97-141 BUILDING PERMIT
VALUE 0 TOWN OF QUEENSBURY No.
97141
TAX MAP NO. 82 . —6-15 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to w cy, BRIAN--&--DARDARA
OWNER of property located at 31 CROWNWOOD LA-NE Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SIIPTIC ALTERATION
at the above location in accordance to application together with plot plans andother in ormation hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
MARGARETE 31 CROWNWOOD LANE
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
SANITARY SEWER
3. CONTRACTOR or BUILDER'S Address
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( I Masonry ( 1 Steel
SEPTIC
7. PLANS and Specifications
SEt4.°I'IC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES May 1 19 99
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 1 Day of May 19 97
SIGNED BY ,LA-P_94 ✓ for the Town of Queensbury
Building and Zoning Inspector
„ , Application for SEPTIC DISPOSAL PERMIT
• r
Town of Queensbury Permit No. .9 /-/ l 1
• Dept. of Community Development
Building&Codes Office DO
742 Bay Road Fee Paid $
Queensbury, NY 12804
J
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Location of property for installation:3( ero row �p
Property Owner's Name: Ef //4>✓ 1”` 0 WC--
_ _ Property Owne ' Mailing Address: 3 / C nO f14--IAI £k-f(? c)P
Installer's Name: a-0-(y • 04 itfie Phone # 7 9 " 7)s 7
Number of bedrooms (if residential): Total daily flow: 3 9
(residential -compute @ 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
• Soil Nature: y sand, loam, clay, other /depth:
' Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet •
Percolation test: `� not required, required [rate min. per inch]
Domestic water supply: ` municipal, well, other i
RECEIVFD
If domestic water supply is a WELL, water supply from any septic absorptio is . feet1
rvHY• 0997
PROPOSED SYSTEM
Fyi/rg-h J e TOWN OF QtiEt_rri a-UFiY, ,
Septic tank 10 D� gallon (minimum,size: 1,000 gal.) GUILDING'AND CODE
Tile field: each trench feet t Total system length: ' feet
•
Seepage pit(s): number of / / size each: /0 ft. by 0 ft. •
Size of stone to be used: # *3 / depth or thickness 2feet .
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
&lean system and associated electrical work to be inspected by a certified agency.) •
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any pew or
approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fad or circumstance known by or on behalf of an applicant;shall be void.
I have read the regulations with ilk
= application and agree to abide by these aad all requirements of the Town of
QueensburQueensburyy Sewage Dispo: • ,Signature of responsible person / .el — Date: 6-- //—/q
7
I
TOL'N OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road II— 1( .30
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Namec:).-)Y- imr\ liT00- \
Location .J 1 C rc - ' 9,li t, 9OCl
Date 5 - -17 Permit # DI 7 f 1 /
SOIL TYPE Sand oam-Clay-
Results of Perco',ation 7est-
(if applicable) R.te-} inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD. • al Length
Length of eac• renc
Depth of tr-nches
Size of stone k,
SEEPAGE PITS: Number- /
Size - 15 ft. x /Q ft.
Stone size �j
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit 4 6?JI2 34/
Openings Sealed? Yes iNo Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle ot_) `'Th
Front 'ea - Left Side - Right Si
Middle Front - Middle Rear
COMMENTS:
,d i --•
SYSTEM USE APPROVED: 14
iJ
Arrived: l '
Departed:
. �j
Building Inspector
0--ke ay ,,.,g- ////N/11 adj
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NA Y ®11997
TOWN
BUILDINGhj� URy
CODE
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BUILDING :; „ is DEFT.
TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination, REVIEWED BY W.�
compliance with our comments shall
not be construed as indicating the DATE
plans and specifications are in full
compliance with the code.