2002-842 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 -
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020842 Application Number: A20020842
Tax Map No: 523400-301-017-0002-029-000-0000
Permission is Hereby granted to: SANITARY SEWER
For property located at: 6 ALGONQUIN 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: EMILIO &JENNIFER CASALE
6 ALGONQUIN Dr Septic Alteration Residential
Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name/Address Electrical Inspection Agency
SANITARY SF,WF,R
DAN DRFLLOS
PO BOX 224
GUNS FALLS NY
Plans&Specifications
2002-842
Residential septic alteration per plot plan and specifications.
$25,QQ PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,October 09,2003
(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 T , October 09,20OZ
rT;tW
&SO7
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
518,745 .4437 �
. FILE No.638 04, '091 A 11:25 `I Il':TOWN OF QUEENSBURY FAX 518. 745 '4437 PAGE ' 1
OCT 0 .4 20O2,
ApgUCAtiotit Mor'Permi7t—SOpt10 01800 09 Systsm
Trnvn of
,Que6nsbury' ��4a Bco,Road Quasnxbury. zsaTOWN 0 C t� cNSODE
BURY.
..,....,..__.., _
UI�DIi�G �ID ,
1, O'WNER INFORMATION -B/: �""..»«.".,.....
.af
Utttoa sc d
Location'of installation° /.
File Permit No° h
Tax'Map Na, ! /
Owner's Name' _ „.
Address:
2. INSTALLER'S NAME '' P.HONENO "
3. RESIDENCE n MOR)AAsTION: (eir6le y ar of dwelling,indicate#bedroo»i(s),and multiply# of
bedrooms with,upplicable'gallc!"J per bedroom to equal total daityfiow)
Year of House No of Bedrooms x onmUtatigil ad ToftW 1294v Flay4c'-
1980 or older x- 150-gaVtidrm
.. .
1980—1991 x 130 gal/t drm _
1991 —present x I gal/bdrin s
Garbage Grinder Installed yes_ L no
Spa or Whirlpool Installed yes i, / no
4. PARCEL INFORhjATTON: (cirole applicable information indicate measurements)
crud at what depth. at what depth munivi al
ing we
Steep slope clay - ifwell;water supply `' r
%slope other from anyseptiq-Jystem' ..
'depth: absorption is
other
Percolation Teat: (Tabs completed by licensed professional engineer or arphitect}
Rate: minute per inch
3. PROPOSED.SYSTEM; For MM Coe ruction: All individual***ago disposal systems must be designed by a licensed
.professional engineer orarchitect•(unless.installed in a Pim-Ang.Board approved subdivision). Add 230''gallons t.o tho size
of the septic tank a nd,leacch field fir each
Garbago arindor,Spa.or Whirlpool Tub. f
i U� 11 min:size 1,OOl7 al. x
Septic`Tank: l._ ._ _S (alp
Tile Field:.-each trench j ' Total System Length:
Seepage Pits}: . number of size ofeaeh: 1t by R.
Size of Stcnato be-used: 0 t depth or thickness feet
sea System Size: z
.Alternative System' +. length andlor.size,
6. HOLDIN07ANK SYSTEM: (if squired)
Number of tanks: / Size of each: gallons /TOTAL;Capacity: gallons
Notii; Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7.' SIGNATURE 4 INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection,please note that pursuant to Section 136-29 of the Code of the Town
of Queensbury;any permit dr approval granted-which is based upon or is granted in
reliance'upon any material misrepresentation or failure-to make a material fhct or
circuum"Mco-known by_or on behalf of.an applicant, shall be void.
I havo , 'd.the lations,with to this application and agree to,abide bythese and'all
requir ents r e.ToWn of Qu . b San' Sewage imsposal Urdiraoun,
1gj#ture of tospona ble person l7ets
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RECENED
OCT 0 4 2002
TOWN OF QIJI ENSBURY
BUILDING AND CODE
s
lL
TOWN01 QUEE:SBURY
BUILDiNG
REVIEWB
have seen or observed, or believe I saw evidence of,
.,olects such as houses, wells,trees,fences, etc., DATE /
„.,,vn on this docu ent. so represe t that l have
,so ally measure d' ante forth on the iagram."
/0
SIGNATU E DATE
t'