98-738 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY
TAX MAP NO . 124 . - 1 - 1 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
OWNER of property located at 3
Street. Road or Ave.
in the Town of Queensbury. To Construct or plsoe a
III-
at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the "fawn of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
FLAHERTY , STACY 138 THUNDERBIRD DR .
+QUEENSBURY , NY 12804
2. CONTRACTOR at BUILt)ER'S Nanw
FLAHERTY AS SOC .
Z. CONTRACTOR or SU[LQER'S Address
4, ARCHITECT"& Name
------------
S. ARCHITECT"S Address
[i. TYPE of Construction — Iplease indicate by X1 SEPTIC
[ I Wood Frsvne ( I Masonry I i Steel f !
7. PLANS and Specif ications
SEPt=C ALTERATION AS PER PLOT PLAN SPECIFICATIONS
B. Proposed use
SEPTIC ALTERATION
25 November 27tg 2000
S PERMIT FEE PAID — THIS PERMIT 'EXPIRES
[If a longer period is required an appfioation for an extension "Vma be rnadtt to the Bulfdltq and Zenine Inspector o/ the
town or CLuaantbury belore the ewpirstian date.F
27 November 1998
Dated at the Town of []ueensbury this f)my of 19
SIGNED BY . ,� � 1i �JtiR/+ for the Town of Queensbury
'""'"`
wild im Zoning Insphicaw
Application for SEPTIC DISPOSA,I.. PERMIT
Town of Quecusbury Permit No.
Iyept, of Community DeveIapment
Building & Codes Office
742 Bay Road Fee Paid :a
Queeasbury, NY 12804 !
Location of property for installation:
Property Owner's Name: %.5 •'"-C ,, �//� x3 "'' AIAf
Property Owner's Mailing Address:
In Name +�'�" S cac� Phone # 7
Number of bedrooms (if residential): e2 Total daily flow:
(residential - compute Q 150 gal.fbdrrn.)
Topography: ✓flat, rolling, steep slope 56 of slope
Soil Nature: . sand, loam, clay, other I depth:
Ground water: at what depth? feet f Bedrock or Impervious Material: at what depth?J& feet
Percolation test: not required, required E rate min. per inch ]
Domestic water supply: ✓municipal, well, other
If domestic water supply is a 'Vv'EY..I., water supply from any septic absorption is feet.
PROPOSED SYS='%4
Septic tank J gallon (minimum size: 1 ,000 gal.)
Tile field: each trench 4Za feet f Total system length. 0- Eb feet
Seepage pit(s): number of f size each: ft by ft.
Size of stone to be used: # G I depth or thickness / '�-- feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: r Size of eacha gallons
Alezm system and associated electrical wcrr3t to be io *� by a certified agaocy.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Q eeasbtuy, any pernxit or
approval garz=ted which is based upon or is granted in reiisnce upon any rnaurial rMisrevresectn6on or fv2ure to make a
ntaterW fact or circumstance Irnown by or on behalf of ewi applicaxSt, sba11 be void.
I have read the regulations with respect to this application and agree to abide by tbese and all requirem+euts of the Town of
QUoen5bjjry Sanitary Sowage Disposal
Signature of responsible person: Date: / r�
Toil OF QUEENSBURY
BUILDING 2CDE RaadRCEME"T
�
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date w199
Permit
SOIL TY Sand oam-Clay_
Results of Percol ati est
( i f apPl cable ) R e-Mi nut /Inc lt�--
TYPE OF S TCN= otal Le t l
ABSORPTION
Length of eac trend
Depth of tre he 2-
S1 ze of sto
SEEPAGE PITS : fumbto Xr � f t `
��
size �
Stave size Si hype
PIPING:
Bldg . to Tank
Tank to [list . 'Sox �` -_
Dist , Sox to Field/Pi t No art a
openings Seal ed7 e
LOCATIONISEPARATION : 0000` feet
Foundation to Tank on feet
Foundation to AbsorpLi feet
Separation of Pits s No
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPER
( circle o Lef ide _ Right Side
Front ea
Middle ront fiddle Rear
COMMENTS :
SYSTEM USE APPROVED :
No
Arri ved: '
Departed:
Building Inspector
2 mot
TorN OF QUEEMSBURY
gIIILOIM6 a CODE NFORCE"T
Queensbury MY 12844
(518) 761-8256
SEPTIC DISPOSAL SYSTEM IMSPECTIOM
Name 13
Location L {i p
�r+-� � Permit # I'C7 % 3
Date Y
-�-�f �. � /�
SOIL TYPE: Sand- Loam- Clay-
Results of Percolation n ste inch_
( i f applicable )
TYPE OF SYSTEM: Tot l Length
ABSORPTION FIE
Len th of each trench
Dept f trenc es
Size o tame
SEEPAGE P. um - f t .
Size - � . x � '—
Stone size Size Type
PIPING. �---
to Tank ---- —
Bldg .
Tank to Dist .
Dist . Sox to F eldlPi o artzal
Openings Seale ? Yes
LOCATIOWSEP TICIMS : feet
Foundation to }lank Lion feet
Foundation to Absorption feet
Separation of Pits Is IN
Conforms as per Plot PpROPERTY ;
LOCATION of SYSTEK ON
( circle Rear - Left Side - Right Side
Front - 'Middle Rear
Middle Front
COKWWS=
C - - 441 ►� -�
SYSTEK USE APPROVED =
YES Mo
Arrived=
Departed Ida
Building Inspector
TOWN OF QU ENSBURY
BUILDING & •
REVIEWED BY
DATE
_ 5811M
Zt M brdw
Nish w Car r+ tlhe u z r� f2 �'
IrO p"%i '�+d��ir�tub
tl�e Cade.
"f have seen or observed, or beNe� ,1;,I v ev,clence of
all obyects such as N . yes, wells, t=et: erlL4s,
shown on this document. i ai etc.,
SU reAresrs �# #;at 1 have
Y m t distances set forth on the qiagraALm
SiGNATU `� ,�o
DA E