2000-938 TOWTST OF QUEENSBURY
'142 Bay Road, Qtieensbury, NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20000938 .Application Nurnbeir: A20000938
Tax Map No- 523400-009-000-0001 -023-000-0000
Permission is hereby granted to; TURNER FAMILY REVOCABLE TRUST
For property- located at. 66 BAY Pky
in the Town of Queensburv, 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 Queensbun Zoning
Ordinance. Type of Construction Value
Owner Address: TURNER FAMILY REVOCABLE TF Septic Alteration Residential
CIO BEVERLY POZZI Total value
1 1 BERMINGHAM LANE Ln
WHARTON, NJ 07885
Contractor or Builder's Name / Address Electrical Inspection Agency
CARR, EDWARD. JR_ & ELISE
28 WOODCHUCK HILL RD.
LAKE GEORGE, NY
Plans & Specifications
2000-93 8
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday, December 21 , 2002
(Ifa 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 ensbu Thur5clay, December 21, 2000
SIC:=NED BY � for the Town of Queensburc-.
Director of Building & XWX E rcernent
Application for Permit — Septic Disposal System
7*0 wlr Of QUeellTbAtry 742 Bay Ifoad Queensbury, NY 12804 (518) 761-82 56
I . OWNER INFORMATION;
........._........ ......... ........
Location of installation: y-- Orrice Use
Tax Map No. / ` / �' File Permit No.
Owrter'tt Name: M+',csr _ may ,,c , �y �,,- Fee Paid j , `
Address:
2. INSTALLER'S NAME , ,I , • PHONE NO. } �
?ffie�RESIDENCE INFORMATION: (eircleyear of dwelling, indicate # bedroom(sJ and multiply N of
bedrooms with applicable gallons per bedroom to equal total daily flraty)
Year of HoU12 No ofBor9oma C x g utation — T k w
l Daily._ r
1980 or older x 150 gal/bdrm
1980 _ 1991 x 130 gallbdrm = � ■ ^
1991 — present x 110 gallbdrm = t ..� [ I ii' E V
Garbage Grinder Installed yes � / no DEC 2 0 2000
Spa or Whirlpool Installed yes _ / no
TOWN _Ji _.4,, craSBURY
4; PARCEL INFORMATION: (circle applicable information 8c indicate measurements BUIi DICV�a J+iV�? GCIC+E
ZQS79 oil t>lss (JCQ..Un4.W_at.9r . `[3t?�]roGk- 9r�n3taotk�44!��1@�griAl E)er"Q5jic Water.Sirliply
l7nt sand al tvlfcri t1el,/h cfi 110lrcri cirJrtlf ►fffrfrictpafl!lulling i4oapn Jcet feet well
Steep slope clay if well; water .sffJrJrly
�gb slope older from any septic-systcnf
deJaih' absorption is fi.
Percolation Test; other
(Tv be completed by licensed rrrafe,sslonal engineer or arcltltectf
late. Minute per lnclr
X PROPOSED SYSTEM: For Neer Construction: All Individual sews a disposal
professional engineer or architect (unrese instniled in a Planning l3oard approved subdivision). Add 2.1U gal to licensed
e
of iltc septic tank and leach field for cacti Garbage Grinder, Spa or Whirlixtol Tub.
Septic Tank: ,gallon (min. size 1, 000 gal.)
Tile Field: each trench fi: Total System L.engill: �.
Seepage Pit(s): number of size ofeach: fl_ by f►,
Size orStone to be used: fi / depth rfr rhlckfres.s
Bed System Size: as
,/I��
Alten Uve SysTterktt, iYL ' ' length and/or size
CC
HOLDING TANK SYSTEM: (if required)
Number of tanks: 1 Size of each: gallons I TOTAL Capacity, gallons
Note: Alarm System and associated electrical work must be inspected by a Town approved
electrical inspection agency.
