98-636 BUILDING PERMIT
VALUE $ 0 TOWN OF +QUEENSBURY No. -
TAX MAP NO . 134 . - 3 - 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to STEWART
OWNER of property located at
4 RYAN ST . Street, Road or Ave.
in the Town of Queensbury, 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.
t�rt1C] 'S Addra is
�H ss 4 RYAN AVE .
QQUEENSBURYr N . Y . 12804
2. CONTRACTOR or Still LDERIS Name
CHET SANDERS ACTION SEPTIC
3. CONTRACTOR or SUILDe S Addr4m
5, A'RC141TE+CT"S Address
6. TYPE of Construction (plassa indicata by x) SEPTIC
i i VVood C-rama i i MaaanrY t l Steel i I
7. PLANS and SVeaificattons
SEPTICNALTERATION AS PER PLOT PLAN SPECIFICATIONS
-------- - — - - 8: xopatlSJ cte
SEPTIC ALTERATION
25 October 14 �g2000
PERMIT FEE PAID - THIS PERMIT EXPIRES
III longer Qu en is i tV d*ni PallC r.ion date ext;�n muse be mad* to xfia Sulidirq and Zoning insprcxor of the
14 October 1998
Dated at the Town of +dueensbury this
Day of tg
-^� for the Town of Queenshury
SIGNED 6Y
Building and Zoning IntpatIlar
Application for SEPTIC DISPOSAL. PERMIT
Town of Queensbury
Dept. of Community Development Permit No. - [
ni }
Building Sc Codes office 1.rN
742 Bay Road Fee Paid
Queensbury, IVY 12804
Location of property for installation. '
Property Owner's Name:
Property Owner's Mailing Address:
Installer's Name: z J� r' +yL Phone # it
� 9
Number of bedrooms (if residential): Total daily flow: 470
(residential - compute 150 gal./bdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: - sand, loam, clay, other / depth:
Ground water: at what depth? feet I Bedrock or Impervious Material: at what depth? _ feet
Percolation test: Vlnot required, required r rate min. per inch, I
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: locV gallon (minimum size: 1 ,000 gal.)
Tile field: each trench 6^ feet / Total system lengt - /'lam feet
Seepage pit(s): number of �1 ! size each: ft. by ft.
Size of stone to be used: # crc . --� I depth or thickness � feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system ant associated electrical work to be h spected by a certified agency.
For your prot...,+ic"3, please now that pursuant to Section 136-29 of the Cade of the Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any 'material xmszvgresentatiom or failure to make a
material fact or envur stance known by or on behalf of an appheard, shall be void.
I have read the regulations with respect to this application, and agree to by awed all roTA"mects of the Town of
Queeoabury Sanitary Sewage Dispoa d
Signature of responsible person: Date: Y-'G�
Xis
,..
TOWN Ur
BUILDING & Cf?QE ENFORCEMENT
742 Bay RoadC{
aQueensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ►'7 tiI
lip
Location / 4 �
Date '��`/ '�` rm-i t #
SOIL TYP oam Clay-
Results of Pe colatio Test-
( if appiicabl Rate- inute/ Inch
TYPE OF SYSTEM
ABSORPTION FIEL : Tot l Length _ . p�
Length of each ench � "2j-er [ c of
Depth of trenche
Size of stone
SEEPAGE PITS : er-
Size - ft . ft .-
Stone size
PIPING: Size Type
Bldg . to Tank " C
Tank to 'Dist . Box e�
Dist . Box to Field/Pi qqLo l-`
Openings Sealed ? Y No Partial
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorp ion feet
Separation o*F Pits t
Conforms as per Pl o Plan o
LOCATION OF SYSTEM PROPER
( ci one )
ant ar - Le t Side - R t Side
T e Front - Mfddl a Rear
COMMENTS :
r'
SYSTEI! USE APPROVED : Oils -I!O
i
Arrived:
Depart
ildi pector
X1�
"W'" MRP 8llit. M DEPARTMENT&Wonof Im
mmft
r m"Im" rri8r our =me* SWi
f4Ind vkk*m ere in foil
"I h8ve seen or 604d, at believe l saw evidence at,
all O* is such 8 banes, wells, trees, fences, etc.,
shown On ft f, l i presen that l have
persona the ' s� t#ls on the dia 1,f. r
sl DAT
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