98-128 Certificate of Compliance
1
Town of Queensbury
Warren County, New York
Late April 10 98
98128
This is to certify that work requested to be done as shown by Permit No. - -has been completed.
This structure may be usedas a SEPTIC SYSTEM
576 CORINTH RD ,
Location
Owner CALDWELL , HOWARD &
TAX MAP NO , 125 . - 2 - 15
By Order Town Board
TOWN OF QUEENSBURY
Dir ce for o� tub/in///&Oeode F nforc,ement
BUILDING PERMIT
VALUE g 0 TOWN OF Q►UEENSBUR.Y Nu 98228
TAX MAP NO o 125 . — 2 - 16 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CALDWELLs HOWA D
OWNER of property located at 576 CORINTH R Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a SEPTIC SYSTEM
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. OWNEWS Address is
ELEANOR 576 COiRINTH RD .
QUEENSHURYr NY 12504
2. CONTRACTOR or BUILOEA"3 Name
CONDON ' S SEPTIC & DRAIN
3. CONTRACTOR or BUILOERS Address
0
4. ARCHITECT'S Name
6. ARCHITECT'S Address
6. TYPE of Construction — (Please indicates by ]c)
i t Wood Frame I I Maloney I I Steel f 1
7. PLANS and Specifications
No.
S. Proposed Ilse
SEPTIC SYSTEM
25 April 10 2000
$ PERMIT FEE PAIL? — THIS PERMIT EXPIRES 19
III a longer period is required on application for an extension muet t1e made to ttw Building and Zoning inspector of Rho
town of Que*nsbury totwe ttse expiration date.l
10 Appr i ! 19
Dated at the Town of Queensbury this Day of r19
r
SIGNED BY for the Town of Queensbury
Building and Zoning 1 nV6ct0r
A.ppucation for SEPTIC DISPOSAL PENT
RE
�/ C�
Tow n
n of Queesbury - �! Permit No.
Dept. of Community Development APR 0 � �� `—'C
Building Ss Codes Office Fee Paid $
742 Bay Road
Quecnsbury, NY 128i34 TOVl/iv t 3 S:i ir :%s` r?, ;RY
Location of property for installation: '"^" '
Property Owner's Name: imwq
Property Owner's Mailing Address: S,007(,
installer' s Name: Onn 1U t ��.t3-�c` t, �*j Phone #
Number of bedrooms (if residential): - Total daily flow: L0
(residential " compute @ 150 gal.fbdrm.)
Topography: fiat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other 1 depth:
Ground water: at what depth feet / Bedrock or Impervious Material: at what depth feet
Percolation test: not required, required [ rate min. per inch. ]
Domestic water supply: -4 municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM � a1.!
Septic tank. ' Gallon (minimum size: 1 ,000 gal.)
Tile field; each trench __�: tO _ feet I Total system length: 940 feet
Seepage pit(s): number of 1 size each.: frt. by ft-
o
Size of stone to be used: # ! depth or thickness C feet
HOLDING TAINK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alana system and associated electrical work to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbtry, any permit or
or is granted is reliance n any material misrepresentation or faiilure to make a
approvsd granted which is based upon Brant upon
material fact or circumstance ]mown by or on bahalf of an applicant, shall be void.
I have read the regulations with respect to this application and agree to abide by these and all ioquiremeiits of the Town, of
Qureensbury Sanitary Sewage Disposal Ordinances.
Signature of responsible person: } /�l7 "'� ` bate: f
TOIN+I OF QUEENSBURY /F
Bllt llli A CODE ENFORCEMENT ( �Q
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name CJ L. rF'c
Location
Bate �G' Pe it #
SOIL TYP an - -C1a -
Results of Pe colation Te t-
( if applicabl ) Rate-Mina /Inch
TYPE OF SYS =
ABS(1RPTION FI LD : Total Le th
Length of eac trench j
Depth of tren hes
Size of stone
SEEPAGE PITS : Number- f t .
Size - fto x
Stone size 7ze ype
PIPING :
Bldg , to Tank 4
Tank to Dist . Box
Dist . Box to Fiel Pit
Openings Sealed? a No artial
LOCATION/SEPARATI feet
Foundation to Tank ion k_ feet
Foundation to Absorp . feet
Separation of Pits C` No
Conforms as per P1 an
LOCATION OF SYSTEM ON OPERTY :
( circle one )
Front - Rear - L t Side - Right Side
Middle Front -
COMMENTS :
SYSTEM USE APPROVED :
Arrived :
Depart
it n or
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DATE
40
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