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2000-423 L... Certnicate of Compliance Town of [ueensbury Warren County, New York June 20 2000 Date ' ig 2000423 This is to certify that work requested to be done as shown by Pen-nit No, has been completed. SEPTIC ALTERATION This structure may be used as a ___ 169 SHERMAN AVE . Location Owner . LOOM I S , AARON , J R . & TAX MAP NO * 1 1 5 . - 3 -- 10 By Clydor Town Board =T(:)", QU U RY Director of Building. & Code Enforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury, NY 12804 county of Warren (518) 761-8256 Building Permit No. 2000422) Permission is hereby granted to Vm)0f[1d !&'r pokAm Jew SjAS A K) Owner of properly located at 1 04 S {PA P � #!E m the Town of(Nmensbury, to construct or place a W PrX C at the above Location mi accordance to application together with plot plans and other uAbrmation hereto filed and approved and m compliance with. the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owne 's Address- Contractor or Builder's Name: SAO V Contractor or Builder' Address: 1W �_ `114 6� z1�1- Electrical Inspection Agency: Type of Construction. Plans and Specifications: CAA Proposed Use: $ PERMIT FEE PAID — TMS 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 Town of Queensbury this (0' Day of JAkft 410100 SIGNED BY. _ *P • for the Town of Queensbury Code Enforcement Officer - --`'� Alrlrliclrtlotl fol* Peru[it - Softie Disposal Systole 7owt Uf Queeirsbuty 7d2134sootyMuni Qu eimbur;i; NY 12804 (518) 761-111236 L OWNUM INFORMNI"JON: . // ,/r� /� _........� ...w. . .........................._ _ _ _._............. .. . ....,,. .....,....... ..- Location of ittstallatioll: b J h� ,t t ., A Office, Use, !rile !'orntit ""I�.�.1 ! /�.� 2- Irvo Paid pwner'a Nauru: .L!� sa .� © 47 ,MI' J' �...._� Atldresa; dood CG'' A- A f /9,r•-r G7 i 2. INSTALLER'S NAME : TAV 1 7M�_! rC/.J Cp @ 0 L j PIIONls NCl. d 3, ILESiDENCC INFORMATION: (circleyear ortlwailint,, Irrd wale ll bedroom(A) and multiply tI r:f' beeb-or rrs with applicable gallurrs per• bedt-aunt to enact rural dent}!f1u111) Yoar of1-louso: No. of 130tlroo1jIs x �; Ippuinlitr�t — •fdo-_�Jl. Dii1v I?krw 1980 or oldor �, x 150 gallbdrnl = dod 00 ddod Y� E17) 1980 — 1991 x 130 1,711bd1 lti - 1991 -- preselit x 110 gallbtll Ili = � JUN 1 6 2000 Garbage Griudar Installed yes 1 no r � '�' ' r.3` rEilPJY F y Spa or Whirlpool Installed yes 1 Fro C7L Eli--� ��N_ ,firr_�C0QE d. PARCEL INFORMATION: (circle nl)plicable ill ratrrrntion &L indicate tnon ski r ell Posits) olr9[rt;n�l.�5` S _'• r uo Gr�uiscl WsttT r I1cd{roc k or�IckFlSc4v�v�ls_lv9atQrlal I)o rc Wnl_d t_Snl�trly f�7rrf do-Wsrrrrrl cot ssArrr crcrrrlr rrr what r!r frrlr � rrrrrric firrfflrrf; rxr r fed+t �_ s► dtfl SY+edep sfupe clay lf'rsrelf; is arer srytply 9& dupe other front any reprlctiry.srerrr delNli: tibsvrptturr is ft. Other I'arcolatioll 'fast: ('1 i) be c'urrrpleret! 6y llt:errsed 1trrfG.ssivrrtrl crrl;Irrecyr• rrr• trr•4lrlrc„Crl __.