98-775 BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No . _ ga775
TAX MAP NO , 111 . — 7 - 19 WARREN COUNTY* NEW YORK
PERMISSION is hereby granted to HILL
TTE
OWNER of property located at 7 BELLE AVE • 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 oueensbury Building and Zoning Ordinance.
t_ OWNER'S Address is
A . 7 BELLE AVE .
QUEENSBURYr NY 12804
2. CONTRACTOR or BUILDER'S Name
1 , B . Se SEPTIC
3. CONTRACTOR or BUILDER'S Address
2 LOWER WARREN STREET
QUIRENSBURY , NY 12804
4. ARCHITECT'S Name
5. ARCHITECT'S Address
5. TYPE of Construction — [Please indicate by X) SEPTIC
f I Wood Frame [ I Masonry { } Steel 1 l
7. PLANS and Specifications
SEPTItC. ALTERATION AS PER PLOT PLAN SPECIFICATIONS
a. Proposed Use
SEPTIC ALTERATION
25 December 21 192000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES
(lf a longer period is required an application for an extension must be made to the $uikfine and Zoning inspector of the
town of Queensbury before the expiration date.)
21 December 19 1998
Dated at the Town of Quen"'
Day of
for the Town of Queensbury
SIGNED BY
g inspector
Application for SEPTIC DISPOS E PERMIT
Town of Queeasbury Permit No.
Dept. of Community Development
Building & Codes Office
742 Bav Road Fee Paid S
Queer sbury, NTY 12804
Location of property for installation: 0
Property Owner's Name: � � c. f�C � ! t) 1 6 0e, �/_'�
Property Orwmer's MailingAddress: 9
Installer's Name: fog / / ` - Phone # ,q, " f--v91
Number of bedrooms (if residential.): Total daily flow: 4(fi- �_
(residential - compute 0 150 gal./bdrm.)
Topography: fiat, rolling, steep slope % of slope
Soil Nature: Yaud, loam, clay, other / depth:
Ground water: atwhat depth?& feet f Bedrock or Impervious 14faterial: at what depth? feet
Percolation test: IrT"� 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 ,r
Septic tank:{60O gallon '((mini rum size: I 't 0 gat..)
Tile field: each trench feet / Total system length: feet
Seepage pit(s): number of f size each: ft. by _ L fL
Size of stone to be used: # I depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Ntmber of tanks: Sizes of each ;aIlons
Alarm system surd sasociated electrical v«vx3t to '#�+ � by a certrtYe�d a�cy.
For your protection. please note that pruranaat to Section 136-29 of the Code of the Town of Queenslxay, any hermit or
approval granted which is based upon or is granted m luxnc-, upx a any material misrePrescultatim or f9gum to make a
material fact or c_*r+*=tance known by or on behalf of an applicant, shall be void..
I have read the regulaIIons with respect to this application Ama agree to abide by these and an req=rmends of the Tov✓n of
Queensbury Sanitary sewago Disposal C?rddmazrce.
Signature of responsible person: ------ Date:
OF EFJSBURY
SUIL3D,wr & con ENFORCEMENT
'142 Bay Road
Queensbury MY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Locations C-- -
Date #
permit # ���—
SOIL TYPE; Sand- Loam-ClaY-
Resulis o*ee
Percolation M 'Te te! Znch. .
( if applTYPE OF Le thABS(yRPTI : T alLength ore �+ ---Depth ofSize ofamber~� f-SEEPAGE t . xSize —Stone sSiz�ypePIPING: �Bldg - t ��—
pist . Box ff
Tank to Field/ P antia
Dist . Bax to No
+Dpenings Sealers? es
LOCATION/SEPARATIO8 / (7 feet
Foundation to Tank et
Foundation to Absorption 7 eet
Separation of Pits a No
Conforms as per plot Plan
LOCAI Il'N� OF SY Ors PROPER" ,
'� _ Right Side
( circle a Le ide
Front - ear iddle Rear
Middle Fro
capENTS
NO
SYSTEMI USE APPROVED =
YE
��
Arrivedmo
Departed: p
Building Inspector
• �
r TOM OF gOEENSBURY
BUILDING & CODE ENFORCEMENT
531 Say Road
128Q4
Queensbur]+ My
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date x g - � $ Permit #
SOIL TYPE : Sand- roam- ClaY......
Results of Percolation on TutelInc
( if applicable ) Rate- �----
TYPE OF Sy T ' D : otal h
ABSORPTION
Length of each enc
Depth of trenc s
Size of stone
SEEPAGE PIT 1 mber-� ft .
Size ftox
Stone size F
yPe
PIPINGa
Bldg . to Tank - -----
Tank to Dist . Box F, -----
Dist . Box to Field P e No arti al
Openings Sealed
LOCATIONfSEPARATION : 19 feet
Foundation to Tank Absorption feet
Foundation to eet
Separation of Pits es No
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPER
( circle
Front Pon
- Cdl'e
Side - Right Side
Middle - Rear
COMMENTS :
SYSTEM USE APPROVED :. YES O
Arrived :
Departed:
'13(2�
Building nspector
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90
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