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2000-325 r �+ d ... V ..��y �x��. }�, ^ •rrt.J �t� �' ;.V., � � -i J �.f/ f I �' • � rr Y ompliance ervi iCate' '' 0 ' 6- n of Queensbury ` women County,,New York aY 19 , 2000 ' .Date 3 yr. , Cal , This is to certify that work requ�ested to be tone as shown by Permit No, t has been completed, SEPTIC ALTERATION. This shidure may bJe used as a HILLCR T AM` I Location LIGHT 'GOT , ROBERT , �•• -4 Owner TAX KAP NOo 974 -1- A By Order Town ward, 0 tJR s t f Director of Building&Code` ntorcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VALUE $ Building Permit No. 2000235 TAX- MAP NO. 97 . -1-1 . 4 Permission is hereby granted to LIGHTFOOTE, ROBERT & Owner of property located at 2 5 HILLCREST AVE. 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: DIANE 25 HILLCREST AVE. QUEENSBURY, NY -. 12804 Contractor or Builder's Name: COOKS. SEPTIC Contractor or Builder's Address: 12801 Electrical Inspection Agency: Type of Construction: SEPTIC Plans and Specifications: SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS, Proposed Use: SEPTIC ALTERATION 25 - May, 16 2002. $ PERMIT FEE PAID—THIS PERNUT 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 of Queen s 16- Dayo May 2000 SIGNED BY for the Town of Queensbury Code Enforcement Officer Application for.Permit-Septic Disposal System Town qf Qtteetisbuiy 742 Bay Road Queeirst)toy,N1' 12804 (518) 761-8256 1. OWNER INFORMATION: .................. Office Use Location of installation:-.. I A S7- Tax Map No. Z/ MAY I Permit Noc7;2(:V1i0— S Owner's Name:. F.Qfj4e cc Paid As8uay........... ............. ............ .............. ............ Address: 2. INSTALLER'S NAME PHONE NO. 3. RESIDENCE INFORMATION' (circle year of dw'e'r1ling,indicate 9.bedrooin(y) and multiply It q1' bedrooms with applicable gallonsper bedroom to equal total dailyflow) Year of House: No. of Bedrooms x Colliputatioll- Total Daily Flo 1980 or older X 150 gal/bdrin = 141 1980- 1991 X 130 gal/bdrin 1991 -present x 110 gal/bdrin Garbage Grinder Installed, yes no Spa or Whirlpool Installed yes n, 4. PARCEL INFORMATION: (circle applicable information &c indicate measurements) To o So -ra li 5- ---iL ature Ground Water Bedrock or 11 Water S" sti pjq��� 120 water -11+"!nt sand at what depth - 171 Wha' t depthvl Rolling feet <.we TC i-1 ,_ Steep slope CI-Y well Yo slope other if ; water sulylily from any septic-system depth: absorption is other Percolation Test: (To be�,'completed 6y,licensed engineer or architect) --nn rn p t e et-M Rath: ch 5. PROPOSED SYSTEM: For New Construction- All individual sewage disposal systems must be designed by a licensed icciised professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 g4llons to the size of the septic lank and leach field for each Garbage Grinder,Spa or Whirlpool Tub. 7 Septic Tank: tr-> [D gall(in(min. size 1,000 gal.) Tile Field: each trench I Cg�&�bft. Total System Length: A. Seepage Pit(s): number of size of each: —ft- by Size of Stone to be used: # t-SIA. depth or thickne.vs Bed System Size: X Alternative System: length andlor size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: I Size of each: gallons /TOTAL Capacity: gallons Note. Alarm System and associated electrical work must be inspected by aTown 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 oil behalf of an applicant, shall be void. I have read the regulations with resp6c`t-to this application and agree to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. 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VI C Q.NW N 0� C O '4) U 0 0 MCUfr 01 V) ro 0 it 0 v -r > Q Q) (U+rW +r- 4-)Hr 0or a 0 0 4! 00 U L It-Q � � .J f0 Va at0LnV) 0V) G lmN- 0 0 jILILV) UW..ILZu V� $Q -TOHM OF QUEEKSBURY BUILDING a CODE ENFORCENENY 531 Ba-Y ftcmd Que_-&-_nSbur-_V MY X2304 SXB-745-4447 SEPTIC DISPOSAL, SYSTEM INSPECTION Name Loca-tion -Z—I Da -to _-Rer-Tni -t SOIL m- C-1 a y- -t Rosuls of P-e- i-col -ti e_ i§on T _ ,-t- ( 1 -F applicable ) Raj-Minut �/ Inch TYPE OF SYSIFEM= I_2_1 f ABSORP_FION FIER-D : T . -tal Lonb-th Length a-F ach 7tr-e-n h _Depth of _t1_ chos T . x-4 Size of stone . SEEPAGE PI-TS : NO Size F x .Stone size PIPING: ze Type Bldg - to Tank Tank to Dist _ Box D -is-t - Box to Fielclo'Pit: Nv_�OVA_ Openings Se-al e_cj ? es 0 Partial 1LOCA-FIOHZSEPARA7FXG - Founda-tion to Tank L.-& Founda -tion to Absor-p ! on -Feet S ep a v-a7ti an o-f Pi is feet Conf'omns as per Plot I an Vc-- s LOCA-UIOW OF SYS-YEN CM PROPER-Flf ( circle one ) Front - Re-ar- - L4----Ft- J e - Righ -t Side Middle Front Mic-IC110 ear, COMMEN-TS = XD �DVN� ? c SYS-FIEN - USE APPROVED= YES No Ar-r-1 D qoo ro 4N -P 0 Q a s, - 4-4- a 4� (D s S. C rl 0 U 0 X a �9 CL f m i Il ip LL '�' 't7 a a LL .to ro S1 C C 4J 0 ro CL -P � 0 r, .}� �' r M rod? NS. O� rot� 4JOW WOroC ' �� cr Q ++ U � 4J �N 0 f-� ,r V) NCCCro0C00 z v C Oryk 04. r OQ 0 VI ,°r�°+° 0x S, �� M r r 0 Z a '0 +� as .0 ° 4~W N 4J 0 m 0) - � � a� a W 0 0)4J H rnx� r.it c c ro'4.ct w W ro U 4J M u► 4�q. � CCLNWN011roC0MUnz �..�� �- off �W 0-1r. �r N �• Q, fY��+� ..1QU}�f`�t13V}AI�.11M ��l.�..l�tl} ��,Cl,' A L" U 0 Q4 Bob Lbhtfoote 11 Mcrest Resklence operty fine 100ogaHon Deck tank 20ft Belt • 15ft 60ft "loft Bft on comer:distance fast two rues Oft between deck and other fine. Infiltraters EQ 24 COOKS SEPTIC 696'4500 "I have seen or observed, or believe I saw evidence of, all objects such-as houses, wells, trees, fences, etc., shown on this document, I also represent that I have p " n ally measure ist ce fo on the diagra ." SI ATU E TE OF QUEEN RY �V' TOWN � op BUILDING & T'. roy��AY 9 2000 REVIEWED BYE AD�� d1d?y DATELa Co