2002-362 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
CERTIFICATE 'QF 'COMPLIANCE
Permit SNumber: P20020362 Date Issued: Thursday,May 16,2002
This is to certify that work.requested to be done as shown by Permit Number P20020362
has been completed,
Tax Map Number: 523400-301-006-0002-044-000-0000
Location: 24 SWEETBRIAR Ln
Owner: TODD AGANS
Applicant: TODD AGANS
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
�..
Director of Building&Code Enforcement
WMEEMEMN
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development- Building & Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020362 Application Number: A20020362
Tax Map No: 523400-301-006-0002-044-000-0000
Permission is hereby granted to: TODD AGANS
For property located at: 24 SWEETBRLAR Ln
in the Town of Queensbury, to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: TODD AGANS Septic Alteration Residential
MONIQUE LAMARCHE-AGANS Total Value
24 SWEETBRIAR Ln
QUEENSBURY,NY 12804-0000
Contractor or Builder's Name j Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2002-362
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Tuesday,May 13,2003
(If a longer period is requited,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the,. of Q nsbu d May 13,2002
SIGNED BY up/, for the Town of Queensbury.
Director of Building&&de Enforcement
518 -745.-4437
FILE No.638.04,-02, '02 A"1" 11?25 ;i D:TOWN OF QUEENSBURY FAX'518 745';4437' PAGE 1 "
=AppUcationt for Permit—Septio-Disposiai Systsin
"Tawn,"vfQtteetssbury742 Day RaadQueensbury,:NY 12604.CJI8j.761-8?36',.
1, OVr ER INFORMATION:• :
Locaticn•ofinstnuation• �` 2�'I r i-�• G•9'dr M ?��
File Permit No _��✓..�
Tax Map No.' l
_ Fee Paid
bb
-o
Owner's Name: " Jr�.r ................_... _..
Address
2. INSTALLER'S NAME .
PHONE NO.�.
3. RESIDENCE INFORMATION: (circle}+ ar of dwelling,indicate#bedroom($) and multiply#.of
bedrooms with applicable gallons per bedroom to equal total daily )
Year of House" No of Bedrooms g C.Qtiili.rz, ;ox1= Total Daily Flo�st �
x.. 150 sai/bdri
A 20021980 or older 10g
1991 —present x 10 al bdrtn
W/V
C3arbage 3rindor Installed yes T
/ aoj®�Q(J� �8
Spa or Whirlpool Installed '.' yes _ / no 60 y,
l
4. PARCEL INFORMATION: (circle applicable information&indicate measurements)
and at what depth at what"depth ci al
a in got feat,
fa • ?�'
Steep ope eslay ff wdt,water supply
%slope other from any septa-system
depth: absorption is }l•
other
Percoledion Test:, (To be completed by licensed professional engineer or architect)
Rate: minute per inch
5. PxZOPOSED SYSTEM-. Iron Ne ego,truction. All individual sewage disposal systo:ns.mtist be designed by R licensed
professional englnm or architect(unless installed in a planning Board approved subdivision). Add 730'gallons to the size
Of the Sande t=k d leach field for each Garbage Grinder.Spa or Whirlpool Tub.
1• �,;�•i<1'-tub.
Septic Tank: 1�QJ $awl-Loon(mfn. size 1,600 gal.)
Tile Field% each,trench `___ Total System,Length:
:�;
Seepage Pits): number of 0 size of each: _1# by
Size of Stone to be used: # / depth or thickness loci
Bed System Size; x
Alternative System: ' length and/or size
6. HOLDINO TANK SYSTEM: •(if'required)
Number,of tanks:. / Size of each: gallons /TOTAL Capacity: gallons
Notsr Alarm.System and*ssociated.otectrical v�ork must be inspected by a Town approved
electiical;insp+ectioit agency.
TJ
7. SIGNATURE &nqFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection,please note that pursuant.to Section 136-29 ofthe Cade 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 thct ar
ciretimiitance known by or on behalf of an applicant, shall be void.
I have read the ieguIations,with,respectto this application and agree to abide-by theme and all
re em Town of Queeas Sanitary evvage Disposal Oi�diaan e..'
$1p` resp+ons ble person,
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