — - /� •. g F T /© co �43v: V� yJ _ J— O � r"r N I "0 _ Q saute L, # - o -- �f'RoPesFa O- I 9-1 N a or believe I saw evidence of, Y I have seen or observed, Wells, trees, tet►ce`•. etc., E'•'zT Ass/a"-;`'� all objects such as houses, shown on this document. I also to resent that I have { Ily measured ista a set forth on the tagram." I 1, - DATE SIGNATURE i ... . . . l ''• J A+ f MAY 2 2 1997 TOWN OF QUEENSBURY BUILDING DEPARTMENT ,r_inY 01._ .. .._ _ Based on our limited examination. TO\1"�' Rt t CODE compliance with our comments shah gilt�itJ� -� not be construed as indicating the plans and specifications-eC --- �',\ are in full compliance with the code. i r" p - + - - /� -Irk S�PT/� Fuller Construction Co.,Inc. „-- - �ys-re 10� 9 John Clendon Rd. . / TOWN OF ��IE Queensbury, NY 12804 DRAWN %D �I rr� _ REVISED P 'EVIEWED BY DRAWING NUMBER I.