2007-222TOWN OF QUEENSBURY
742 BayRoad, Queensbury, NY 12804-5902 (518) 761-8201
Permit Number:
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
P20070222 Application Number. A20070222
Tax Map No: 523400-289-007-0001-012-000-0000
Permission is hereby granted to: PETER &WANDALEE ROZELL
For property located at:
47 REARDON 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. Tyke of Construction Value
Owner Address: PETER &WANDALEE ROZELL
47 REARDON Rd
QUEENSBURY, NY 12804
Contractor orBuilder shame /Address
ROZELL INDUSTRIES
145 PARK ROAD
QUEENSBURY„ NY 12804
Septic Alteration Residential
Total Value
Electrical Inspection Agency
Plenc Rr 4r~rificari~ns
2007-222
ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Sunday, May 11, ZUUB
(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 ee Flri y, May 11, 2007
SIGNED BY for the Town of Queensbury.
Director of Building Code nforcement
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APPROVALS: ZONING
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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: ~~e ~ ~d °Z'~ ~ INSTALLER: ~O sZ ~~~ ~ ~~~~~~ ~~
ADDRESS: ZL ~ ~~"~~~n ~ ~ Q~,~ ADDRESS: ~/~/ < ~~~ /~ ~JN /
PHONE NOS. ~~.~"" ~ T~ ~ ~A1C ~/-68~/ PHONE NOS. ~/~~ ~~3 ~ ~'rLL ~~ `Cj~/
LOCATION OF INSTALLATION: ~~/~ /~c',~6~,/~~~~ w~~N.~!/~,Y
.................................................3.......BEDROOMS...... ...................................................................................i....~...€.........................................................................~ RESIDENCE 1 RMATION.
:•••• NFO
•YEAR.BUILT ~ .X i COMPUTATION= ! TOTAL DAILY FLOW
.................:.............................................i. ....g..................................... .......5...........~............ .....................................................t GARBAGE GRIND,E,~j
1980 or older ~ • X ; 150 gallon per bedroom ; _ ~SU INSTALLED?
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
i.........1981....1991..........' _ ....................................................................1
- `• :. X 130 gallon per bedroom I ~ SPA OR HOT
I ..................•.............................9.......•.....••..•............................<. ....9...............................•......•..••..............................~........... .........................................................................~
1992 -present ' X ' 110 gallon per bedroom ~ _ ~ INSTALLED?
................................................ a..............................................1............1..........................................................................,...........,..........................................................................1
PARCEL INFORMATION:
/ TOPOGRAPHY: FLAT ROLLINGSTEEP SLOPE %SLOPE
/ SOIL NATURE: SAND LOAM / CLAY 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: cOr~ GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH Sv FT.
/ TOTAL SYSTEM LENGTH: Z ~ v FT. SEEPAGE PIT(S): HOW MANY?
/ SIZE OF EACH FT. X FT.
/ SIZE OF STONE TO BE USED: # ~ /DEPTH OR THICKNESS FT.
/ BED SYSTEM SIZE: X
/ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
/ HOLDING TANK SYSTEM: (If required) NO.OF TANKS: /SIZE OF EACH
/ GALLONS. /TOTAL CAPACITY.• GAL.
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 requireme is of the Town of
Oueensbury Sanitary Sewage Dis o al rdinance.
QUESTIONS ? CALL 761-8256 OR EMAIL
codes®aueensburv.net
VISIT OUR WEBSITE FOR MORE INFORMATION
www.aueensburv.net
Signature of Person Respolf';ible Date
.J~; Town of Queensbury • Community Development Office ~ 742 Bay Road, Queensbury, NY 12804
Septic Inspection Report /
Office No. (518) 761-8256 Date Ins r
pection request received: ~ D~]
Queensbury Building & Code Enforcement Arrive: am/pm Depart; ' /
742 Bay Rd., Queensbury, NY 1n2804 Inspector's Initials: ~-- am/
NAME: _ !~-t3 Z -~. j / E
LOCATION: s~~[~
RECHECK:
Soil T Loam Cla
T of Water: Munici 1 Weli Water
Waterline se ration distance ft.
Well separation distance ft
Other wells: .
ft.
Abso tion Fiek1: Total len h ft.
of each trench ft.
De th of trenches ft.
Size of Stone
See Pits: Number
Size:
Stone Size: x
PERMIT NO.: ~ ' ZZ-Z
INSPECT ON:
Comments anther rii~~
Pi n Ze T
Buikii to tank
Tank to Distribution Box ~
Distribution Box ieid Pit
0 nin Sealed. N Partial ~--
End Ca
In Outlet Pi & Baffles N
Location Se rations
Foundation to tank ft,
Foundation to abso tion ~-- ft,
Se ration of Pits ft.
Conforms as r Plot Plan
E ineer Re rt and As-Built Y
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Location of System n Property:
Front Rea Left Side Right Side
Middle Front Middle Rear
~ m
Approved
Partial Approved and needs ~ be re-inspected, please call the Building & Codes Office
Disapproved
Last revised 021006
Last revised 1/6/05