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2002-240 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518)76178256 CERTIFICATE. OF COMPLIANCE Permit Number: P20020240 : Date Issued: Friday,May 06,2005 This is,to certify that workrequested to-be,done as shown by Permit Number P20020240 has been completed, Tax Map Number: 523400-279.017.0002-026.000-0000 Location: 80 SUNNYYSIDE RD.NORTH Owner: KENNETH&JOAN ALDOUS Applicant: KENNETH&JOAN ALDOUS This structure may be occupied as a: By.Order of Town-Board.. Septic Alteration Residential TOWN OF QUEENSBURY Director of Building&Code Enforcement y TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020240 Application Number: A20020246 Tax Map No: 523400-279-017-0002-026-000-0000 Permission is hereby granted to: KENNETH&JOAN ALDOUS For property located at: 80 SUNNYSIDE RD. NORTH in the Town of Queensbuty, to construct or place at the above location in accordance with application together with 'plot plans and other information hereto filed and approved and incompliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction Value Owner Address: KENNETH&JOAN ALDOUS Septic Alteration Residential 80 SUNNYSIDE NORTH Total Value QUEENSBURY,NY 12804 Contractor or'Builder's Name f Address Electrical Inspection Agency Plans &Specifications 2002-240 SEPTIC ALTERATION AS PER APPLICATION ,$25.00., PERMIT FEE PAID- THIS PERMIT EXPIRES- Thursday,April 10,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of eensbury; Wednesday,April 10,2002 SIGNED I,( for the Town of Queensbury. 10'�ode Enforcement Director of BsLg Application for Permit—Septic Disposal System Town of Queensbury 742 Bav Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: ..............__......_........_...__.........._.._.................._._.............._........... .., fi, /�/� Office Use f-y Location of installation: ci�d./R e SC File Permit No. e9LS Tax Map No. jj Fee PaidI� `f Owner's Ne:O am e ryW��l'1 1 t .lt9 tC Address:P7 S ti IV 10 y r` 2 �. �v, e h15' . th l�-'(y1 19,ZOt t 2. INSTALLER'S NAME PHONENO. 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s)and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No of Bedrooms x Computation = Total Daily Flov I 1980 or older 3 x 150 gal/bdrm = y� APR 1 0 2002 1980— 1091 x 130 gallbdrm 1991 —present x 110 gallbdrm = _�D�N OF QUEENSBURY RUIt_.aI AND BODE Garbage Grinder Installed yes_ /.no - Spa or Whirlpool Installed yes_ I no _ 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) TopoQraphv Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Flat -'sand at what depth at whq depth municipal i am 2--feet feet e Steep slope clay if well,water supply _%slope other from any septic-system depth: absorption is 1t. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: �---minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool-Tub. Septic Tank: 1660 gallon (min. size 1,000 gal.) Tile Field: each trench .S ft. Total System Length: ­5% } Seepage Pit(s): number of size of each: ft by Size of Stone to be used: # / depth or thickness feet Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE .