1999-687 CERTIFICATE OJI,,. 'COMPLIANCE: -
,.TOWN OF QUEENSBURY
• WARREN COUNTY, NEW YORK
November 4 . 99
. Date 19 .
99687
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 '
3 GRIPPING PLACE
Location
DELLA L']ELLA, MluMA L ,cc —
Owner
TAX MAP .NO. 114 . -1-13. . By.Order of Town Board
rfTOWN OF QUEENSBURY "
• is ,
Director Of: Building & Code' Enforcement ". .
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518)761-8256
VALUE $ 0 99687
TAX MAP NO. 114 . -1-13 Building Permit No.
DELLA BELLA, MICHAEL &
Permission is hereby granted to
3 GRIFFING PLACE
Owner of property located at
SEPTIC ALTERATION
in the Town.of Queensbury,to construct or place a
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.
C1 DNS Ad3eURIFFING PLACE
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 November 3 2001
$ PERMIT 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.)
3 November 1999
Dated at the Town of Queensb ry this Day of
SIGNE for the Town.of Queensbury
• Code Enforcement Officer
A
• Application for SEPTIC DISPOSAL PERMIT •
Tower of Queensbury
• Dept of Community Development • Permit No. 7
Building & Codes Office ((((
742 Bay Road Fee Paid $
Queensbury, NY 12804 -
Location of property for insta112tion:
// ✓ *; I
Property Owner's Name: tit Af',.„( j � /��
Property g Address: 6O P i ��
Owner's M P4 � tr
Installer's Name: a. \S Phone # ��
/lam
Number of bedrooms (if residential): Total daily flow:
(residential -compute @ 150 gal./bdrm.)
• Topography: i?ty rolling, sI _steep cps % of sloes
Soil Nanne: / sr*d, loam, clay, other /depth:
• Ground water: at what depth? feet / Bedrock or Latervious Material: at what depth? feet
Percolation test: not required, re uire^ [rate min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septid absorptca is feet.
• PROPOSED SYSTEM
Septc+ T
tan gallon (minimum size: 1,000 gal.)
Tile field: each wench / z feet / Total system Iength: -' feet
Seepage pit(s): number of / slze each: - ft.by f� ` l31-E
Size of stone to be used: # / dent. or thickness feet
•
•
E OLDfl G TANK SYSTEM: (if required)
• Number of tanks: : Size of e`ch= ,Tons
CAlarna system and associated electrical work to be ;i-cected by a certified ara.
For:cs protection, please note that pursuant to Section 136-29 of Code of the Town of Q. .scuiy, any pew or
app,_.,vzl is based tin or is grained in reliance raisrepresen or failure to make a
material fat or circimistance known by or on behalf of an aopLic , a=ail be void.
•
I have read the regulations with rebF ct to this applicatio --ee * a ' these and all:°R:ramenis of the Town of
Quee--sb.ury Sanitary Sewage Disposal O74 >
esponsibleperson: �2 Date:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name DELI 1ELLA
Location 3 C - FU
Date U_y—qcj Permit # q19-6 j
SOIL TYPE: Sand-L.a -Clay-
Results of Percol .,tio Test-
(if applicable) R.te-. mute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: ' ot:1 Length
Length of ea.h tre 'c
Depth of tren es
Size of stone
SEEPAGE PITS: Numb:r-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? /es No Partial
LOCATION/SEPARATIONS
Foundation to Tank 1 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:
Eop CA\D
•
SYSTEM USE APPROVED: (.. YES) NO
Arrived-
Dena
' B " ding spetr
1111111 Lg.\(\M,
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
I
Name _ g,\(\'� e
Location :3 AP?c
Date/ J - 5� I Pe rmi t # cAot—�F/
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation :st-
(if applicable) Rat:-Minu '-/Inch
TYPE OF SYSTEM: 4 �,J tn�DeRtr.�
ABSORPTION FIELD: btal Length 3(�
Length of each tre ch era, +
Depth of trenches
Size of ston,- TIMMVIRMAt
SEEPAGE PITS: Numb-r-
Size - ft. ft.
Stone size .�
PIPING: ze Type
Bldg. to Tank -- k1h�ti0G,
Tank to Dist. Box I yp.121)
Dist. Box to Field/Put ytibyei T(=4
Openings Sealed? <==Yes� No Partialloyptv
LOCATION/SEPARATIONS`-
Foundation to Tank Etiocr, feet
Foundation to Absorption feet
Separation o= Pits feet
Conforms as per Plot P an (25ms No
LOCATION OF SYSTEM ON 'ROPERTY:
(circle one)
(Eront=5- Rear - - Sid- - Right Side
Middle Front - Midd e Rear
COMMENTS:
CO' TO 13 __k M b? E L
•
UEE1QS N.
SYSTEM USE APPROVED: YES NO
Arrived:
Depar
i/ 1dingeétor