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2007-275a 00 ~ O O ~ N ,Q ~O ~ ~ W W ~ v ~ ° ~z ~ V ~ W ~~ ~ ~ ~w N ~ i~ E~ d ~ ~ ~ w ca ~ "v O ~,., 0 ~ O~ ~ ~ ~° a~ A ~ ~ 'd +~ ~ ~ ~ ~i -1 ~ o ~ N ~ °° ~' z ~ ~ b ~ ~ o ° ~ ~ ~ .~ No 0?3 v ~ -° ° ~ ~ ~ ~ o h~ V z ~ ''. x x W~~ ~ [~ o o ~ U U O~ ~, w N ~ ^ ~ Q, ~3 ~ A~~~ O d a ~ .~ N a Z ~~~~ p, ~ ~ o a W W ° ~ ~ °" 0 ~ ~ ~ o ~ ~~.~ o~b~ ~. ~ ~ o ~ ~ o ~ cV .~ ~ ~ +; y. eoe oA o ~ a ~ ~ ~ ~ „ y, ~ tin TOWN OF QUEENSBURY 742 Bayltoad, Queensbury, NY 12804-5902 (518) 761-8201 Community Development -Building & Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20070275 Application Number. A20070275 Tax Map No: 523400-289-011-0001-023-000-0000 Permission is hereby granted to: STEVEN & CHRISTINE JOHNSON For property located at: 96 HALL Rd in the Town of Queensbury, to constrict 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: STEVEN & CHRISTINE JOHNSON Septic Alteration Residential 12 WING St Total value GLENS FALLS, NY 12801 Contractor or Builders Name /Address SHAWN MCKENNA 10528 STATE ROUTE 149 FORT ANN, NY 12827-0000 Plans & Specifications 2007-275 SEPTIC ALTERATION RESIDENTIAL Electrical Inspection Agency $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 atthe To af•@u~ensbt Monday, May 14, 2007 SIGNED BY ! ~ ~r w ~ ~`~~ ~ '~ ~ for the Town of Queensbury. Director of Building & Code Enforcement Ir.___r_..~..._.a._r.r_s .............r. _...__.._.._.. _.....___. _.....i r...r.................r ' OFFICE USE ONLY ~ TAX MAP NO. PERMIT N0. RMIT FEE ~ ~ ~ ~ ~ ~ r r APPROVALS: ZONING TOWN CLERK ; % f f"`. ~ i ° - ``'.I J ; . .............. i..TQVYLV.t.... _.~~-y~L1RY APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMI~'UILDING AND CODE A PERMIT MUST BE OBTAINED BEFORE WORK BE(iIN3. APPLICATION 13 SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID PERMR. / A ~ OWNER: ~~ 2 J Q ~ ~n vin S O ~J INSTALLER; ~(rw w ti !~ ~ C ~ ~C ~ 2 W~~ t ~~-~- I ADDRESS: ~ ~~ S l~'h 1 ~ S , ~ y I Z ~ ~ ( ADDRESS: Q ~ Z ~ S . ~ I~ ~'~•~ ~ y PHONE NOS. ~~ ~ '"~ 7 /CCll2 ~ ~ ~ Z ~ PHONE NOS. ~~~ `L{ " 7(a l ^ ~ S ~/y LOCATION OF INSTALLATION: __I ~O ~~ I, ~ 2 ~ n~ . ..»YEAR,BUILT.» ..,.......NO.~OF..»..... .X. ..........COMP ...................................... .... .................................:..........»..................., RESIDENCE INFORMATION: ,,,,, BEDROOMS ..,• „NOTATION^,,,,,4,•. .,:,. „TOTAL DAILY FLOW ...,._.......~ 1980~or older X C#ARBAQE QRINOER ».. .» ..... ...........~............... 150 .gallon,per bedroom ...^.~ ...,...........»~. »p.»~....... ..) INSTALLED? ~v_, 1981 •1991 »X~~ •.,.130 gallon per~bedroom ~~• ~~~: ~ » ~~~~~~~~~••~~~ jl ........................»..........-....................,..............................»».......................................»..........»..............,..,...............,...,........,...........,....,...............................,,...,.,.,; SPA OR HOT TUB 1992 • present X 110 allon er bedroom ^ f INSTALLED? ~_ ».»......_.................».....» ...........,.......................».... ,......» .................. ~............. p............................................... ...............,,.........................»..».................. PARCEL INFORMATION: •~ / .TOPOGRAPHY: FLAT ROLLING~~„ STEEP SLOPE %SLOPE / SOIL NATURE: SAND_,~ LOAM CLAY OTHER Cy~ ~ ~~- n C~.~dN~ / G~,OUNDWATER:'N°~AT V~HAT DEPTH? BEDROCK/IMPERVIOUS MATERIAL: AT WHAT DEPTH? /~ / DOMESTIC WATER SUPLY: MUNICIPAL WELL !