2001-285 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010285 Application Number: A20010285
Tax Map No: 523400-091-000-0003-031-000-0000
Permission is hereby granted to: FRANK& PAULA BATTISTE
For property located at: 6 MIDNIGHT 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: FRANK&PAULA BATTISTE
6 MIDNIGHT Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
FRED SMITH EXCAVATION
Plans &Specifications
2001-285
SEPTIC ALTERATION AS PER APPLICATION
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,May 11,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Tow,e-i eensb ; Fri , ay 11,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
• • . , • • Application for Permit.—Septic Disposal Systein. .
Town of.Queensbury 742 Day Road Quequsbury, NY, 12804 (518),761-8256
1..OWNER INFORMATION: • /
•
Location of installation: . 6.M 1.01fi W-/- •;D. k . • • Office Use
• • .
Tax Map NO. /, • / File Perinit
• Fee Paid ° • ••
. • Owner's Name: VP()k -441 P-77° /. 4771-7 Sie"
• Address: s.ornc- - •
•2. INSTALLER'S NAME ! •teEd Srr 1-711 . - . PHONE NO. 19 F/F
• 3. .RESIDENCE INFORMATION:. (circle year of dwelling, indicate#bedroom(s) and Multiply.II of
bedrooms With applicable gallons per bedroom to equal total daily flow)
Year of House:• No. of Bedrooms x Computation = • Total Daily Flow
1980 or older. • • - - x 150 gal/bdrm =
1980—1991' • . . - • x 130 gal/bdrm N•4 •
1991 —present. - . 110 gal/bdrm
• .• . I 2001.
Garbage Grinder Installed yes • / no RECPvED
°<-
• Spa or Whirlpool Installed yes . / no MAY-1 f
OF a iEnv IPVE_
4, PARCEL INFORMATION: (circle applicable information & indicate theaSureMents). TOWN • 4 "—•
BUILDING AND COD
QiWittlk9_ SarstuRstWItt.ot. Domotic_NotOr.$wply
calf al what depth at what depth mantel'al
Rolling • loam . fret •• feet. • we -
Steep slope clay - if well; water supply
%slope other . from,any septic-system
depth: absorption is . ft.
other .
Percolation Test: (To be completed by licensed professional engineer or architect)
'! • • Rate; minute per Inch
. • 5. .PROPOSED SYSTEM: For New Conitniction: MI individual sewage disposal systems must be designed by a licensed
professionalefigineet or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons lo the sin
• of the septic tank and leach field for each dai:bagc Grinder, Spa or Whirlpool Tub.
- ,EXI-S-PY1 Q
• . .Septic Tank: )
ODD gallon (min. size 1;000 kaL)
Tile Field: each trench 10 fl. .1 Total System Length: c9 6
Seepage,Pit(s): number of - size of each: . ft. by • ft.
Size of Stone to be used: -II / depth or thickness.;
Bed System Size: . x
•
Alternative System: length and/or size . -
6. HOLDING TANK SYSTEM: (if required) -
Number of tanks: / Size of each: - gallons /TOTAL Capacity: gallons
Note: Alarm System and associated electrical work must be inspected by,a Town approved
electrical inspection agency. -
..; 7, SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)•
For your protection, please nate that pursuant to Section 136-29 of the Code of the Town •
of Quoensbury, 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 regtaations with respect to this application and agree to abide by these and all
requirements -ro of QueensburySamtary Sewage Disposal Ordinance.
gi" 'C-/6?) •
Signature of responsible person ate
PliWim. -------- 2.5(?IV\ 1
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location 1W aNc0 ri ,
Date g' ) O () IPermi t !------A('
SOIL TYP SaLo m-Clay-
Results of Percola ion est-
(if applicable) Ra e-Min. te/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length )I
Length of each trenc -•, LACV
Depth of trenches • ' -
Size of stone '
SEEPAGE PITS: Number mill
-
Size - ft. x Mil t.
Stone size
PIPING: S ic Type
Bldg. to Tank �,. -`%►.;G
Tank to Dist. Box ° " V\ G___
Dist. Box to Field/Pit " ilwc_ 62
Openings Sealed? ' 'No P.rtial
LOCATION/SEPARATIO ' .
Foundation to Tank �y15 fee-
Foundation to Absorption _Z.p feet
\
Separation of Pits -- _ feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Fron addle Rear j
COMMENTS: >
•
—2)14D
SYSTEM USE APPROV 1 (:::]YES
Arriv-j ,r
0(
iglil
. i✓ / / r
/ Building" sector
l
"I have seen or observed,or believe I saw evidence of,
-9 all objects such as houses,wells,trees,fences,etc.,
shown on this do ument. I also represent that I have
1 rson ally m red Vie dis nces set forth on the dia am."
TOWN 07 CUEyNFAIR`r BUILDING DEPARTMENT ', -- f
Based on our limited examination, SIGNATURE ATE
compliance with our comments shall Q 0 0 0
not be construed as indicating the
plans and specifications are in full
compliance with the code.
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BUILDING p I.
REVIEWED BY
DATE • . 's1
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