7. SIGNATURE 8t INFORMATION ,FOR RESPONSIBLE PERSON (please read)
For your protection, please note that pursuant to Section 136_29 of'ilre Code of' Ilia Town
of Queensbury, any permit or approvaI granted which is based trpon or is granted in
reliance apart arty matctrinl ntisrt•Erosotttation or failure Ics rnako a row�teria) tact or
known by or on behalroran applicant, shall be void_
I have road Ilia rogu o s with respect to this application and agree to abide by these and all
requirements of To o bury Sanitary Sewage Disposal Ordinance.
urea respo sl ape o Da#e
CO.MONmain
THELCTIINSION SERVICE, 1'4c
nlffice R Roadnhe
NIUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL C� �6 ..
7 �3 Cut-in Card lVo. ................... .
'P . .
ermit I+3o- ,.....�..,,....�............ rt
...........Ce . NO .�_,...... ..
Owner....... .............lI -'.........p L -.... ...,...
A l"�• x
Location .... ..
Installakion Consisting of ..... .a t ... ...........................
»................................................................................................
r ............&.._..................
Installed 33y..,,1..!..,...{ ........................ .......()ft....,..erti -icat Lac. any
cent_ cafe
�I The conditions following governed the issuance of this certificate, and any certificate prevtiouslY tssund�e
cancelled: -
lication shall he promptly made for inspection.
,i This certificate only covers the electrical equipment and installation conditions as o tc. .
introduction of additional equipment or alterations. application - TiUns ai any time. and if its
Inspectors of this company shall have the privilege o}- hkin 1 ate-
, rules are violated, the Company shall have the right to r .
........ .�.......................�..............,...
I Date..............��.....~. ,.: .�. ...�......... INSPECTOR ................ Ntern6er N.F.P,A.. 1.A.E-1.
oc:)R(A
TOWN OF QUEENSBURY
BUILDING &._ CODE ENFORCEMENT
-742 Bay Road
aueensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name , RPV,) :I t�i� f�1
Location (do A�{
Date _ — ^ 0 A Permi t # =`L'j
SOIL TYPE : Sand- Loam-Clay-
Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Tot ength
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS : Number-
Size - ft . x ft .
Stone size
PIPING : Size ype
Bldg . to Tan . . �-t .``sC - ,
Tank to Cl1 �-4e5
Dist . Box to Field/Pi
Openings Sealed? Yes o Partial
LOCATION/SEPARATI
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan T es No
LOCATION OF SYSTEM ON PROPER
( circle one )
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS :
SYSTEM USE APPROVED . S NO
Arrived: �-
Dep
ui ding ctor
TOWN OF QUEENSBURY
iLDING _&_ CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Zt:1
Location .4e; /
Date � 2( ermit # 00 'le
SOIL TYP : San - Loam- Clay-
Results of P col ati on Test-
( if applicab e ) Rate-Minute/ l ch.
TYPE OF SYST04:
ABSORPTION FIELD: Total Len h
Length of eac trench
Depth of trenches
Size of stone ' ,
SEEPAGE PITS : N = �r-
size x ft.
Stone size
PIPING : Size Type
Bldg . to Tank
Tanis to Dist . Box
Dist . Box to Field it
Openings Sealed? Yes No Partial
LOCATION/SEPARAT S :
Foundation to T k feet
Foundation to sorption feet
Separation of its feet
Conforms as r Plot Plan ��es No
LOCATION OF YSTEM ON PRO ERTY :
{ circle one
Front - Re r - Left Side Right Side
Middle Fr t - Middle 'Rea
COMMENTS-
?
c= C�FIf� 1�0/4 +� tL
L eoc-,A- f I ci
I_.. AK s e Tin Nk4c- 'Sd::t�fo
SYSTEM USE APPROVED : Y S
Departed : /.Z t#" 'S
Building Inspector
Mw//V(-
ZX1 fl'IA4c
TOWN OF QU ENS URY
BUILDING&
REVIEWED BY
DATE
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