97-514 BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 No. 97514
TAX MAP NO. 147 . -1-21 WARREN COUNTY, NEW YORK
d*.-- g a(Y (' I )
PERMISSI N is hereby granted to DWYER, THOMAS B.
OWNER of property located at 36 STEVENS RD . Street, Road or Ave.
in the Town of Queensbury,To Construct or place a SEPTIC ALTERATION.
at the above location in accordance to application together with plot p ans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
36 STEVENS RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
SANITARY SEWER
3. CONTRACTOR or BUILDERS Address
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCHITECTS Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel
SEPTIC
7. PLANS and Specifications
SEPTET ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID -THIS PERMIT EXPIRES September 4 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 4 Day of September 19 97
SIGNED BY C t')'Ci Uvt^a for the Town of Queensbury
Building and Zoning Inspector
•
Application for SEPTIC DISPOSAL PERMIT
( I�
Town of Queensbury Permit No. -7 -5I T
• Dept. of Community Development
Building&Codes Office
742 Bay Road Fee Paid $25 `c)c-)
Queensbury, NY 12804
Location of property for installation: . (.0 s1_evpitil"
47)
Property Owner's Name: / " �� .( 2 SEP 0 4
097
Property Owner's Mailing Address: 3(c) s%Q ti.Q,U c TOWN R
BUILDING CODE
Installer's Name: J) /3 !—i .(T r�il�e-✓ Phone # 7 /7 '7
Number of bedrooms (if residential): Total daily flow:
(residential -compute @ 150 gal./bdrm.)
Topography: OL flat, rolling, steep slope % of slope
• Soil Nature: . 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
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
•
Septic tank ° Jn gallon (minimum.size: 1,000 gal.)
o •
Tile field: each trench / v feet / Total system length: ,2 a ' feet
Seepage pit(s): number of / size each: ft. by ft. •
•
• Size of stone to be used: # / depth or thickness / feet .
• HOLDING TANK SYSTEM:. (if required)
Number of tanks: Size of each: gallons
(Alann 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 permit or
approval granted which is based upon or is granted in reliance upon any material misrepresentation 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 'cation and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal c ,Signature of responsible person: Date: 9� 7
TOWN OF QUEENSBURY 1/1414(ki
BUILDING A CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804 -�
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Dowy-o-vA
Location -t P./U'eN cD d
Date°1 '-<7.---l 7 Permfi- 5 )44
SOIL TYP : and •.m-Clay-
Results of Percolat on Test-
(if applicable) Rate Minute/Inc
TYPE OF SYSTEM:
ABSORPTION FIELD: Tot,l Lengt
Length of each trench r . . LAt4
Depth of trenches
Size of stone
SEEPAGE PITS: Dumber-_
Size - '/ ft. x IF ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box L.v`t
Dist. Box to Field/Pit R" 1,W
Openings Sealed? a No Partial
LOCATION/SEPARATION
Foundation to Tank Q, Aeet
Foundation to Absorp ion [. feet
Separation of Pits. eet
Conforms as per Plo Plan No
LOCATION OF SYSTEM ON PROPER V :
(circle one)
Front - Rear - Le't Side - Rig t Side
Middle Front igalidle Rea
COMMENTS:
•
SYSTEM USE APPRO.'ED: 401111P. !
Arrived: ,;
Departed:
f/
u1 i 'g Inspect,..
Ito
TOWN OF QIIEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
pliance with our comments shall
n t be construed as indicating the
p ns and specifications are in full
mpliance with the code.
a
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s ID
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T OW N co ,
IA''ti5 i'„a c a ✓nhe's
REVIEWED BY /v
DATE SP04199 '
BUILDING:�q�p
17-D') l�
allabjesh ash
shown fly ( rent.i t�rpre3� t�
person suEad the distances set fiNtttlNh'on the dtslle
SIGNATURE DAB