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2000-201
00 C-er 1 icate om"/%t f C 1anU#%e ".down of Queensbury Warren County,New York Nay 91 2000 Date �. ..- MOM This is to certify that work requested to be done as shown by Permit No. has been,completed. SEPTIC ALTERATION This structure may be tised as a 43 OAK TREE CIRCLE Location Owner GREEN, PATRICIA MAX MAP NO, 93#-5W133 By Order Town Board OF 'FF RY.-,—" r Director of Building& Code"W rcemeut BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 0 Building Permit No. 2000201 TAX MAP NO. 93 . -5-133 Permission is hereby granted to GREEN, PATRICIA Owner of property located at 48 OAK TREE CIRCLE in the Town of Queensbury,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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner's Address: 48 OAK TREE CIRCLE QUEENSBURY, NY 12804 Contractor or Builder's Name: QUEENSBURY SEWER Contractor or Builder's Address: JAY SWEET 0 Electrical Inspection Agency: Type of Construction: SEPTIC. Plans and Specifications: SEPTIC ALTERATION AS PER., -PLOT PLAN SPECIFICATIONS Proposed Use: SEPTIC ALTERATION 2 April 14- 2002. $ kRMIT FEE PAID—THIS PERMIT EXPIRES (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 To!� f Queensbury this I'Day of April 2000 ofeensl SIGNED BY for the Town of Queensbury Code Enforcement Officer Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. .OWNER INFORMATION: {................................................................................_.............................................».....t Office Use Location of installation: j C �/ •�c t,. , File Permit No. 1 Tax Map No. } Fee Paid �i ' Owner's Name: / ..........................................................................................................---....».....I Address: 2. INSTALLER'S NAME :_ t (ee=u.C(�C. PHONE NO. 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 older x 150 gal/bdrnn = 1980— 1991 - x .130 gal/bdrm = 91 present x 110 al/bdrm g '7rG Garbage Grinder Installed yes_ / no }�_ APR 1 r- 2000 Spa or Whirlpool Installed yes / no k TG,V,; 0- 1 =Y BUIL.CitF1L . 4." -PARCEL INFORMATION: (circle applicable information&indicate measurements) To o era h Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply sand at what.depth at what depth munici Rolling loam feet feet we Steep slope clay,, if well;water supply slope other from any septic-system depth: absorption is ft. other Percolation Test: (7'o 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:. 0 6e;l gallon(min. size 1,000 gal.) Tile Field: each trench ft. Total System Length: ft. Seepage Pits)a number of_ size of each: �' fl. by` ft.CR�L O C TG—Z7 Size of Stone to be used: #_ ;.3 1 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 of the Code of the Town of Queensbury, any permit or approval granted which is based.:npon 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, ( 3 Sign to a of tespiDnslbI6 person Date T0` � OF QUEENSSURY Sid I L[l I NC A CODE EN FURC EMENT 742 BC-1- Rco a cl Quec--ns; anrsy MY X2804 v — (518) SEPTIC DISPOSAL SYSTEM INSPECTION _ Locati can Date -5- Perini t # ( � SOIL -UYP� : Sand-- Loam-- Cl ay- Resul is of Percol a-ti on Test- ( if applicable ) Rate-Mi-n /Inc h TYPE OF SYSTEi4 ABSORPTI UW FI ZEW .'U : Total L e-n t h Le-ng-th of each trench Depth of tr-enches Size of stone SEEPAGE P N um rr- Si ze - Stool size PIPING ° _ Size Type BZ dg _ to Tank _ Tank to Dist _ Boxy Dist - Box to Fi el OJ/P Openings Sealed ? Yes Na Parti al t..iriCA-FI t/SEPARATION Fc3unda -ti on to Tank feet Foundation to Ab sor ti on feet Separation Qi= Pits feet Con-For-ms as per Pl o PZ an Yes Na LOCA-rX ON OF SYSTEM ON PROPER ( ci rcl e Front - ear >-- Left Si de - Ri g t Si de Niiddl a f=rc5n -t -- Middl a Rear COMMENTS SYSTEM USE APPROVED = YES NO A fir-rr-i w e+d ; D ep a r--�4a� f " Sum 3 c.�i ng I nspe'ctor C� r ro +J +J 4-) 0 d 4� / tU 0 � or. 0 W I Cn N �' Q V) au CO L J c �r z a W J c c or. c roa Q) a � U cz I 0 r- L .0tY r ro ro � � b C rl I 0 d v 0 4J 4 Q 4- .0 u lL 000 a a r WM0Cv �� a) >. I I � V) CL 4 � Id. ro r- 40 0 4- a(A �, �+ ro � © �. ro ,� ro 14J -P 0 s. � �" a LQ 64- N LU croQCa) O M H 0 I ""D.U. 0 4' '�' 0 0 ul +� ,r ,r � or. -„1 Y �" 04- Vt '� +j 000 0) P7" � � Iffoof 4J r a .0 i I tJ C Fo ro ro f� i�1 �-• v Z w a� 0 w0rn� v � 0CH " F- � *a ahu � w to �'' �Y9 0 N rWoNt� r ro �r O 000 `0(4 4- 1 C a N Uol N 0 -0 Ll E V1 '� U �. .r- 0 ,t 3)It�.�x�t�151X3 NOW >EMIC 4o PIEi !P1 ; ' ( tf~('ri A L Vfck x NotF No VSS11100 35. It' (Omcpjx- r'I ?AV APb(P) 1?OOL UP 1'o uG. IoS APOUND FbOU >aR0'��rC�. IN-GRt�u�fu'Sw�n�Itil�CrR�o� " , � �r HUMSpF: : P�l'IRICI� P,, GP�.�11 t . - QIIECFlS�t�1'y t. PI�:VU'yOfK'K �ZEj'1'� �"�TRe�i IN WVIp:', 51-133 � vPmltl(., pVAfilfl 81 tyMn MoRkrS r;�,Iiec.l) AWPOWAT SCAtr. 93. GREEN,;'.PATRICIA' 48° QAK-.TREE' CIRCLE 5UTIC ALTERATION o VO4-EAQ5;1)e uj => Lu 2 :Ew (� rB� � tl E k , �r� N .� i' O:3 X(5/ ` U ,tea ^.+2 ` � LRJ C � C W 9P INOCOCC T USE48 . Q - �' DECK x m y N uc • 6 r i NO ZMA9 35! ,' 4' CONCRF E ,f ?001., up To Ne UUNp POOL PROR3��p �N—GRtauN sw�M� a� FOOL "I haw or observed;or lieve I saw evidence of, ? AT HOME OF all obi Su u r trees,fences,etc., pA , r. rV shown on this document,I also represent that,I(have 4b onY, -rRu personally measured the distances et fort on the diagram:' T1% MAFP ID ,' 93-5-133 PPROXIMk SCALE�RAuJ�FIr� pR 'r 't� By cy MA/u k C��c.i);. �IGNATURE DATE -r; =ZOI bs Vhwfix<IpPOVID(z �t Rulibur&Cox +LE