____� Halt': nih nrte per 11jelr 5" PROPOSED SYSTEM: For New Cow(ruclion: All individual sewage disivsal sysicnis 111t15t be tlesigned by a1 licensed ptoressiumpiI englitcer or arcliilet:t (t1nless Illsialled III it 11W Ind iig Ikratd itkn), Adid 250 t,alloiis it) the site of lira septic lank anal Ica h Iicld ]bi- esiclt�(;aubage Cif hider, Spit or Whillivul 'Pula. Septic "I"auk: j Go ti7 gcrllurr (irrrrr. slays 1,000 sal j Tile I°iold: each tr•errclr r! - G rf1. 'i'otal System Lcngilt: Seepage Pit(s): ►cumber of_ooU - size of eacfr,- fl. b yr fl. Size of Storso to be used: rr J rh:lrrlr or, elr►ckue x _,___..-._-._.doodd r't Ded System Size: x Alternative System, lelrgth on(1/010size G. HOLDING TANK SYSTEM: (ifrequited) Number of tanks; 1 Size of each : gallons 1 '1'Q'rAL Caltacity: gallons Nate: Alarm Systent ntid associatod electrical work muss ba itlspected by a `I`own approved electrical inspection ailency. 7. SIGNATURE & INFORMN11ON FOR RESPONSIBLE PERSON (please read) For your protection, Islonso auto that pursrrarst to Section 136-29 orllso Code ortlra '!'own orQueerrstrnty, any Irotrni[ or nlrlsrovnl I,rarrted which is based killers or is t;rnrrted in Iolirrrrce upon folly Plinio$ inl rrrisr frill asootfotion or I'stiluro 10 rrr:rkd fo nrnteli:rl Incl, or circdisrrstarico kturrvrr by or oil belsaltoof nil alrlrlicarrt, shall be void, I !save refod tiro rolisrintiorrs %visit retried to tlsia rrltltncnlinn nnrl nt,rd+o to nw4lo [sy ifresa nnrl all regniro rr rtlro "! own of Ctueerssbtrry Smri[ary SeWn8o lJisl7osnl Cl/rdlitl:rllce. 11AA A ig ature of resp6tolgible person Cl e i f y IIIITOWN OF QUEEN BUR'y MEAT �e I WILDING &742 Bay Road Queensbury_ NY _IM4 (Sig) 761 .8256 SEPTIC DISPOSAL_ SYSTEM INSPECTION S Name Location � � �� ��+►' Date r`,�D Permit SOIL TYP IS -Loam-Clay- Resints of ercoRatteoMinutellnCh � -- -- ( if applicable ) / TYPE OF SYSTEM: L int)l ABSORPTION FIELD * 1 ota -rF Length of each trench f Depth of trenches acT Size of stone b r- SEEPAGE PITS : f utn m x f Size - � � _ Stone size — zze e PIPING: Bldg . t Tank to Dist . 80 <. Dist . Box to Fi d /PYes No artzal Openings Seale LOCATIOf1ISEPA TION ;� feet Foundation to ank ti on feet Foundation to Pbso rp eet Separation o s o Conforms as per Plot Plan LOCATION O SYSTEM ON PROPER ( circle 1 Left Side - Right Side Front - _ Middle Rear Middle ront COMMENTS SYSTEM USE APPROVED' O NO Arri ued Departed- 8ui ding inspector r CEIV JUN 1 6 2009 TOWIIN ()F QIIJEEN�SBURV BUILI)INO�?,AN CODE 2o - - - FILE COPY -� ° i. No aged on Ou; imAed compliance-wth W1 =wrnenisshall I have seen or observed, or believe I saw evidence of, nol be construp-0 �-.s indicating Me al I objects such as houses, wells, trees, fences, etc., J;Ons are sn iull p N -dcgurnent, 7 plans and specific*k own on t a I o represent that I have compliance 'A"th 01 p onally ar ed the races set forth on the Aiagram. 7 Xek� r ) � YA e ��DKTE LOO" IS , AARON , JRo TOW OF (QUEENS PURY 169 SHERMAN AVE . V BUILDING & d-4---- k REVIEWED BY DATE