96-346 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 3 19 9 .
This is to certify that work requested to be done as shown by Permit No. y634
has been completed.
This structure may be used as a SEPTIC ALTERATION
Location 51 RIDGE RD.
Owner CARTER, JAMES & ELIZABETH
By Order of Town Board
TAX MAr NO. 52 . -1 . 1 TOWN OF QUEE SBURY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 96346
TAX MAP NO. 52. -2-1. 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CARTER, JAMES & ELIZABETH
OWNER of property located at
51 RIDGE 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 plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
BOX 1325
FORT ANN, NY 12827
2. CONTRACTOR or BUILDERS Name
STARK & SONS
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 June 24 19 98
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
24 June 19 96
Dated at the Town of Queensbury this Day of
SIGNED BY for the Town of Queensbury
Building and Zoning cto
J
--- Application for SEPTIC DISPOSAL PERMIT O
SI'AMI' RECEIVED
Location of property fur installation: it'•a b ��- O
Owner's Name J: ` tit C-.�'•?'7 z.r-- PERMIT NUMBERt0
Owner's Mailing Address: �l �� ce,
tri
1'I:I: PAID OS
z
Installer's Name: S'%e€Yr k .5.-0,s Phone #: 7%%,1--o, f'f
td
Number of bedrooms (if residential):
Total dailynow (residential - compute qr 15(1gal. per bedroomf `��
I � 1 ):
Topography: Hat I I Rolling I I Steep Slope % of Slope
Soil Nature: [1 Sand I Loam Clay I I Other /Depth:
Ground Water: at what depth? !7^' Y/1,6>G✓// feet
Bedrock or Impervious Material: at what depth? 41")4//a147,1✓feet
Percolation Test: I k I Not Required I I Required/Rate min. per inch
Domestic Water Supply: I I Municipal I rj( I Well I I Other
If domestic water supply is a WNi.1.: water supply from any septic absorption is /.f,(1 feet
PROPOSED SYSTEM: JUN 2 i- 6 199
Septic tank:/UV U gal, (minimum size: 1.0(1O gal.) t►1! Cl
'tile Held: each trench feet. / total system length feet.
Seepage Pit(s): number of A- / size each: ft. x ul ft.
Size of stone to be used: # 2 I depth or thickness _ Z feet.
IIOLDING TANK SYSIEM: (if required)
Number of tanks: • Size of each: gal.
Alarm 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 ('ode of the Town of
Queenshury, any permit or a p proval granted which is based upon or is granted in reliance upon
any material misrepresentation or future to make a material fctct 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
requirements of the. Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsib'e person: �l v '''<f' ,-9,-- i/. ,�' Date: i /1/'7'
TOWN CF QUEENSBURY 31
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location `J l 6i;c)cjz.....Date �
�� Permit #9C M r
SOIL TYPE: Sand-Loam-Clay- 54ti
Results of Percolat'on Test-
(if applicable) Ra e-Minute/Inch
TYPE OF SY TEM:
ABSORPTION FIELD. Total Length
Length of -.ch • ench
Depth of tr,•nc' -s
Size of sto e
SEEPAGE PIT Number-
Size - ��. ft.,. 3 ft.
Stone size ;
PIPING: Size -e
Bldg. to T. k . ' z f 50
Tank to Di .t. Bo w
Dist. Box to Fief = P • - g-b
Openings .ealed? es No Partial
LOCATION SEPARATIC
Foundati .n to Tank °Meet
Foundation to Absorpti. feet
Separat on of Pits L° eet
Confo s as per Plot Plan fp No
LOCATII OF SYSTEM PRO' RT.
(circ e one)
Fron ' - Rear - Left Side - ;eight Side
Mid. e Froflt - !v!iddle Rear
CO , ENTS:
SYSTEM USE APPROVED: YES NO
Arrived: ( ° 0 5
Departed: ! V
Building Inspector
• r
e0
TOWN CF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804 C L"
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 5:
4-k K Cz ')
LocationL `llsi
Date ! - 6
Permit # --
/M_J___
SOIL TYPE: Sand-Loam-Clay- r., . 1v
Results of Perco ation Test-
(if applicable) ate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD Total Length
Length of each ench
Depth of trench
Size of stone
SEEPAGE PITS:- -lumber-
Size - ft. X ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. ox
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan — Yes No
LOCATION OF SYSTEM OF PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - "riddle Rear
COMMENTS:
&Mc Z--i*co r----- .
SYSTEM USE APPROVED: YES NO
IA
Arrived: -W
Departed: wjl
-\.14 /( -
Building Inspector
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 BAY RD., QUEENSBURY NY 12804
INSPECTOR'S REPORT: ARR3I/> DEPART;2J IN'
REQUEST FOR INSPN RECE�VED:
NAME �i 1 iC)rCIL F
LOCATION 7/. {/
DATE •f.r PERMIT #
TYPE OF STRUCTURE: _ C\S—
RECHECK _ APPROVED
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR Fs.
REINFORCEMENT IN PL CE
THE CONTRACTOR IS RE "ONSIBLE FOR
PROVIDING PROTE TION "OM FREEZINt
FOR 48 HOURS FOLLOWING THE PLACE-
MENT OF THE CONCRETE.
MATERIALS FOR THIS PURPO ON SIT
FOUNDATION/WALLPOUR
REINFO C T IN PLACE
FOUND N DAMPPROOFING
B FILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING: _
JACK STUDS/HEADERS -
BRACINGBRIDGING
JOIST HANGERS
JACK POSTS/MAIN BE.,
AIR INFILTRATION BARRIER
HEATING ROUGH-IN
INSULATION:
FOUNDATION WALLS INTERIsR R-
FOUNDATION WALLS EXTERIMINII
FLOORS R-
WALLS R-
CEILING —
R_
DUCT WORK OR PIPING IN
UNHEATED SPACES R-
144cp‘C..4"(
6/(
ire frviQ
Ue <GLt ur-fell�L1P/c,
o.)er Ne). y Go • //
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si mos stem doped;of beim 1 sow swim et
se 014ects se*ilii lieuses,wells.tlies•Weft OtC,
shosni on this dssument. I also represent that I Mee
perso" ally tosssored the distances set forth oath*diorelk"
,
SIGNATURE DATE
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