98-201 CI+R rIFICNUE Ole COMPLIANCE
TOWN OF QUEENSDURY
WARREN COUtil'Y , NEW YORK
Da to may 1
19 98
2CiW [ l -I -- 1
This Is to certify that work requested to be done as shown by Permit No . 98201
has been completed .
This structure may be used as a SEPTIC ALTERATION
Location 21 JUNE DR .
Owner RYTHER , MAYNARD & HELENE
TAX MAP NO , 72 . - 3 - 6 By Order of Town Board
/ }TOWN OF QUEENSBURY
_ _.-- _,
Director of Building 8 Code Enforcement
BUILDING PERMIT
VALUE s 0 TOWN OF QUEENSBURY No. 98201
TAX MAP NO . 72 a — 3 - 6 WARREN COUNTY, NEW `VOiRK
PERMISSION is hereby granted to RYTHER . MAYNARD & i-1ELENE
OWNER of property located at 21 JUNE DR * Street, Road or Ave.
in the Town of Queensbury, To Construct or plaoe a SSMUG I! UMEATIf71v7
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and 'Zoning Ordinance.
1. OWNERS Address is
21 JUNE DR .
QUEENSBURY , NY 12804
2. CONTRACTOR or Bur LDE RS Name
QUEENSSURY SEWER
3. CONTRACTOR or BUILOER05 Address
JAY SWEET
0
4. ARCHITECTS Name
S. ARCHITECTS Address
6. TYPE of Construction — (Pissse indicate by X)
SEPTIC
4 ) Wood Frame t } Masonry 4 } Steel I }
7. PLANS and Specifications
SE:A57IC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
a. Proposed Use
SEPTIC ALTERATION
25 April 30 2000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES 19
(if a longer period is required an application few an extension must tie mode to tho Building and ,Zoning inspector of the
town of Ckwansbury before the expiration date.)
30 April 19
Hated at the Town of Queensbury this Day of 14 19
r P
SIGNED BY Z&i for the Town of Queensbury
Building sod Zoning 1
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept. of Community Development Permit No.
Building & Cedes Office
742 Bav Road
Queensbury, NY 12804 Fee Paid $
Location of property for installation:
Property Owner's Name: t y\ ct r Y 14 PR F d
Property Owner's Mailing; Address: rr'
Installer's Name: ce a Phone #
Number of bedrooms (if residential): -__ Total daily flow:
(residential. - compute a 150 aaL/bdrm.)
Topography: 'C_ fiat, rolling, steep slope ho of slope
Soil Nature: _ sand, loam, clay, other I depth:
Ground water: at what depth? feet I Bedrock or Impervious Material: at what depth? _ feet
Percolation test: A not required, required [ rate min. per inch ]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank:`lgao e/gallon (minimum size: I ,000 gal_)
c
Tile field: each trench c - �'' feet I Total system length: t` feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # -54- �7 J d" or thickness �_ feet
HOLDL"i FG TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system associated electrical work tc be irsspected by a certified agency.
For your protection., please note that pursuant to Section 136-29 of the code of the Town of ih�nsbury, 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 Dispos Ordinance_ C,
Signature of responsible person: E.c. Date: ,+ rd
71
TOWN OF QUEENSBURY 01 - 10 , 3 a
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(519) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
LocationId
� .�•-
Date !!E5.- I 'ate_..._ Permit # 1 �
SOIL TYPE: an - Loam- Clay-
Resul is of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
140 .
ABSORPTION FIELD: Total n th
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS : Number _
Size - fto x ft .
Stone size
PIPING : S ' ze 'Type
Bldg , to Tank
Tank to Dist . Box "
Dist . Box to Field/Pi
Openings Sealed? a No a ti
LOCATION/SEPARATI feet
'Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits No
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPERT
( circle
Front - ea - Left Side - Right Side
Middle Fr nt - Middle Rear
COMMENTS :
SYSTEM USE APPROVED: YES-+ No
Arrived :
Departed :
ed :
~
B11 ,11 ldiny nspector
v
TOWN OF Su y
ti@�q�T.. n' P r / ' - ""' OF
W� YV wwma
4u q09 .. ' t " 17AYN1
OUt ! �f
FILE COPY
Mw��rrlr�+rM,�rMr�r�►t�r�r�
Sy
f`
APR 91998