95-390 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 95390
TAX MAP NO. 48.-3-27. 226
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CURCIO. JAMES & JOANNE
99 HALL 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.
1. OWNER'S Address is
BOB 99 HALL RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
BELL. IVAN
3. CONTRACTOR or BUILDER'S Address
0
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
)Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
SEPTI0' ALTERATION AS PER PLOT PLAT SPSCIYIOATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES July 9 19 97
(If a longer period is required an application for,9n extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration crate.)
Dated at the Town of Queensbury this 13 D July 19 95
SIGNED BY for the Town of Queensbury
Building and o mg Inspector
H
Application for SEPTIC DISPOSAL PERMIT 0
STAMP RECEIVED
� 0
Location of property for installation: L r
Owner's Name J ' N. C V r( 1 V 'IiRMI't'NUMBER 1 C
Owner's Mailing Address: q,l.-l., r I I 390 `11
1'
' / A1U �S• CO
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Installer's Name: 1 t,/l' ^ ( CC Phone #: 7 UQ� �'
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0,
-z,
Number of bedrooms (if residential):
Total daily flow (residential -compute (i) I5(1 gal. per bedroom):
Topography: l,lat ( I Rolling I I Steep Slope g,% of Slope
Soil Nature: Sand I I Login I I Clay I I Other /1/ t '
Ground Water: at what depth'? feet
11 JUL 1 01995
Bedrock or Impervious Material: at w iat depth? feet
TOWN Oi-QUEENSBURY
Percolation Test: it Required MI Required/Rate in61.146.D1 l ND CODE
1-4
Domestic Water Supply: 1(i:r'i Municipal mil Well [—I Other —
If domestic water supply is a WELL: water supply from any septic absorption is feet
PROPOSED SYSTEM:
M:
Septic tank: 1 0 t0 V gal. (minimum size: 1,000 gal.)
Tile Field: each trench feel. / total system length fee
Seepage Pit(s): number of / size each: ft. x ft.
Size of stone to be used: # / depth or thickness _______ feet.
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gal.
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 ('ode of the Tony 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 o fan applicant, shall be void.
I have read the regulations with respect to this application and a pee to abide by these and all
requirements of the ?'own of Queeusintry .S ri ary Sewage Uis c sal Or a Ice.
Signature ofres ponsib'e ��
b / person: Date:
770
3t`30 r"Y1
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name v•vn
Location . 0
,r
Date 2-1:O—C15 Permit #. I -- qo
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Tes '-
(if applicable) Rate-Minu ►e/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD Total Length
Length of each trench 1
Depth of trenches f
Size of stone f
SEEPAGE PIS: Number/ j.
Size - ft. x /. r ft.
Stone size 3
PIPING: Size Tjpe
Bldg. to Tank / a/c.
Tank to Dist. Box i y•( /�
Dist. Box to Fie1djP'.—
Openings Sealed? \ No Partial
LOCATION/SEPARATII .
Foundation to Tan s I,. feet
Foundation to Abs rpti on •-•,= 'feet
Separation of Pits • eet
Conforms as per Ni of Plan No
LOCATION OF SYSTEM ON PROPERT
(circle .; -
Front - M Lft Side - igh Si
Middle Front - fiddle Rear
COMMENTS:
ed• P41-'
per
SYSTEM USE APPROVED: 46, NO
Arrived: 9411
Departed: /6ft
3/I-
Building Inspector
RECEIVED , A
J U L 1_ 01995 r . ;,.fin•
TOWN i - OUEENSBURY DATE
BUILDING AND CODE -------______._ /G ,
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hipcts such as houses, ,
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• !c document. I also represent est I lime
',°, '+'dances set forth on the diagram."