98-657 +�1'A",j' RT1F1+cATE 1JR COMPLIANCE
TOWN OF UU£ENSSURY
WARREN COUNTY, NEW Y+ORK
Date October 22 19 98
- � 98657
This is to certify that work requested to be done as shown by Permit No .
has been completed .
SEPTIC SYSTEM- LEACH TANK ONLY
This structure may be used as a -- -
80 SWEET RDA
Location --
MC QUIRE , VERNON
Owner d �-- —
TAX MAP NO . 64 . - 1 - 5 . 4 By Order of Town Hoard
TOWN OF Q,UE�ENSBURY
Uirector of 'Building & Code Enforcement
BUILDING ING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 98657
TAX MAP NO . 64 . -- i - 5 . 4 WARREN COUNTY, NEW YORK
PERMISSION is tweby granted to MC GUIRE VERNON
OWNER of property located at
80 SWEET RD . Street. Read or Ave.
at the Town of Oation in yff a
To Construct or place a SEPTIC SYS
at the above location in accordance to application together with plat plans and other information hereto filed a
nd
approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance.
1, OWNER'S Address is
80 SWEET RD .
QUEENSBURYs NY 12804
2. CONTRACTOR or IDUILOERS Name
HLACKMERE , MICHAEL
S CONTRACTOR or BUILDER'S Address
Narrw
S. ARCHITECT'S Address
6. TYPE of Construction — [Please indicatebY X) SEPTIC
I I ►Mood Frame # I Masonry # I Steel t 1
i. PLANS and SPecif"lions
SEPT:W, SYSTEM - LEACH TANK ONLY
o. Ory..W�rx_i lif!
SEPTIC SYSTEM—LEACH TANK ONLY
25 October 26 2000
S PERMIT FEE PAID -- THIS PERMIT EXPIRES
19
Ilf a iongor erk3d is req laefon the x Ipation date extension '"Wilt W m ede to the Building and Zoning inspector of the
Ouewns
uqv
26 October 1998
Dated at the Town of C]u ry this
Day of tg
for the Town of C]ueenstxary
SIGNED BY 6uiWimand :L;n�;InonaP +etar
w
Application for SEPTIC DISPOSAL PERMIT
Town of Queembury Permit No, 13
Dept. of Community Development 7
Building & Codes Office ,I
742 $av Road Fee Paids
Queensbury, NY 12$04
Location of roe for installation: gA') <5CDf e f-
P property
Property Owner's Name: ri c7►q
Property Owner'.5 Mailing Address: 90 c L 'lE'G' )� cact_C u'eC'F^cS1i'U+` '�''
Installer's Name: Rc , )L EQ ejA, 1 d G QA Phone # 7
Number of bedrooms (if residential): a Total daily flow: 3
(residential - compute @ 150 gal.lhdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: J/ sand, loaarn, clay, other I depth:
Ground water: at what
depth? feet / Bedrock or Impervious N aterial: at what depth? feet
Percolation test: "s/ 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: 1000, c0 gallon (minlMUM sine: I V000 gal.)
QId
Tile field: each;ae h 9YCa feet ! Total system lend: feet
J ,nleyl
G
Seepage pit(s): number of + I size each-. .� ft. by � ft. � �►"
Size of stone to be used: # �• I depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
P.larm system azad associated electrical w+or]c to be a 'ted by a �tified aslmcy.
For your protection, please note that pursuant to Sec boa 136--29 of the Cods of the Town of Qnseusbury, any permit or
approval granted which in based upon or is granted in reiiaxtce ig3on any material misrepresoutation 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 mquu-eiments of the Town of
Queemblury Sanitary sewage Disposal Ordinampe.
Signature of responsible person: _ ' Date: p
t
k
ik
Tow OF WEENSBURY
BUILDING & COD742 SadENENT
Ro
Queen
sbury NY 12B0 4
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
N ame
Location roe
�
�P e rm i t
Date
SOIL Sand-Loam- Clay_
Results o Percoat
Rate-Minutellnch��-
( if appl i able)
TYPE OF S 'TE" th ----
VELD : Total
ABSDRP�TIoONea h trenc
Length ------
Depth of tren es
Size of stone er_
SEEPAGE PY - f t .
size - ft - x
:r �
Stone size S1ze Y€ye
PIPING: Tank ___--- -� ----
Bl d g - to
i1 i s t . Box -----z;
Tank to FieldlQit �- artia
Dist . Box to
openings Sealed? Yes No
L.00ATICMIsEPARAXIOHS : feet
Foundation to Tank tion feet
Foundation tr.) Absorp feet
separation of Pits es NO
Conforms as per Plot Plan pROPER
tOCATION OF SYS M Oli
e one) eftPeRea-r
Right Side
®rloddle
Rear ,
Id
Front
COMMMTS00
SYSTEM USE APPROVED -
YE NO
Arrived*
Departed: �- --
Building Inspector
I
z 1r
DATE
i
8r1y8 DA�YVJ��'1: HOUSEL1. �
2i rf
144U Thh'L:.
2:3 FT
5II T
37 MWEET ROAD
/A j ,,