98-503 BUILDING
PERMIT
5f �1 � N OF QUEENSBURY
VALUE $ 0 TOWN No.
TAX MAP NO . 48 . - 8 - 4 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Street. Road or Ave.
OWNER of property" located at LOT
in the Town of Queensteury". To Construct or 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 Town of Queensbury Building and Zoning Ordinance.
r3A
ddress Is
TATE RT . 9r SUITE 3
EORGEr NY 12845
OR or suiLVERS Nama
LS G'ROUPr INC .
OR or 6WLOER'S Address
ANDLER , PROJECT MGR 1810 ROUTE 9
EORGEr NY 12845
4. ARCHITECT'S Neena
5. ARCHITECT'& Address
a. TYPE of Construction — (Please indicate by X1 SEPTIC
f 1 Wood Frame ( 1 Masonry f 151409 l 1
7. PLANS end SP00"ieatlons
SEPT" ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8, Proposed Use
SEPTIC ALTERATION
25 August 18 19 2000
S PERMIT FEE PAID -- THIS PERMIT EXPIRES
fit a longer period is required an sPPG"tlen Ior an aatsnsloo .Huse be .reach to the gufw(ng and Zoning inspector of tha
town of OWensbury before the arpiretion date.)
18 August 1998
Dated at the Town Of Clueerulbtlry this
Day of is
for the Town of aueensbury
SIGNED By Ste+wing and Zanine +MPa aw
Loca tic n 0r property Cur 1 ,115Uill:1tioit. 1 w4q --Jlk
1 `"" tI•I' NL3 M13 Ell.
Owner' s Name: 1 it2 M.i^_ftazZs G>rcu: LLC /`�
Address : • r R .r,s, a r r_,_ _r=a ,W r za G (� 4- '_
(yT 1u Shea. E
Installer' s Naltte: ' ^=~mow `-''-�
Nuntitar or 1�cSrcattts (if rcl: cr:tIal ) :
600
"natal daily now (rczidettlial - ct:rttttutc Ty L.10 gal . I:cr t:a�rt:artr } :
TCp gral:Iry: meat �' ll.s:lliotg+ = Slcep Slztlta ri) iiCSlr+ttc
Sc:ii t; ture: Sand l _ T ix:ain Cla t] tlrcr ll3cq:t11:
C== ro� rd ,V»ter: at tivital dcat.t? st7 feat AUG 19
13cSrock or Impervious Matcria[ : at what dantlt'! Ccot V
r'crct:lationTest: Not ttcquirad I:pCquircdflt:to r min. l,ar issc`.r
17011+e46C Wetter SuF;r+i ;r. �' xwtuttic- pai Neil Other
if alomestic water su1:S3if is a W1 :1 .I .: water Sup1liv from any saptic a11sorptiort is rcat
i' itOT'OSr:.D SY.SM' q,fl - ~
5c,tictanks (mist•ssttum$irc: I.'C,M) gaI.) 3z
•Ills Meld: trench �6. rcci. / tutsl syntcm length
Secpaga Pit(:z) : sxumber or NSA / S's�e each: Cl. s fl
STzc or stunt to be used: # 2 s't one 1 cTcpttt or tft'sckttess (eet•
110LDIri1G TANK SYS'Iiihi : (if rcquircd)
Numt:cr or tanks: r�''3 Sirs of aacls: gsl .
Alanrt system: and associated e7eerricrtl work to be inspected by a ceru`fred agency.
For your protection, please stare chat p ursuartt to Sactiort 136-29 of the Code of tit Town of yY=
Qrteensbury , any perrrtlt or approval granted which is based upon orisgranted in rcrrntrcr rrpnrr
frrifure to +make a irtateriar fact or circuntstance k.rratt�rr by or ore
an} rrrateriai rrtisreFrreserttatiorr ar
brl:aIfof ar: appslicant, sit a11he uoM. -
P hert=e read the reg:rraflons tvirh respect ro tlzis cr ppriccrtion and agree ra abicfe by tense ailet all
regrriremcnrs o f the Town Of Llrrecrzsl>ury Srtrritary Selvage !Disposal Ordinance.
