98-659 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBUR.Y No. 943fi59
TAX MAP NO . 112 . - 1 - 63 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to TRYHENDI S r 'NARK & LORRIE
OWNER of property located at 123 RIVER ST . Street. Road or Ave.
in the Town of Oueensbury, To Construct or place a SEPTIC SYSTEM
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 Oueensbury Building and Zoning Ordinance.
t. OWNER'S Address it
123 RIVER ST .
HUDSON FALLS , NY 12839
2. CONTRACTOR or BUILDERS Name
SA�N�gI,�TCAtRY SEWER
� CS DRELI.[)31L PC] Address
224
GLENS FALLS NY 12801
4. ARCHMCT'S Noma
5. ARC141TECT'S Address
6. TYPE of construction — (Please indicate by X) SEPTIC
i i wood Frame f ) Masonry 4 I Steel 41
7. PLANS and Specifications
SEPTnT
C SYSTEM
& Proposed Use
SEPTIC SYSTEM
25 October 21 2000
$ PERMIT FEE PAID - THIS PERMIT EXPIRI S 19
(If a longer period is required an application for on enimnsion must be made to the Building and Zoning insoector of the
town of Ou**nsbury before the *Kpiration date.)
21 October 1998
Dated at the Town of Queensbury this Day of 19
ic
SIGNED BY for the Town of Oueensbury
Building and zoning I notpeotor
- ---� Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Dept_ of Comatunity Development Permit tm
B"dTr3ing 8t codes office742 Bay Road Fee Pai
Queensbury, NY 12804
Location of property for installation: e.�L- . r
Property Owner's Name:
Property Owner's Mailing Address., 2-3
Installer's Name: K..! f1 Aj r T IV L-? {f � �.+ P � Phone ,# -7 92Z
.Number of bedrooms (if residential): i Total daily flow: 1i`%.dr22
(residential - compute a 154 gai.lbdrm,)
TOP°graPhy". flat, rolling, steep slope % of ter.
pe
Soil Nature: ✓sand, loam, clay, other I clelstb:
Ground water: at what depth? feet t Bedrock or Impervious Material: at what depth? feet
Percolation test: �not required, required [ rate min. per inch I
Domestic water supply: ✓municipal, well, ocher
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank /�c, c ? !?won (minim 11M size 1,000 gal•)
Tile field: each trench feet I Total system length: 4' feet
Seepage pit(s): number of AJ- A I size each: fit by ft
Size of stone to be used: # ! depth or thickness / feet
. r?LDING TANK SYSTEM: (if required)
Number of tanks: Size of each-. gallons
Alarm, ayo mn and associated ale ctncal work¢ to be mspecked by a caftfsed agc�ocy,
For your psotectmac6 please note that gcievsut to section 136-29 of the Cade of the Town, of
. y p Or
approval granted which is basal upon or ie graded in relisooca upon any mataesal
.ma or finlnra bo msloe a
.material fact or ch=wustaaaca known by or on behalf of sn applicant, aknll be voeid.
I have rread,}thhe�,regulatiows -withSewage to dale application and agree to abide by these and all xequirancvts of the Town of
QueembnrSignature of responsible person: ea24 ,� R , _ Date y / 9 — 9 4P
ti TOWN OF QUEENSBURY
BUILDING a CODE ENFORCEMENT
742 Say Road L
Queensbury NY 12804
(518) 761-9256 } '
SEPTIC DISPOSAL- SYSTEM INSPECTION 11
Name
Location
Date ?� Permit #0
i
SOIL _ m- Cl ay-
Resul is of Percolation Te
( if applica le ) Date-Min a Inch
ASSORPTIONTYPE OF SFI Total en th 41
Length of each t nch
Depth of trenches
Size of stone
SEEPAGE PITS : Nuts a ft .
Size - f t .
Stone size 5ize�fiYpe
PIPING:
Bldg . to Tank
Tank to Dist . BOX
+. [ rr
Dist * BOX to Field/Pi t Openings Sealed ? =:"2' � �o Pam
LOCATION/SEPARATIONS : # feet
Foundation to Tank feet
Foundation to Absorption Separation Of Pits feet et
Conforms as per Plot Plan C�
LOCATION OF SYSTEM ON PROPERTY:
( circle one) ft Side t Side
Front -
Middle Front - Z ddl a Rea r
COMMENTS
SYSTEM USE APPROVED : YESO
Arrived - �.
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Bui di pector
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j SIGNATUK DATE
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