2007-286 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20070286 Application Number. A20070286
Tax Map No: 523400-301-017-0001-028-000-0000
Permission is hereby granted to: WILLIAM &HOLLY ALDRICH
For property located at: 4 MORGAN Dr
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. Type of Construction Value
Owner Address: WILLIAM &HOLLY ALDRICH
4 MORGAN Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total value
Contractor or Builder's Name/Address Electrical Inspection Agency
QUEENSBURY SEWER
JAY SWEET
Plans &Specifications
2007-286
septic alteration
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Sunday, May 18, 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 o Bens id ay 18,2007
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
�' ." v 'I'^ _ .___ ++"' . % , """'"""'-���
l 12� 5' OFFICE USE ONLY
TAX MAP NO. PERMIT NO /�*
ERMITFEE �; o REC711VED
0
APPROVALS: ZONING10
TOWN CLERK ;
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"'--------------------- � 'i�n1��,.�. _ _
BUILDING AND CODE
ARV �
APPLICATION FOR SEPTIC DISPOSAL SYSTEM PERMIT;I rI II
A PERMIT MUST BE OBTAINED BEFORE WORK BEGINS.APPLICATION IS SUBJECT TO REVIEW BEFORE ISSUANCE OF A VALID
PERMIT.
OWNER:
INSTALLER:
ADDRESS: ADDRESS: t
PHONE NOS.- I
PHONE NOS.
LOCATION OF INSTALLATION: 3 _ �I S 2
_................................................................................ ...........
/ J
......................................................................................r...........;.....................,............,.:.....................................
YEAR BUILT NO.OF RESIDENCE INFORMATION:
BEDROOMS X COMPUTATION- -
.".............•.•............................. _ TOTAL DAILY FLOW
i
1980 or older 1.......:.............................................................................�............ ....................
."."..._...............".........._........ X 150 gallon per bedroom GARBAGE QRIND
....... -
1981 -1991V. ...................................;....,...,..j.... �,. ....Q INSTAL
t............I............... 130 gallon per bedroom..........I......................X.....................,..,..................................................... -
1992 resent ' --/�
....................................................................................
»......"p...................... ........ �. X 110 gallon per bedroom
PA OR HOT TUB
INSTALLED?
PARCEL INFORMATION:
✓ TOPOGRAPHY: FLAT ROLLING
STEEP SLOPE %SLOPE
✓ SOIL NATURE: SAND LOAM CLAY OTHER
✓ GROUNDWATER: AT WHAT DEPTH?
WHAT DEPTHS BEDROCK/IMPERVIOUS MATERIAL: AT
✓ DOMESTIC WATER SUPLY: MUNICIPAL WELL
(IF WELL: WATER SUPPLY FROM ANY SEPTIC-SYSTEM ABSORPTION IS
FT. )
✓ PERCOLATION TEST: RATE IS I..
COMPLETED BY A LICENSED PROFESSIONAL ENGINEEPER RNUTE PER INCH OR ARCHITECT)TEST TO BE
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 TAN • O!of GALLON (MIN. SIZE IS 1,000 GAL.) TILE FIELD: EACH TRENCH.2 FT.
✓ TOTAL SYSTEM LEN TH:12—* FT. SEEPAGE PIT(S): HOW MANY?
✓ SIZE OF EACH FT. X FT.
✓ SIZE OF STONE TO BE USED: #_2 _/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.
:.......:.............:.....................,...:.,.,:.:.............................,.................:.:.:.,.:.:...:.............,...:,:...,.....:,,...,......,:.:.:.,.:.:::.:.,".:...........:.:.:.:.,.,.:.:.,.,.:.,.:.:.:.
APPROVED ELECTRICAL INSPECTION AGENCY. PLEASE REVIEW LIST PROVIDE NOTE: ALARM SYSTEM AND ASSOCIATED ELECTRICAL WORK MUST BE INSPECTED BY A TOWN
D. 11
..:.:..:.:.::.:.:. : .:..........:::....,. . u
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, an
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 (4i4g
1-8256 OR EMAIL
Queensbury Sanitary Sewage Disposal Ordinance. s ury net
ORE INFORMATION
bgty net
Signatur Per n Responsible Date
Town of Queensbury • Community Development Office - 742 Bay Road, Queensbury, NY 12804