~~ (IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS ~ n ~ FT. ) / PERCOLATION TEST: RATE IS_. MIINUTE PER INCH (TEST TO BE COMPLETED BY A LICENSED PROFESSIONAL - GINEER 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: ~ ObU GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH FT. / TOTAL SYSTEM LENGTH: ~ 2-~ FT. SEEPAGE PIT(S): HOW MANY / SIZE OF EACH~Q FT. X S_ FT. / SIZE OF STONE TO BE USED: # ~ /DEPTH OR THICKNESS ~2 FT. / BED SYSTEM SIZ,~: ~Q X ~ ,, / ALTERNA VE S TEM: LENGTH AND/OR SIZE / HOLDING TA SYSTEM: (If required) NO.OF :TANKS: /SIZE OF EACH / GALLONS. OTA CAPACITY.• GAL. T :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 Queers bury, any 1 permit or apps al granted which is based upon or is granted in reliance upon any material misrepresentation or failure to ma a m erial fact or circumstance known by~or on behalf of an applicant, shall be void I have read e r ulations with respect to this application and agree to a i ~ these and all requirements of the Town of QUESTIONS ? CALL 781-as266 OR EMAIL Queens S itary Sewage Disposal Ordinance. codes~aus nsburv,~t VISIT OUR WEB31TE FOR MORE INFORMATION ~'~~Q ~ www.aueenaburv.net Sig a of er n Responsible Date Town of Queensbury • Community Development Office • 742 Bay Road, Queensbury, IVY 12804 Septic Inspection Report Office No. (518) 761-8256 Date InsP~,c~il request received: Queensbury Building & Code Enforcement Arrive: ~/ am/pm part: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: -,~,~i~- NAME: ~/ °~I~ ay PERMIT NO.: a G"~ ~ LOCATION: INSPECT ON: s RECHECK: Sal T :Sand Loam Cla T of Water: Munici I Weli Water Waterline se ration distance ft• We{I separation distance Other wells: ft• ft. Abso Field: Total len ft• Le of each trench ft. De of trenches ft• Size of Stone See Pits: Number Size: x Stone Size: Pi in Size Buildi to tank Tank to Distribution Box Distribution Box to Field Pit O ni Sealed: Y N Partial End Ca Inl Outlet Pi & Baffles Y N Location Se rations Foundation to tank ft• Foundation to abso ion ft• Se ration of Pits ft• Conforms as r Plot Pian Y N E ineer Re rt and As-Built Y N Location of System on Property: Front Rear Left Side Right Side Middle Front Middle Rear Comment, andlor diagram A ~~~~ r G ^ ~t~/ 0~ ~l'~7 ``rc' !~ f sv~ v:~- yStpm Use Status Approved Partial Approved and needs to be reinspected, please tail the Building & Codes Office Disapproved Last revised 021006 Last revised i/6/05 Septic Inspection Report Comments and/or diaaram Office No. (518) 761-8256 Date Ins n request received: Queensbury Building & Code Enforcement Arrive: F~~ am/pm Depart: am/txn 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: ~,_ NAME: __ •. ~-- LOCATION: r RECHECK: PERMIT NO.: ~ 7 ^ 7 INSPECT ON: v Soli T Sa Cla T of Water: Munid I Waterline se ration distance ~ ft. Weil separation distance Other wells: ` ft. ft. Abso on Field: Total len ~- ft. Le of each trench ft. De of trenches ft. Size of Stone 2 Pits: Number Size: x Stone Size• Pi Size T Bulkli to tank ~/" UL Tank to Distribution Box " ~ Distribution Box to Field Pit ~/` 0 ni Sealed: N Partial End Ca ~,~ In Outlet Pi & Baffles Y N Location Se rations Foundation to tank ft. Foundation to abso on ft. Se ration of Pits ft• Conforms as r Plot Plan Y N E ineer Re rt and As-Built Y N ~~~//~~~ ~ L 3~/-sS2~ 3 ~ ~ cy33 G~ ~ ~~2 ~~~ ~t sr ,~,~~~f Location of System on Property: Front ~ Left Side Right Side Middle Front Middle Rear system use status: Approved r~ Partial Approved and needs to be re-inspected, please call the Building & Codes Office Disapproved Last revised 021006 Last revised 1/6/OS COMMONWEALTH ELECTRICAL INSPECTION SERVICE, INC. Main Office l76 Doe Run Road - Manheim, PA 17545 MUNICIPA' L CERTIFICATE -ELECTRICAL APPROVAL Permit No7~...~......L;,r..7....`r~., Cert. ~ O 2 2 6 3 Cut-in Card No ..................................... Owner ..................t ~~?L4`7.l1...~ C.7.,e~..................................................................................~~....//........... Location ......~'~..C~........z:~.../.