Loading...
1999-711 , „._ CertificatJof • Compliance Town of Queensbury • Warren County,New York November 18 99 Date , 9\0 \()) 99711 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 •- 11 a, MONTRAY RD. Location Owner BIRMINGHAM, PHILIP & JEAN TAX MAP NO. G . -4 -2 By Order Town Board TOWN OF QUEENSBURY Director.of But ding Code nforcement BUILDING PERMIT TOWN OF QUEENSBURY No. VALUE $ 0 99711 TAX MAP NO. 69. -4-2 WARREN COUNTY, NEW YORK. . PERMISSION is hereby granted to BIRMINGHAM, MIMI? & JEAN OWNER of property located at 114 MONTRAY RD. Street,Road or Ave. in the Town of Oueensbury,To Construct or place a SEY1[� AT TE#tFdTbON. at the above location in accordance to application together wl plot plans n er information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t. OWNER'S Address is 114 MONTRAY RD. QUEENSBURY, NY. 12804 2. CONTRACTOR or BUILDERS Name CONDON SEPTIC &:. DRAIN SERVICE 3. CONTRACTOR or BUILDERS Address 4. ARCHITECT'S Name 5. ARCHITECTS Address 6. TYPE of Construction—(Please indicate by X) • SEPTIC , 1 )Wood Frame ( I Masonry ( I Steel 7. PLANS and Specifications No. . 8. Proposed Use SEPTIC ALTERATION 25 November 18 2001 $ PERMIT FEE PAID -THIS PERMIT EXPIRES_ 19 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the expiration date.) 18 ,•; November:. 1999 Dated at the Town of Queensbury this Day.of 19 BY � , - . for the Town SIGNED of Queensbury Building and Zoning Inspector ._ . Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept. of Community Development Permit No. "— Building &Codes Office 742 Bay Road Fee Paid $ca,c Queensbury, NY 12804 Location of property for installation: //q / t) vu !i / : Property Owner's Name: I)rI f Rude-min , 7 9 Z �r 4 �` ` NOV 15 1999 Property Owner's Mailing Address: f/ (-/ f 6 of - '4Ay �. T y Cice/V V 77'v ,e�'a �� Installer's Name: OvJcim fi ��? r� i A/iu jr4j�ltt Phone # ? ` 31S —� a- P - . Number of bedrooms (if residential): Z Total daily flow: g 6 D (residential -compute @ 150 gal./bdrm.) Topography: X flat, rolling, steep slope % of slope • Soil Nature: ) sand, loam, clay, other /depth: _ Ground water: at what depth?,I4—feet / Bedrock or Impervious Material: at what depth? feet Percolation test: 1 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 { Septic tank- Y2.0©6 gallon (minimum size: 1,000 gal.) -IVEttigh 1 AS Tile field: each trench ' ) feet / Total system length: -/ct feet Seepage pit(s): number of / size each: . ft. by ft. ' Size of stone to be used: # / depth or thickness feet HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: callous (Alarm 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 Queensbury, any permit or approval granted which is based upon or is granted in reliance upon any material ntisrepreseuta6on or failure to make a material fact or circumstance known 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 re iirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: i,4 ran) Date:/(` �� y CkJoI l . TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION NameY\N\At\, )\( l . Location l\ Mak, al �') Date - _ Permit c\- 7 l SOIL TYPE: and Loam-Clay- Results of 'er.colat. n Test- (if applicable) Ra e-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total e f t `5r Length of each tr nch 1 (� Depth of trenc'he 0 Size of stone '♦ , SEEPAGE PITS: Nu ber- Size - ft x ft. Stone size .� PIPING: Size pe Bldg. to Tank Tank to Dist. Box �' 60/2. 37 Dist. Box to Fi el /Pam T — Openings Sealed? Yes No Partial LOCATION/SEPARAT ONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits eet Conforms as per Plot Plan Yes No LOCATI _ SYSTEM ON PROPERT . (c i rcl on ) ,_) Front - Rear,,‘ Side - Right Side Middle Front - Middle Rear COMMENTS: SYSTEM USE APPROVED: YES ' NO Arrived: ,.,/ Departed: f. Building Inspector (OTUcto iv S -Sccfi.-. •ft. v :Pk/9 fit) -- cf“.7,OC • 7)R: r,.., Fly ...ouxin iv,a-ft ri 1 /pi in-o iu .-roe y A:7) - 791'5-3 t° /Ail-OR/4N rAuE - 7,e-cfs11-- \ • Cipes fais 1 /.)-toy QUgriuSZui-y e, Y /..1-g-01 BE0E-1\PED I cl.-7ii . t '':C7,• ,F tl _:-.•:. , - HO V 1 5 1999 a-t) NOV 1 5 1999 -1-n ,,-: c,- c -, -,.:)-;R.Y. . T.1."A.r:: 07 eURY r 56 1 7-5-- , . , 0)0 • ' it ) ( . 4, VP')It I .5Er4( iti I TOWN OF QUEENSBU -Y E)kiss-1-1 7 1 rt( '' ,TiVfit/64-42_s o qa BUILDING & REVIEWED BY ' . to • DATE g GA/0 4 6,--c . ' c - _ "I have seen or observed,or beNeve I saw evidence of, TOwN OF auE. EtaguRy surotiG all objects such as houses,wells,trees,fences,etc., - Based on our fitted exarninahanDr-PARTMaT, shown on this document.I also represent that I have comPffance with our_comments shall personally measured the distances set forth on the diavam." ,,,,•• not be construed as raic-etivi the Plans and specifications are in full il-K ...e COMPlianee with the code. 1 I GNATURE DATE ' liq 112diviPAy RD