2007-274TOWN OF QUEENSBURY
742 Bayltoad, Queensbury, NY 12804-5902 (518) 761-8201
Community Development -Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070274 Application Number.
Tax Map No: 523400-301-007-0001-028-000-0000
Permission is herebygranted to: DOUGLAS & JOANNE IRISH
For property located at:
8 BUENA VISTA Ave
A20070274
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. T3~e of Construction Value
Owner Address: DOUGLAS & JOANNE IRISH
8 BUENA VISTA Ave
QUEENSBURY, NY 12804
Contractor orBuilder shame /Address
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Septic Alteration Residential
Total Value
Electrical Inspection Agency
Plans & Specifications
2007-274
C ALTERATION RESIDENTIAL
$25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Wednesday, May 14, 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 ensb M~dd ,May 14, 2007
SIGNED BY ~° for the Town of Queensbury.
Director of Building & de E orcement
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APPROVALS: ZONING ~ ' f•1
TOWN ~ '
' CLERK
APPLICATION F012 SEPTIC DISPOSAL SYSTEM PERMIT: °DD~
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS. APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER: ~ V Q, ~~` ~'S~ 1J h INSTALLER: /fl/T ~Q,w ~
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ADDRESS: _ ~ ~ f °L 1~ ~ ~/J'i'b-- ~}-c,l~ ADDRESS: ~ ~ O ~ ~~
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PHONE NOS. ~ 7 ~ ~' ~ ~ ~~ PHONE NOS. ~ / ~° ~ v !~ ~~
LOCATION OF INSTALLATION:
NO. OF .................................................I..................................................................,....,.,.............
YEAR BUILT ~ BEDROOMS X ~ COMPUTATION= I = RESIDE E INFORMATION.
.................................»......»...........,............ ~ TOT
AL DAILY FLOW
. .I ...........................................................................!f...........,............
V ... ...
1980 or older X 150 allon er bedroom i NARBAGE GRINpF,.,R,
.. ........................ g P l ;~y ..................................
» ....... .........».»..».................... , ........... I STAL
1981 -1991 ...................»g.............p...................................~...._ .,,,.............................................
......1....... '•. LED?
X 130 ailon er bedroom ~~~~~~~'~"'~'~
' .............................................:......................i...................................................................................... TUB
PA OR HOT
1992 -present ~ X 110 gallon per bedroom I : I
........»....»»» ......................................................................... . INSTALLED?
PARCEL INFORMATION:
/ TOPOGRAPHY: FLAT R ING STEEP SLOPE
. ~ /aSLOPE
/ ,SOIL NATURE: SAND LOAM CLAY OTHER
/ GROUNDWATER: AT WHAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT
WHAT DEPTH
/ QOMESTIC WQT~'R SUPLY: MUNICIPAL / WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS F'I' )
/ PERCOLATION TEST: RATE IS PER MIINUTE PER INCH (TEST TO BE
COMPLETED BY A LICENSED PROFESSIONAL ENGINEER OR ARCHITECT)
PROPOSED SYSTEM FOR NEW CONSTRUCTION: Ali 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 IN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT.
/ TOTAL SYSTEM LENGTH: FT. SEEPAGE PIT(S): HOW MANY? 1i
/ SIZE OF EACH~FT. X __s~___,FT.
/ SIZE OF TONE TO BE USED: #~_ /DEPTH OR THICKNESS Z FT.
/ BAD SYSTEM SIZE: X
/ ALTERNATIVE SYSTEM: LENGTH AND/OR SIZE
/ HOLDING TANK SYSTEM: (If required) N0.OF TANKS: /SIZE OF EACH
/ GALLONS. /T'OTAL 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 requirements 'of the Town of
ensbury Sanit y swage Disposal Ordinance.
~/0~
S nature of Per Responsible Date
QUESTIONS ? CALL 761-8256 OR EMAIL
~des~aueensburv net
VISIT OUR WEBSITE FOR MORE INFORMATIgN
www.gueensburv net
,F~; Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury; NY 12804
L.._-~-.__-
Septic Inspection Report
Office No. (518) 761-8256 Date Ins
Queensbury Building & Code Enforcement Arrive: ~'e-
742 Bay Rd., Queensbury, NY 12804 Inspector's
NAME: _1_ ~t~~
LOCATION: _~~~ ~ ~l t~-+~____
RECHECK:
Soil T Sand Cla
T of Wa unici Weli Water
Waterline se ration distance ft,
Well separation distance
Other wells: ft,
ft,
Abso Fiek1: Total len ft,
Le of each trench ft,
De of trenches ft,
Size of Stone
Pits: Number
Size• x
Stone Size:
Pi i Size T
Buikii to tank ~~
Tank to Distribution Box <<
Distribution Box to Fie Pit ~~
0 ni Sea Partial
End Ca
Location Se rations
Foundation to tank ft.
Foundation to abso ' n
Se ration of Pits ft.
Conforms as r Plot Pian Y N
En ineer Re rt and As-Built Y N
Inl Outlet Pi & Baffles Y N
Location of System on Property:
~ 4~
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No.. n7 - ?_~y
' ON: cS'-LS--p'7
Fron Re Side ht Side
Middle Front fiddle Rear
Approved
Partial Approved and needs to be re-inspected, please call the Building & Codes Offloe
Disapproved
Last revised 021006
Last revised 1/6/05
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BUILDI-VG hND CODE
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