&INFORMATION FOR RESPONSIBLE PERSON(please read).. For your protection,please note that pursuant to Section 136-29 ofthe Code of the 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 void. I have read the,'regulations with respect to this application and agree to abide by these and all requirements ofthe Town of QueensburySanitary Sewage Disposal Ordinance. Signature of responsible person " COMMONWEALTH ELECTRICAL INSPECTION . CTION SERVICE,INC. Main Office 176 Doe Run Road-Maitheim,PA 17545 . MUNICIPAL CERTIFICATE -' ELECTRICAL APPROVAL Permit No........... 84819 ...Cert. Cut-in Card Na..................................... Owner................. �L: ..................................................... ;.: Location._....RO.... .. Y2 r.. ................... Installation Consisting of/�..,,,50uc';2tw.� ?oi .............................................!�'�'"�1� n/ _....._ ............ ..c.S..-..-_..............-...__.......- .....................................................:............................................................................ 13 Installed By....� ......... � The conditions following governed the issuance of this certificate,and any certificate previously issued is cancelled:This certificate only covers.the electrical equipment and installation conditions as of date. Upon the introduction of additional equipment or alterations,application shall be promptly made for inspection, Inspectorsof this Company shali have the privilege of makin i spections at any time, and.if its f" rules are violated,the Company shall have the right to v e th' ificat A �Date................................................... INSPECTOR ....... . ....................................... Member N.F,P.A.,1.A.E.1. `r , � 'W 0 � a� D � � r W a 0 to N � Ek W >W W �• V) 'r r #r5� a. `j 0 �7IY. CJ Aft)0' or w w 0 V Z V) 0 (4(JO�Z �rr-1 zo C m � � " 0 ro m as E V 0 � 0 0r 4- � W 1.6 0 0 P CM IZ 4- ,0` #1 S. J �,r H C N P Q W .Q) 01 �# G » 0 W.0 U I W 0 0>» h ro 0r- H U C 0 r40104- CLO Q» I+ of 0 CL a .© 1.6o0CV) C4J00 P V 0 r, S. 4-), Q Or M y Q 4• U (4 4J4JM a) I- 'r" oOCCC 3QCtU0 1 CQ W 0'r' V} - N a N C X � 0 0 0 0 0: C Q r• H 0 4„ or 0 0 0 +r -P-' Or- (A M 0 N O.LLI' 04-W N +) 0C M P4JP Eo 0 I Imo' 4J 0.0 1 -C 0 Q I 0 V C it tit it 00 r W p9 �a r 1% 4-)Z Q 0 X f.r, ti 10 S• 0 U P N ro Q) :3 W00)PO4NCHM� +) C CCit4- C `0 'r* � 1 U +J MI M4- CIOO C IINW N 0 CL 0r. V) 0) 4w00QCU 'r0 "0 X III N 0 0 0•r *M 4) 0 tr-W 'r 4j b r- (0 'r ao 0 0 4) 0 0 U S. 'r 0 L. 0 Queensbury Laboratory Queensbury Water Department 823 Corinth Rd Queensbury,N.Y. 12804-9725 (518)793-8866 New York State Certification# 10565 EPA Lab Code#NY01262 Report of Bacteriological Examination Date Collected:04/02/2002 Sample Number: 61490 Date Tested:04/02/2002 Time Collected: 11:45 AM Collected By:Joan Aldous Time Tested: 2:00 PM Sample Point:Bathroom Faucet Address of Sample': 80 Sunnyside North, Queensbury,NY Supplier:Kenneth Aldous Sample Age(hours) Fed Id: 2.25 Total Coliform (#/100ml):<1 Heterotrophic Plate Count(#/Iml):2 E.Coli: Free Chlorine: Fecal Coliform: Procedures Used: Total Coliform-Membrane Filter with LES Endo Agar, SM 18 92.22B i�kCCEIVED Plate Count-48 Hour with Plate Count Agar 9136,SM18 9215B Fecal Coliform-Membrane Filter with mFC Agar APp 1 0 TOWN OF QUEENSBURV E.Coli-Nutrient Agar with mug 9130,40CFR 141.21 (f)6ii Suit ow N D CODE AT THE TIME THE SAMPLE WAS SUBMITTED: The results of the analysis of this sample were satisfactory and met the requirements for potable water. Laboratory Director � �' � ___--- � �� � o � � ■ s��F � � s e 1 � � .• ■ . �► ■ ����� � I Kenneth Aldous 50 Z Jvrs ?WA? 5?An . 7S* Wfu To SF—mT,� W ya, WZU TO fb.Ar MATS SS ' JCtfy [ENE To SSW, LIuF 7 Fo�nrah7 , xrwen ti.Mk 2 • "y R w441. We7llllly M)" of 50 0 50 100 ISO 200 250 Feet i BUILDING & ��s To REVIEWED BY DATE