1999-430 CERTIFICATE OF COMPLIANCE
TOWN Or QUEENSBURY,
WARREN COUtITY', NEW YORK:
Date July ,14 19 99
36 I
9943O
This is to certify that work requested to be done as shown by Permit No:
has been completed.
SEPTIC •ALTERATION
. This structure..may ;be used as a`;
1 HILLCREST AVE'.
locati.on,
EARLE; HAROLD & JUDITI-I
Owner
TAX MAP .NO. 91 . -4-20 By Order of Town Board
.'TOWN' OF QUEENSBURY
•
--Director of Building;& Code. Enforcement
BUILDING PERMIT
VALUE $ .0.::: '.: : :..TOWN OF QUEENSBURY
TAX MAP NO. 91 . —4-20 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to EARLE, HAROLD & JUDITH
OWNER of property located at 1 HILLCREST AVE. Street, Road or Ave.
in the Town of Queensbury,To Constructor place a SEPTIC ALTERATTfIU at the above location in accordance to application together with plot plans and other information hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
1 HILLCREST AVE.
QUEENSBURY, NY 1280,4 ..
2. CONTRACTOR or BUILDER'S Name
CONDON .SEPT:IC. &;:DRAIN: SERVICE
3. CONTRACTOR or BUILDERS Address
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC :
( 1 Wood Frame ( I Masonry ( I Steel (
7. PLANS and Specifications
SEPTIMaALTERATION.-AS . PER PLOT PLAN:.;SPECIFICATIONS .:.,
8. Proposed Use.
SEPTIC ALTERATION
::July,. : ..,.: .:.:'.
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 12
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of.Queensbury before the expiration date.)
12;; ; .: .,..July;, -19 .1999...
Dated at the Town of Queensbury this Day of 192.001
SIGNED BY _ __ \ i for the Town of Queensbury
Building.and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury �j+�
Dept. of Community Development Permit No. `
Building &Codes Office of
742'Bay Road Fee Paid $0_vi
Queensbury, NY 12804
f
Location of property for installation: / j`-7 r170ke S/ k RF . IV
ED
Property Owner's Name: / 4iOAD ea rA JUL 1 2 1999
Property Owner's Mailing Address: / 44// C rFS-f P tiN OF OUEEN BUt'v
_ rODE.
Installer's Name: ( n1c( jr e �- Phone # 7Yer
- Number of bedrooms (if residential): 3 Total daily flow: 1 70
(residential -compute @ 150 gal.bdrrn.)
Topography: y fat, rolling, steep slope % of slope
•
- Soil Nature: sand, loam, clay, other /depth:
• Ground water: at what depth? )$-feet / Bedrock or Impervious Material: at what depth?fzt feet
Percolation test: )( not required, required [rate min.per inch]
Domestic water supply: k municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM iaC rry `1 0c�i4 L %�?J�s w �'lf r
gY 151/m7
Septic tank,.Lallon (minimum size: 1,000 gal.) O
Tile field: each trench feet / Total system Iength: • feet
Seepage pit(s): number of / size each: - ft.by ft.
Size of stone to be used: # / depth or thiclmess feet
•
HOLDPNG TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alarm system and associated electrical work to be inspected.by a certified agency.
For ycin protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or
aL,.auval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance Imovn 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 San;t,+ry Sewage Disposal Ordinance.
Signature of responsible person`. -S Date:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 'El V .R( -A V)
Location \ 1FA,LL V
Date 7—I -Perini t #99
SOIL TYP : San - oam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total L�eng h
Length of each trench
Depth of trenches t
Size of stone
SEEPAGE PITS: N,umbe;- /
Size - f\ x /'ft.
Stone size ----
PIPING: Size Type
Bldg. to Tank
__ _Tank to Dist. Box _ __
Dist. Box to Field/"it
Openings Sealed? Yes No Partial
LOCATION/SEPARATION':
Foundation to Tank feet
Foundation to Absorption _ feet
Separation of Pits f feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
0 cm v-mot -TEE6
Cam,, \ -\
vK
SYSTEM USE APPROVED: YES NO
Arrived:
Depart
B Iding I s ector
, . _ ,_ _ 9A-11)
TOWN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name --G..4)( e o) c..(r)
Location \ \\\\\NAY"
Date 7J 'H7eit #(: --_3
SOIL TYPE• and--Loam- ]ay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench /
Depth of trenches / {
Size of stone /
SEEPAGE PITS: Number- / /
Size - ft: x / ;ft.
Stone size
PIPING: Size Type
Bldg. to Tank . �'_ Ci.-'+ �t>
Tank to Dist. Box 1-4 0 K_ To Ey.15
Dist. Box to Field/:P '
Openings Sealed? 4 Yes . o Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
k t• -1-'RLL LYE DJ \v 0 0
bE TNT
'AEED t $_:‘ ,o,,, ��
o i.5 EgCo t.,11,3
SYSTEM USE APPROVED: YES NO
Arrived: • : : —
Depar -1
/1•� ��
wilding sector
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TOWN OF QUEENSBURY
BUILDING AND CO.DE
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