Loading...
2000-338 f n jolt t Av 1 C ate of , Complitlinco"e Town ofQueensbury Warren County,New York Date may 19p 2000 This is to Mc�iy tb t work requested to be done as shoe by Permit No, has been completed, SEPTIC ALTERATION This structure maybe used as rv� 7 WHIPPOORWILL RD Location Owner NDULTON, JCHN � NANCY TAX NAP NO, 82A -5w37a24 By Order Town Board T F QUEENS r Director of Buildin'&Cede�'Enforcement . � BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 0 Building Permit No. 2000338 TAX MAP -NO. 82 . -5-37 . 24 MOULTON, JOHN & NANCY Permission is hereby granted to 7 WHIPPOORWILL RD. Owner of property located at, in the Town of SEPTIC ALTERATION Queensbury,to constructor place a at the above location in accordance to 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. Owner's Address: 7 WHIPPOORWILL RD. QUEENSBURY, NY _ 12804 Contractor or Builder's Name: CONDON_I S. .SEPTIC ..& ,DRAIN Contractor or Builder's Address: 0 Electrical Inspection Agency: Type of Construction: SEPTIC _ . Plans and Specifications: SEPTIC. ALTERATION AS PER PLOT PLAN SPECIFICATIONS . Proposed Use: SEPTIC ALTERATION 25 May._ 7 2002. - $ PERMIT FEE PAID—THIS PERMIT EXPIRES' (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.) 17 May., 2000 Dated at the Town of Queensbury this Day of SIGNED i�, LQCQL" for the Town of Queensbury Code Enforcement Officer Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: .............................................. .................................................r........... Office Use Location of installation: if 7 4'-j j Tax Map No. File Permit No.,�,, Fee Paid Owner's Name: _6 CJ1 4 '1 IU Address: ]/-(,' A aj 2. INSTALLER'S N 4CPHONE NO.' ?e "Era 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daiglg&CEIVED 1 or older x 150 gal/bdrm = LIB"() MAY 16 2000 1980- x 130 gal/bdrm = 1991 -present x 110 gaVbdrm = I�OWM F QUEENSBURY AND CODE Garbage Grinder Installed yes no X— Spa or Whirlpool Installed yes_ no 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) o2ograp y Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply e�pza sand at what depth at what depth rm—unicipal�) Rolling -7o—am feet feet --w-eTr— Steep slope . clay if well.water supply —Va 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 Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add250 gallons to the size of the septic tank and leach t field for each Garbage Grinder, Spa or Whirlpool Tub. Septic TankeX"fl ff allon(min. size 1,000 gal.) Tile Field: each trenchd J1. Total System Length: �o Seepage Pit(s): number of size ofeach: ft. by Size of Stone to be used: # depth,or thickness __feet 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 note:that pursuant to Section 136-29 of the Code of the Town of Queensbury, 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 regulations with respect to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person Date 00 C >y CL U > /, - r I a wu mQ "0N 0 H C C0 1 V� dl. Q � � �r r, .�, rROO � © r CL 'q� tu W z t C qp E .Y 0 o r»E Lt. N 0 Xr, M c ut +pQW u 'r � Q Q S. � h CI Q C ' QJ s w U M U.. N" • t I d ya h 14 NrW U � � �� � t � AUL C r 0 to 0 1 0 cn 4J Ill W +� 0 (o S. 0 to LL 0 ro C low 0 'u � M Q? f-� 'r V) (t� C C C �J Ir QU 0 W M C ` C. r- yH 04- ��„ r 0 0 0 � ir0�a tnz 0£ LL � U9 0 M t0 4J aQC64 04-W �ul �� 4 014 Cn -P � +� 0 t) 1 h v J 0.Q A. 0 tJ I 4J CM to 1C ro �M r N ..� 3 �WQ Cats QJ� N Cz 6 . ' 'r�" ` v � 0- Upr-- W w > Ot.,441CR( CCro4- < �. C-0 'gym(A E U41 M U14-10 C a N W N 0: U C 0 0) U :s 3 p, 1~U 'r 0 'p L� �• � ro 0 W 'r- 4JNrro It" ao00000U, LY-c �• �•z a !y '00 �� (116U (TCAJ q 'k, lu U-) 7ft LL TOWN OF QUEE RY BUILDING& EPT. REVIEWED BY DATE IVE ".CE MAY 16 2000 r TOWN OF QUEENSBURY BUILDING AND CODE 6 1 �r0i 30 "1 have seen or observed,or believe I saw evidence of, t all objects such as houses,wells,trees,fences,etc,, shown on this document f also represent that I have personally measured the distances set forth on the dia A 1� C opt C SIGNATURE DATI O__:.:j �l1 t. Sao R,t�r �l t Q Ad 0�V�A/ f