97-467 � �_ T . .
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date August 21 19 97
97467
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
Location 693 RIDGE RD.
Owner CRISLIP, NED & JOYCE
By Order of Town Board
TAX HAP NO. 55 . -1 -12 .. 4 TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 97467
TAX MAP NO. 55 . -1-12 . 4 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CRISLIP, NED & JOYCE
OWNER of property located at 57 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.
I. OWNER'S Address is
R.D. #1 RIDGE RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
COLLETTE CONSTRUCTION
3. CONTRACTOR or BUILDER'S Address
9 COLLETTE LANE
HUDSON FALLS, NEW YORK 0
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( I Wood Frame ( 1 Masonry ( I Steel
7. PLANS and Specifications
SEPTIIC,. ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 August 19 19 99
$ 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 Queensbury before the expiration date.)
19 August 19 97
Dated at the Town of Queensbury this D.
i f
SIGNED BY -( 14111k for the Town of Queensbury
Building and "'fling Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury , Permit No. q -7- 1167
Dept. of Community Development J -' I
Building &Codes Office OC)
742 Bay Road Fee Paid $025�
Queensbury, NY 12804
5?
Location of property for installation: '< JT i Z
Property Owner's Name: It)9 ;s p/i o
Property Owner's Mailing Address:
Installer's Name: ;�i ( +67 e !/ Phone # 7 g 7 - CI 2
Number of bedrooms (if residential): j Total daily flow: (7/r7.�
(residential -compute Q 150 gal./bdrm.)
Topography: flat, rolling, steep slope 90 of slope
Soil Nature: sand, /loan% P44 clay, othz:/depth:
Ground water: at what depth? — feet / Bedrock or Impe vicus Material: at what depth? feet
Percolation test: not required, required [rate min. per inch ui
Domestic water supply: municipal, ✓ well, oar
If domestic water supply is a WELL, water supply from any sec c absorption is /ex) feet. /'/U.S
PROPOSED SYSTEM
isf
Septic tank: //Z'D gallon (minimum size: I,000 gal.)
Tile field: each trench j'0 feet / Total system e gth: -.?' 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
I
Alarm system and associated electrical work to be inspected by a certified agency.J
For your protection, please rote that pursuant to Section 136-29 of the Code of:fie 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 wick.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbury SnnitAry Sewage Disposal Ordinance. f�
Signature of responsible person: �- !- �', Date: -17/?
\ \ — U ;
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTN
Name _....i\r'S -_-1....lx,c) mei
Location _
Date .,,9 `97Permi t # — (p 7
SOIL TYPE: Said-Loam-Clay-
a
Results of Pe colation Te t-
(if applicabl ) Rate-Minte/Inch
TYPE OF SYSTE
ABSORPTION FIELD: Total /Length .0
Length of each trench , ,70
Depth of trenchOs `' ,2'3'
Size of stone e2„
SEEPAGE PITS: Number
Size - ft. x ft.
Stone size
PIPING: \ Size i Type
Bldg. to Tank ,ik-s&
Tank. to Dist. Box yo v �
Dist. Box to Field '',it 5'1 c
Openings Sealed? Yes No Partial
LOCATION/SEPARATII S
Foundation to Tan ' 4, feet
Foundation to Ab •rpton S v feet
Separation of Pi s ,�j,- eet
Conforms as per 'lot. Plan -7 QV No
LOCATION OF SYS M ON PROPERTY:
(circle one)
Front - Rear - eft Side Right S�Sc
.)
Middle Front -,Middle Rear
COMMENTS: #r
i
i
is ) frp/J
17
r
SYSTEM USE/APPROVED: el) NO
Arrived: AO
Departed:
'-4
Building Inspector
Collette Construction, Inc.
9 Collette Lane Hudson Falls, NY 12839
747-9451 or 747-5133
747-5781 FAX g/ sfq
pco ,,{ v 0
1.1...�> UEENSBURY gtJt{.DtND DEPARTMENT
0. `' TOWN Of Q
r
- _
Based on our timltaed comments shalt
camptiance w'
��t-c�, ; not be construed as indicatyngt e
j ( plans and spedflcations are in full
0 .....---E
Db
11',.�./.0(' comR9iance with tfie code.
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