2007-202TOWN OF QUEENSBURY
742 Bay Road, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070202
Application Number: A20070202
Tax Map No: 523400-301-007-0002-027-000-0000
Permission is hereby granted to: CHARLES B KING
For property located at:
246 AVIATION Rd
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. ape of Construction
Owner Address: CHARLES B KING
246 AVIATION Rd Septic Alteration Residential
QUEENSBURY, NY 12804-0000 Total value
Contractor or Builder's Name /Address
Value
Electrical Inspection Agency
Plans & Specifications
2007-202
SEPTIC ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday, May 03, 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 T n o ueen ry;~ S ,May 03, 2007
SIGNED BY t.~ ~~V'( for the Town of Queensbury.
Director of Building & Code Enforcement
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APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT:
A PERMIt MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: ~ INSTALLER:
ADDRESS: ~ -`ICJ ~' UIQ~~ f L~
ADDRESS:
PHONE NOS. J ~ ! ' ~ ~1"J
LOCATION OF INSTALLATION:
PHONE NOS.
i ..... F .............................................................................................................................................................................~ IDENCE INFORMATION.
I YEAR BUILT I NO.OF X ; COMPUTATION- I - ~ TOTAL DAILY FLOW I
BEDROOMS ~ I -
..............................;...........i.......................................................................... GARBAGE GRIND~E~t
1980 or older 3 ; X 150 gallon per bedroom ~ = I 0 I INSTALLED? J
1981 -1991 i I X 130 gallon per bedroom ~ •••.~•~~~~.~~~~~•~••~~~~~~~~•••••••~••- I S
I .............................................._;............................................. «.......... ~ ......................................... ..... ......_........................................................... i OR HOT
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1992 -present . ~ X I 110 gallon per bedroom _ ~ ~ INSTALLED? ___Lr~
PARCEL INFORMATION:
/ TOPOGRAPHY: FLAT ROLLING ~ STEEP SLOPE %SLOPE
/ SOIL NATURE: SAND LOAM~_ C Y OTHER
/ GROUNDWATER: AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH?
/ DOMESTIC WATER SUPLY: MUNICIPAL, WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS FT. )
/ PERCOLATION TEST: RATE IS ~ _ ~ PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: All individual sewage disposal systems must be designed by
a licensed professional engineer or architect (unless installed in a Planning Board approved subdivision). Add 250
gallons to the size of the septic tank and leach field for each garbage grinder, spa or whirlpool tub.
/ SEPTIC TANK: ~~~~+ GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH •~~ FT.
/ TOTAL SYSTEM LENGTH: ~ ~y FT. SEEPAGE PIT(S): HOW MANY?
/ SIZE OF EACH FT. FT.
/ SIZE OF STONE TO BE U /DEPTH OR THICKNESS FT.
/ BED SYSTEM SIZE: X
/ ALTERNATIVE SYSTEM: ~ LENGTH AND/OR SIZE
/ HOLDING TANK SYSTEM: {If required) ~. OF TANKS: /SIZE OF EACH
/ GALLONS. /TOTAL CAPACITY.• ~/~ GAL.
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NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDED.
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 QUESTFONS ? CALL 761-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. codes~aueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
~v ate`' www.aueensburv.net
Signature of Person Respo le Date
Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, NY 12804
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~~~ Septic Inspection Report
Office No. (518) 7b1-8256 Date Ins nest received: .
Queensbury Building & Code Enforcement Arrive: '• am/ part:
742 Bay Rd., Queensbury, NY 12804 Ins s In als:
NAME: ,--
LOCATION:
RECHECK:
:s/4/o~.
am/pm
PERMIT NO.: ~~ ~ ~~
INSPECT ON:
Comments and/or diagram
Soli T Sa m la
T o .Muni " Well Water
Waterline se n distance ft•
Weil separation distance
Other wails: ft•
ft.
Abso n Field: Total len ft•
Le of each trench ft•
De of trenches ft
Size of Stone N ~-`'~ ''~ ~
e Pits: Number
Size• x
Stone Size:
Pi i Si
Buildi to tank
Tank to Distribution Box ~
Distribution Box to Field Pit
O i Sealed: Y N Partial
End Ca
In Outlet Pi & Baffles Y N ~ ~ `'
Location Se rations
Foundation ~ tank /5 /N ft•
Foundation to abso tion ft•
Se ration of Pits ft•
Conforms as r Plot Plan N
En ineer Re rt and As-Bull N
Location of Syst n Properly:
Front ea Left Side Right Side
Middle Front Mi le Rear
~yatprr- Use Status•
proved
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Last revised 021006
Z.._ ~jL
Last revised 1/b/OS
Septic Inspection Report
Office No. (518) 761-8256 Date Ins on oast received:
Queensbury Building & Code Enforcement Arrive: am/pm pepart: am/pm
742 Bay Rd., Queensb~u/ry, NY 12804 Inspector' T'nitials: ..-~,_.~(~
NAME: t~ ~~ ~ PERMIT NO.: d~~ ' ~~
LOCATION: V~'r ~~N INSPECT ON: 07
RECHECK:
Soli T :Sand Loam Cia
T of Water: Munici I Weli Water
Waterline se ration distance ft.
Well separation distance
Otfier wells: ft.
ft.
Abso tion Field: Total len ft.
Le of each trench ft.
De of trenches ft•
Size of Stone
See a Pits: Number
Size• x
Stone Size:
Pi in Size T
Buildi to tank
Tank to Distribution Box
Distribution Sox to Field Pit
0 ni Sealed: Y N Partial
End Ca
In Outlet Pi & Baffles Y N
Locatron Se rations
Foundation to tank ft.
Foundation to absor ion ft.
Se ration of Pits ft•
Conforms as r Plot Pian Y N
En ineer Re rt and As-Built Y N
Location of System n Property:
Front R r Left Side Right Side
Middle Front Middle Rear
Comments and/or diagram
(c'c-- ~~
~jq-L. O ~ ~/ G-L....1j
system Use Stag
Approved
Partial Approved and needs to be re-inspected, please call the Building & Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05