2002-867 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518)761-8256
. ATE. OFCOMPLIANCE
�ERTIFI�
Permit Number: P20020$67 -Date Issued: Thursday,July 17. 2003
'This.is to certify that work requested',ta be~done as shown:byhermit=Number 7
has been completed.-
Tax Map Number: 523400-279-017-0002-033-000.0000
Location: , 60 SUNNYSIDE RD,NORTH
Owner: CHRISTINA SCHONENBERGER
Applicant: CHRISTINA SCHONENBERGER
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
< 742 Bay Road,Queensbury,NY 1280475902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020867 Application Number: A20020867
Tax Map No: 523400-279-017-0002-033-000-0000
Permission is hereby granted to: CHRISTINA SC14ONFNBFRCTFR
For property located at. 60 SUNNYSIDE RD. NORTH
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: CHRISTINA SCHONENBERGER Septic Alteration Residential
R.F.D. #1 HIGH St Total Value
LYME,NH 03768
Contractor or Builder's Name/Address Electrical Inspection Agency
STEVENSON. WALT
Plans&Specifications
2002-867
Residential septic alteration per plot plan and specifications.
$25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Friday, October 17,2003
(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 October 17,2002
SIGNED BY r7D��;F for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit—Septic Disposal System ��`�'`
Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256
1. ONVNER INFORMATION:
Office T3se
Location of installation 0� -'"�)
�-�G�✓
((���} _ File PermitrNn•. ��
Tax Map No.ZZZL7/_�__/ 3 R,F�.s t `t 0
Owner's Name: '4 � �o Fee Paid
! -� [OC-T.._t.....�;-..o...................................................................... -
Addr ss .� C ! / V OkWl Or (-IIJEENSBURY
' t_"5 ni'!^ '' 1 CODE
2. INSTALLER'S NAME d rev c� z� pPHONE NO. 793-. 73�?
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 Flow
1980 or olde 2 x 150 gal/bdrm = .>ez�
1980— 1991 x 130 gal/bdrm =
1991 —present 92 x 110 galtbdrm =
Garbage Grinder Installed yes_ t no
Spa or Hot Tub Installed yes_ / no
4: PARCEL INFORMATION: (circle applicable information&indicate measurements)
Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply
Flat 114iO at what depth at what depth municipal
Rolling loam feet feet well
.Steep slope clay ZZAw if well; water supply
_%slope other from any septic-system
depth: absorptio}'4i is ft.
Percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minuteper 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: —gall n(min. size 0001 gal.) A0 4'G/r, �ilvk- d`ate
Tile Field: each trench ft.� System Lengthy' �✓J ft.
Seepage Pit(s): number of size f ea h: ft. by ft.
Size of Stone to be used: # / dep or ickness feet
Bed System Size: x
Alternative System: length andlor 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 of the 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 of the Town of Queensbury Sanitary Sewage Disposal Ordinance.
Signature o esponsible person Date
Iv
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7. SIGNATURE 8Z Il�tFOIiMATIS�T�Ft�kt�E:�kv1���tss.� �s��•,1��Lo,�•-•��.v
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Septic Inspection Report
Office No. (518)761-8256 Date Inspe ion questreceived:
Queensbury Building&Code Enforcement .Arrive: am/pm am/pm
742 Bay Rd., Queensbury,NY 12804 Inspector s Initials:
NAME: SXhcr
PERMIT NO.: 967
LOCATION: ��T
INSPECT ON:
RECHECK:
Comments and/or diagram
Soil Type: Sand Loam Clay
Type of Water: Municipal/Well Water
Waterline separation distance
Well separation distance
Other wells: ft,
Absorption Field: Total length ft.
Length of each trench ft.
Depth of trenches
Size of Stone
Seepage Pits: Number
Size: x
Stone Size:
.Pi in Size LY2 e
'41, P70
Building to tank RIC
Tank to Distribution Box
Distribution Box tAZield Pit
Opening Sealed4Y,40N/Partial
Location/Separations
Foundation to tank -L- ft,
Foundation to absorption ft,
Separation of Pits ft.
Conforms as per Plot Plan ;UY_N
Location of System on Property:
Front Rear Left Side RiE Sid
Middle Front Middle Rear
System Use Status:
Approved
Partial Approved and needs to be re-inspected,please call tbe'Building&Codes Office
.Disapproved
L:\SueHemingway\Building.Codes.Inspection,FORMS\Septi-,Inspection Report.doo January 28,2003
10/06/2002 14:01 6037959346 LYME TOWN LIBRARY PAGE 02
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-10t,"NOM-rLENS URYSUILIG! GH-f-AUMENT-
8mied on our limited examination,
13UILDING &- C S EP compliance with our comments shall
w Y r11)t be construed as indicating ti�,q
REVIEWED BY
plans and specifications are in full
DATE comioNance vvith the cede