~ ... ...... . L~k...l ................ Installation Consisting of..S.!..C?~'4-:....~~:.:$'r:rr.1....D~..~ .~J.~..r.~'~..(1..E..~ .................................. .............................................~~,f:'.~:71 r,............................................................................................. ....... ... ... ...... . .. . .. .. . . , .~.A . . ..... . ., . ~ ./. .. . ..... . .. . .. ... . ... ... .. ... ... ... ..... .................... .......... . . ... .... . ... ... . ........ .. .... . ... .. ... . . ... . ... . .. . .. .. ..... . Installed By....L!'...'~,".../..~..C~/.U~ ...................................Lic. No................................................... The conditions following governed the issuance of this certificate, and any certificate previously issued is cancelled: - This certificate only covers the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations, application shall be promptly made for inspection. Inspectors of this Company shall have the privilege of ma ' g inspections at any tune, and if its rules are violat©ed, the~Cfompany shall have the right t r ke ertif e. Date...'. ~:!..`..~../ ..................... INSPECTOR ............................................................. .................................. Member N.F.P.A., I.A.E.I. Septic Inspection Report Office No. (518) 761-8256 Date Inspn request received: . Queensbury Building & Code Enforcement Arrive: w,~., am/ Depart: 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: s~~ NAME: LOCATION: RECHECK: Sal T :Sand Loam Cla T of Water: Munid 1 Weli Water Waterline se ration distance ft. Well separation distance Other wells: ft. ft. Abso tion Field: 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 Builds t~ tank Tank to DisMbt,rtion Box Distribution Box bo Field Pit 0 ni Sealed: Y N Partial End Ca In Outlet Pi & Baffles Y N Location Se rations Foundation to tank ft. Foundation to abso 'on ft. Se ration of Pits ft. Conforms as r Plot Plan Y N E sneer Re rt and As-Built Y N Location of System on Property: Front Rear Left Side Right Side am/pm PERMiT NO.: D ~'~ INSPECT ON: ,G/ C~~.O ~ ~ ~~,/~ Middle Front Middle Rear ~ n~~ J r/~ Approved Partial Approved and needs to be re-inspected, please call the Building & Codes Office Disapproved Last revised 021006 Last revised 1/6/05 <~ (+~ ~ -.~. _______~._._._._~_. ~ ~-- _ -- 2 `~ ~ ° `• _~_.. __ _ _ ____ q ~. .-03' 2`~ ~~ _ _ ~ tl N Q l n r`n --.. ~ ~~ d C '~ ~ . ,_ ~_ ~ ~- ~ z -~ ~ ~ _ _ _ n d~ ~ ~ c_, ^ °~ (n '`*~- ~ f ~Z S _ ~. ,. ~. 1 ~G .,~' ~ ~ ~ ~ ra ~. ~ ~ i a ~; ~' ~ _ ~,,~ ~ ~ ,, .. ~ ~~ _ ~ ~ ~ '1 ~.. ~ ~ ~ ~ ~,~a b ~ ~ _ / ~ `~ ~~ ~ r _ is r `, IV G ;; _ IQ7 .,_ Septic Inspection Report Office No. (518) 761-8256 Date Inspection request received: Queensbury Building & code Enforcement Am~e: am~part: am/pm 742 Bay Rd., Queensbury, NY 12804 Inspector's Initials: NAME: O PERMIT NO.: ~ ~ '~ LOCATION: INSPECT ON: RECHECK: Safi T :Sand Loam Cla T of Water: Munici i Well Water Waterline se ration distance ft. Well separation distance Other wells: ft. ft. Abso Field: Total len ft. Len of each trench ft. De of trenches ft. Size of Stone See Pits: Number Size: x Stone Size: Pi i Size T Buildi m tank Tank to Distribution Box Distribution Box to Field Pit 0 ni Sealed: Y N Partial End Ca In Outlet Pi & Baffles Y N Location Se rations Foundation tD tank ft. Foundation to abso ion ft. Se ration of Pits ft• Conforms as r Pbt Plan Y N E ineer Re rt and As-Built Y N Location of System on Property: Front Rear L Side Right Side Last revised 021006 Comments and/o~diaaram Close. o ~~ Middle Fro Middle Rear Approved Partial Approved and needs m be reinspected, please call the Building & Codes Office Disapproved Last revised 1/5/05