2007-157v
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TOWN OF QUEENSBURY
742 BayRoad, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070157
Application Number. A20070157
Tax Map No: 523400-309-006-0001-040-000-0000
Permission is hereby granted to: CARL & LINDA WINCHELL
For property located at:
23 NATHAN St
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 QueensburyZoning
Orriinance. Type of Construction
Owner Address: CARL & LINDA WINCHELL
23 NATHAN St Septic Alteration Residential
QUEENSBURY, NY 12804 Total value
Contractor or Builders Name /Address
STONE INSTALLATIONS
4305 ROUTE 50
SARATOGA SPRINGS, NY 12866-0000
Value
Electrical Inspection Agency
Plans & Specifications
-157
C ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Thursday, April 17, 2008
(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 To of ens a pril 17, 2007
SIGNED BY for the Town of Queensbury.
Director of Building & Code Enforcement
'.-.....r......__...r....
~ ~~ '.I OFFICE USE ONLY.~..+ ..................... % r,
TAX MAP NO. i~/~/,J/- ~ ' .. ,' S,' t f ~
PERMIT NO, RMIT FEE ' ~ '
A°PROVALS: ZONING ~- ~ ' '
~`.,,,, TOWN CLERK
~ ~Ui~ Dlr~'U A t
__________________________ _ ItiL~ CODE '
r71rf .._..,
AI'l'LICATIONFpR SEPTIC DISPOSAL SYST I ,II 'II ~'I I ~~~
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO R lV 1 PEI~,rT'~
PERMIT.
EVIEW BEFORE ISSUANCE OF A VALID
OWNER:
INSTALLER:
A~:iDRESS~
DRESS: Q
PHONE NOS._~~ ~~ ~
~.-------_ PHONE NOS. ~~a --~~'~
LOCATION OF INSTALLATION:
YEAR BUILT ........................................~...........~.................................,.:...,........................,.........
»•....... BEDROOMS X COMPUTATIONS i = ~ TOT
• .... ....... F
» . .........
-
D NCE
REST E INFORMATION
...................•.. ..X.. .......................,...............................
AL DAILY FLOW
1980 or
older
'
...........
....
..... .........,.,...........................................
150 gallon
per bedroom
~,..~.. ..............~
..
..
- ..... ...........~........,..-.........".... ....
GARBAGE GRINDER
,
..»
.,.. ,
x
1981 •1991
'
...~ ........................................
...».
130
- INSTALLED?
a
.............................
..........»»...... ..... ........................................
gallon per bedroom
1992
................................................................... ..... .......,..,....,..,.,,.............
-present I
,.~...
.,,
»...»
.. .............,....................;
. ......» .. .......................
110 gallon
er b
d
X
SPA OR HOT TUB
_
~
p
..............................................
e
room
...........
................_...........................
I
I INSTALLED?
...........,..........
.....,,.,,,F..........................,.........,...................,
PARCEL INFORMATION: """°"'~°~°`
/ TQPO RAPHY: FLAT ROLLING,,~_ STEEP SLOPE
SLOPE
/ ,SOIL NA~; SAND~_ LOAM .CLAY
OTHER____
/ GROUNDWATER: AT WHAT DEPTH?
WHAT DEPTHS ~DROCK/IMpER~O~I~MATERIAL: AT
/ .DOMESTIC WATER St IPI v; MUNICIPAL WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS
FT. )
/ PERCOLATION TEST: RATE IS
COMPLETED BY A LICENSED PROFESSIONAL ENGINEEIR OR ARCHIT CT(TEST TO BE
PROPOSED SYSTEM FOR NEW CONSTRUCTION: Ail individual sews a dis o )
a licensed professional engineer or architect (unless installed in a Planning Board approved subd vision)eAdd 50y
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
/ S~P_TIC TANK: ivv,~ GALLON (MIN. SIZE IS 1,000 GAL.) TIL FIE D: EACH TRENCH
/ ~TAL SYSTEM LENGTH: FT.
FT. SEEPAGE PIT(S1: HOW MANY? ,~~= 3~ ~ ~$~,~ p~
/ SIZE OF EACH FT. X _______FT. v
/ SIZE OF ST NE TO BE U~Fn• #
__ /DEPTH OR THICKNESS FT.
/ ~D_ SYSTEM SIZE: ~X~
/ ALTERNATIVE SYSTEM:
LENGTH AND/OR S/ZE
/ HOLDING TANK SYSTEM: (If required) NO.OF TANKS:
/SIZE OF EACH
/ GALLONS. /TOTAL CAPAC/TY.• GAL.
NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY~A TOWN
I APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST P
...,.,.,.,.~ ..:...:...........:.:.:...:.:.....:.......::....:.:. . . :. . „. ROV I DED.
For your protection, please note that pursuant to Section 136.-29 of the Code of the Town of Queen
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 ali requirements of the Town of
Queensbury Sanitary Se ge Disposal Ordinance.
Si ure o o ®sponsible Date
QUESTIONS ? CALL 761.8256 OR EMAIL
codes~Taueens_ bur., rtet
VISIT OUR WEBSITE FOR MORE INFORMATION
www gueenaburv net
Town of Queensbury • Community Development Office • 742 Bay Road, Qaceensbu , NY 12804
Septic Inspection Report
Office No. (518) 761-8256 ~~ In n ~
Queensbury Building & Code Enforcement Arrive:
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia
NAME:
LOCATION:
RECHECK:
~~
s/31o~
ie`e a
NO.: _..1~1
ON:
L.Ir~ ~E~ ~`~5 ~~
~~
~ ~ ~~ ~ ~~~
ea please call the Building & GxJes Office
Approved a to be reinspected,
Last revised 021006
bast revised 1/6/05
Septic Inspection Report
Office No. (518) 761-8256 Dail Inspection i
Queensbury Building & Code Enforcement Arriire: ~:L~
742 Bay Rd., Queensbury, NY 12804 Inspector's Initia
NAME: ~~ •~C +~ E~ ~
LOCATION: ~' *~~N'a~ ~.
RECHECK:
Front Rear Left Side Right Side
am/pm
r
Middle Front dle Rear
m
Approved p~~ call the Building & G~des Office
Partial Approved and needs to be reinspected,
Disapproved
Last rev€sed 021006
Last revised 1/6/05
In Outlet Pi & Baffles Y N
Location of System on Property:
Front ea Sid Right Side
Middle Front Middle Rear
In Outlet Pi & Baffles Y N
Location of System on Property: