98-292 -wr-_ __ r► - �._ AMU.IR w _ _.
Certificate of Compliance
Town of Queensbury
Warren County,New York
June 2
Date 98 98292
This is to certify that work requested to be done as shown by Permit No. •
has been completed.
SEPTIC ALTERATION
This structure may be used as a
474 RIDGE RD.
Location
Owner HUBERT, HAROLD & ALICE
TAX MAP NO. 57 . -1-11
By Order Town Board
TO UEENSBUR
/ abet,
Director of Building& ,ode Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 98292
TAX MAP NO. 57 . -1-11 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HUBERT, HAROLD & ALICE
OWNER of property located at 474 RIDGE RD. Street, Road or Ave.
in the Town of Oueensbury,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
474 RIDGE RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
SANITARY SEWER
3.anTRIlfiffforL 1810 224
GLENS FALLS NY 12801
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X) SEPTIC
( )Wood Frame ( )Masonry ( )Steel ( 1
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
No.
8. Proposed Use
SEPTIC ALTERATION
25 June 2 2000
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of t]ueensbury before the expiration date.)l June 19
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
Building and Zoning ctor
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No.
Dept. of Community Development
Building&Codes Office 742 Bay Road Fee Paid $ rJU�
Queensbury, NY 12804
l
Location of property for installation: ! -. y f l ce'
Property Owner's Name: /46Ni a L,7) /v 6 e 7v7--
N 199E4
Property Owner's Mailing Address: in d t f-
Installer's Name: -_A � . - Phone # 7 9 d 7 c)S 2
v-' t • e -- 7
Number of bedrooms (if residential): Total daily flow: cJ `�
(residential - compute @ 150 gal./bdrm.)
Topography: DI__flat, rolling, steep slope % of slope
Soil Nature: sand, i/( 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 /0° feet.
PROPOSED SYSTEM
,E tfI7r 6
Septic tank: /C'7 gallon (minimum size: 1,000 gal.)
Tile field: each trench c feet / Total system length: ' a ` feet
Seepage pit(s): number of 01/// / size each: ft. by ft.
Size of stone to be used: # Z / depth or thickness / feet
•
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
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 Code of the Town of Queensbury, any pew 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 this application and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Disposal • .11'"+ - D
Signature of responsible person: t2�� Date: 6 -/-j 0p
V k 0' y ( {)
�'�.: 1^ _ sue. ,�. i w
I
i, //0 zo �✓t.,(( TOWN OF QUEENSBURY BUILDING DEPARTMENT
Based on our limited examination,
compliance with our comments shall
not be construed as indicating the
plans and specifications are in full
f compliance with the code.
f
Ly y
f •
1 .
/
Joy 0 , 1998
Q (oJ i'l�/ht-
/
{
I � 0 S3 FILE
‹----so ‘> i ,,, ,, ,
...7_0 _,_„, c
i , .74.__
, ,
4. __ ,00 _,,. ..._.4
i , !
i ,
/"1
,
"I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells, trees, fences,etc.,
ow on this documen also represent that I have
' parson Ily measur nc t forth on the diagram."
Y/ r��j
J1
SIGNATU DATE J �f
)\. 30
TOWN OF QUEENSBURY
BUILDING 8 CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
..\:)
Name tt C,Nc- 6
Location LA 7 L
__ Z,,x_tc)
Date C® -D- 9E Permit # {�9 F`0.....9
SOIL TYPE: and-Loa -Clay-
Results of Pe colation est
(if applicable Rate- nute/ nch
TYPE OF SYSTEM: a
ABSORPTION FIELD: al Len h,
Length of each tre
Depth of trench j
Size of stone
SEEPAGE PITS: Nu ber-
Size - f . x ft.
Stone size
PIPING: ize Type
Bldg. to Tank .>
Tank to Dist. Box fr 5p 2 3c
Dist. Box to Field/Pi -, 4 n
Openings Sealed? detrIP No Par ial
LOCATION/SEPARATIi .
Foundation to Tank jfeet
Foundation to Absorption "75— feet
Separation of Pits -feet
Conforms as per Plot Plan et No
LOCATION OF SYSTEM ON PROPER
(circle
Front 'ea Left Side - OghSide
Middle Front - Middle Rear
COMMENTS:
we, 1-) t��'�lac - 0
SYSTEM USE APPROVED: YES NO
Arrived:. �� I5V
Departed: /l _,13-ae)
Building Inspector
(JtlCit
• .
t
i
;/ '
„„ •
/1- T l99
boo
I4 /0J
"I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells,trees, fences,etc.,
` ow on this documen also represent that I have
100 personally measur i nc t forth on the diagram."
212—
SIGNATU DATE