Sierrarrrre aCrest+o+rsiirre trcrscszr: 111
.t ' � I723 hCrri2.
, ---- TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12844
(518) 761-82 6 91-1440
SEPTIC DISPOSAL SYSTEM INSPECTION
Name S
Locati or -d
Date j Z it
SOIL TYPE: an Loam Clay-
Results of Percolation Test- ,
( if applicable ) R�yte- Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Leng�h Lq-7,
Length of a ch trench 4ff5-
Depth of tre ches
Size of stun
SEEPAGE PITS : Fl�umbera-
Size - to xft .
Stone size
PIPING: YPe
Bldg . to Tank
Tank to Dist . ox
Dist . Sox Field/Pit
Openin ealed? Yes No ar a
LOC ON/SEPARATIONS : feet
Foundation to Tank feet
Foundation to Absorption
Separation 0 Pits feet
'
Conforms as per Plot Plan es No
LOCATION OF SYSTEM ON PROPER `
( circle o
Front <Re - Left Side - Right Side
Middle Front -- middle Rear
COMMENTS :
SYSTEM USE APPROVED : YES O
Arrived:
Departed:
Building inspector
I
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury MY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Locati o a_71/ �1r1� le
Date #__ _
SOIL TYPE : Sand- roam-Clay-
Resul is of Pe col ati on Test-
( if applicabl } Rate-Minot nch
TYPE OF SYS
ABSORPTION FIE
Total ength
Length of each tr h
Depth of trenches
Size of stone A.
SEEPAGE PITS : umber- ft .
Size - ft . x
Stone siz _
PIPING: Size ype
gl dg . to Tank
Tank to Dist . iiox
Dist . Box to Field/Pi t � a
rti
Openings Sealed .e
LOCATION/SEPARATI &
feet
Foundation to Tank feet
'foundation to Absorption feet
Separation of Pits No
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPER
( circle one )
Front - Rear - Left Side - Right Side
Middle Front - Middle !tear
c0w4ENTS : I d f
for" ! f f° /Gf rlt leg
SYSTEM USE APPROVED : YES '
Arrived: 3, 3�
Departed:
I
Building Inspector
OFF
IIF
(�yr
�!' I `\ � �4 ` +.. 'r_y -- ;T' f `, • 'jy .1 ' �.t 1
fs
Off, 11 IF
f` r ` ', f S ` - `f OFF Fes`
f v. - yOFF
t OF
IF FIFFIF
' '.fir_. 'c) �. -.,t ��'�• M {
OF
OF 1 ~ ti .� n a �t't{ f
OF
l ,
y�.6, OFF ,r^ x e1 `F
OFF
OF
` 1 a �LOff` lam I FOr
Fr
I
If F-
13 Y' �. _• W t,�' "' Far, - f ; 't ^ / N
Yr i j f 1, '• 5 _ r
Rix p
oeo� OFF
I If
OF
VON
r4 �' A mow —
i' t9 p b 1
is p ►, - .�_% , .' °° _ A 11 f !�
S ,
,, f -- ' + v een or s rved or
'�' " ~
rig 1 °, �' ` j' ' f lj 'cts such as f� us fi v► effce ofi', +
4 , i . / es, Is, tr fend etc., ; �
+ Cl f,. all � he fn on this � nt I � N
r — _ .. Y� !I ocu a sofiepresenttha I e"� t',',.^' ` i I t
r o - 11 Y sur he istanees W
f 1 set for#h o the Ord
r, 1 �± I SIGMA RE 1 r r
I.,i OFF,.' i` ; ' I { , .y� I SATE i ' S16
.
/ � : t tr art" w { i i .i+`�,
a.
np
sir \ � t a" .' . *� w
` ; y 1 .
� � ti U