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2002-263 TOWN OF QUEENSBURY 742 Bay Road,,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518)761-8256 BUILDING PERMIT Permit Number:, P20020263 Application_Number: .A20020263 Tax Map No: ' 523400-308-016-0001-052-000-0000 Permission-is Hereby granted to: RICHARD & GLORIA MONROE For property located at: 370 CORINTH 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. Type of Construction Value Owner Address: RICHARD& GLORIA MONROE Septic Alteration Residential 370 CORINTH Rd Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name f Address Electrical Inspection Agency SANITARY SEWER DAN DRELLOS PO BOX 224 GLENS FALLS NY Plans &Specifications 2002-263 SEPTIC ALTERATION AS PER;PLOT PLAN SPECIFICATIONS $25.06; PERMIT FEE PAID- THIS PERMIT EXPIRES: Thursday,April 17,2003 (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 Town of Queensbury; Wednesday,April 17,2002 SIGNED BY 11 for the Town of Queensbury. Director of Building&Code Enforcement, :.518 745;-4437. _ FILE No.638\04i02 '02 AM i;i 1 25' I D;TOWN OF QUEENSBURY FAX 518 745 4437 PAGE 1 Y ; t I "Application,for.Permit—Septic i3ispvtsgl System Town of Queensliury 742 yRoad Qaeansbury,NY 1?SO4. (318)761-8TS6 1. O'WNER ii ORMATION Otto � '�. ,�!f� ce Uae . Location'<of izistmUatiosi File.P•ezrmitl�ta: Tax Map No 1 J Fee F Paid Owner's Name- t1 _.......:..::... . ......._....._ Address: 7 Q . `-Z : PHONE NO 2. INSTALLER S NAME : d �� 3. RESIDENCE INFORMATION: {circle year of dwelling,indicate.#bedroom(s) and multiply,# Of bedrooms.with applicable gallons per bedroom to equal total daily,�low)APR 16 2002 Year of House:-, No afBedrooms x Comy�x td4>l=. 'total Oaily Elm TOT OF QUEENSIBURY 1980 orblder 21: ' x 150 gaVbdrm s _BUILDING e4fVQ CODE 1980-1991,._.. , ;.• x 130 gaUbdrm = 1991 Present Garbage x 110 gallbdrm ■- . Garbage orinder,kixtalled ` yes _ I no Spa or Whirlpool Installed yea '_ Y no 4. PARCEL INFORMtATIC1N (circle applicable information 8s indicate measurements) a at what depth at what depth Rglltng aaM w Pest feat- well Steep sloe a .afWell,water supply P P y from any Sep He . ___ 'gib slope other absorptions . j: epth: other, Percolation Test: (To be completed by.licensed professional engineer or arFhitect} Rate: • minute per.inch S. PROPOSED SYSTEM: For N=Coal K ction: All individual sewago disposal systems must be designed by a•licensed pro�sa;oral engiisear'or architect(unless'installed In a Planning Boa=d appsovad aubdivisioit). Add 230 gallons to tl�o size, of the septic tank and leach ld for euch�arbage C_9rinder.Spa or Whirlpool'nst+.- Septic Tank:1 � gallon(min:-size 1,000 gal.) Tile Field: each trench+-�.1? Total System Length: Seepage Pit(a) number, sloe of each: ._,__.__.f; by�}} Size of Stone to be used. # t depth or thtakness: lest Bed System Size: x Alternative System:,` length and/or size 6.' HOLDINCI TANK SYSTEM:. (if required) Number of tanks;,,--!s - /'Size of each: gallons. /.TOTAL Capacity; gallons Note• Alarm Syrtem and associated electrical work must be inspected.by a Town approved electrical pe6tion'agency. 7. SI{}NATURE &-INFORMATION FOR RESPONSIBLE FERSON.(please read)-'' For-,your protection,please note•that pur*usnt to Section 136-29•of the Code ofthe Town of Queenaburyr,any per}iiit or approval grarned which is based upon or is seamed in reliance'upots oily material misxepreaentation or failura to make'a material thct or isirctunstance known by or on hehali of an applicaxtt; akie►il be void. I hnva end the gulations with ' act to this a placation'aand agree to abide by these end all requir l' of ei.`r'own of Q,� Miry Slur ry Sewage Disposal OrdinanC . ip ature.of respo llsible person pate ' R .0, lo� 4J 0 4l 0 0 "CS 4J 0 4) OJ nr. 0de lu 4• = Ul " r ` ` a. ,► U z W x ( No w 4J - Cn N 4J 0) C rd � C c ro Ck 0 U �V)W I LU LU or I,- 'r r-�{� 00 ^r I x L or W N tL 0 P4J \ z S. 0 4J 0 !� rw M C -P0. W J'r C C i» U! u i 0 0 4 0 Z 4- 0 0 N� }� 0.0 or' NI ``r Vy �'""' r, ,�,I "C M 'r" "7 1— <a. S�,U) r � C Q ` . 0 wJCu LL0 v>' t` RS } WaU1w0 •• I r< 0. Q 101 0 0. � , L6ro c C4J0ro� 4J � 0 0Z � w roV) 0 �. 0� rovl4JOW u1U. 00c . U !� da �1� Ol I_ 'r" u? V) CCCro0C00 W ' W 0 or- (A 4- LL N C rX i, 0 0 0 0 0: S.. 11 V) r v C A» r1.4 0 4" t h 0 0 0 (A LL V) "� r 1y�p aw1- (`' 0 (1.W ;nc-- 4J 0m 04J Cy.� ) � �it 0 { E 1 u� 1 �tM 6 CL 4 .0 It 0) S- 0 E• U 4J r W W 0 ro 0 0 WC toP0L0Z04M.Y. +� c< C4. ro4- c*0 #� w U +) 4• LL (AC11NWN0CL-0CW0 000„ CU ,r070 X �S 0 it 0 Wor �oM 0 0'rW -r_ 4Jbr- 0 'r CL 0 0 Q; 00 U S.itO 0 SID BE D � 1000 TOWN F UE�143B ICY BUILDING REVIEWED BY ©ATE 3000 GNV )NIG-1irifa L I mneSN33n6=10 NM01 ZOOZ 9 T ddV 'I have seen or observed, or believe I saw evidence of, cts4M' es,wells, trees, fences, etc., sh wn also represe that I have p rsona lyistances forth on the d' gram." DATE