98-242 CERTIFICATE OF COMP..L..IANCE
TOWN OF QUEENSBURY
WARREN COUNTY , NEW YORK
Da to May 2 _ 19 98
� 212 98242
This is to certify that work requested to be done as shown by Permit No .
has been completed .
This structure may be used as a SEPTIC SYSTEM
Location 27 CEDARWOOD DR .
Owner NAVATKA , LARRY & RITA
By Order of Town Board
TAX MAP NC3 . 6 8 . - 5 W 3 �.- -,"'tiGwT N �
Director of Building & Code Enforcement - �
BUILDING PERMIT
VALUE IS 0 TOWN OF QUEENSBURY Na. 98242
TAX MAP NO , 68 . - 5 - 3 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to NAVATKAr LARRY & RITA
OWNER of property located at 27 CEDAR` OOD DR . Street. Roar! 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 Queemsbury Building and 'Zoning Ordinance.
1, O"Eft ff%80D DR .
QUEENSHURYr NY 12804
2. CONTRACTOR or 9U1 LOE WS Name
SANITARY SEWER
3' Rtgftjrft1L0Wjf4W 224
GLENS FALLS NY 12801
4. ARCHITECTS Nam"
S. ARCHITECT'S Address
6. TYPE of Construction — tpleese indicate by xi ,SEPTIC
l I (Mood Frame f I Masonry I I Steel I I
7. PLANS and Specifications
SEPTIC SYSTEM AS PER PLOT PLAN AND SPECIFICATIONS
No,
8, Proposed Use
SEPTIC SYSTEM
May 15 2000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES , 19
(If to of er period is w before tnO expiration on date ixtenalon must be math to the Building and Zoning inspector of the
15 May 19
Dated at the Town of Queensbury this Day of 19
for the Town of Queensbury
SIGNED BY
Bnilda+g and zoni.q rtapea
Application for SEPTIC DISPOSAL._. P'EPMIT
Town of Queensbury
Dept. of Community Development MAY Permit No.
BtailBay 8c Codes Office ✓
742 Bay Road Fee Pai $
Queensbury. NY 12804 'i/`�f�{/J(�-
6 (J - 5f /�
Location ,� ,7 of property for installation: ,.�' _ +L:-- oe GAoor,, 6.,c_-ar..>o> DW!e&�r
Property Owner's Name: ' z A,/,*f i op ,rf7" ,,re�
Property Owner's Mailing Address: , �G-
Installer's Name: •' y Vo geA J L^`- Phone #
Number of bedrooms (if residential): , / Total daily flow:
,,��// (residential. - compute 0 150 gaUbdrm.)
Topography: f, flat, rolling, steep slope S6 of slope
Sail Nature; Qt sand, Ioam, clay, other / depth:
Ground water: at what depth? feet I Bedrock or Impervious Material.: at what depth? feet
Percolation test: •not required, rewired [ rate min. per inch j
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tan[c013� gallon (minimum size: 1,000 sal.)
Tile field: each trench feet f Total system leash feet
Seepage pit:(s): number of I size each: fL by &
Size of stone to be used: # ��7 / depth or tbiclmess � feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each,: Qailons
Alarm 7 and associated electrical vork to be inspected by a cearffied agency.
For your protection, please note that puumant to Section 13&29 of the Code of the Town of Queeosbory, any permh or
approval granted which is based upon or is granted in role mee upon any mataria almosentation or fidom t+o maker a
snat,esrial fact or fiance lmown by or on behalf of an applicant.- shall be void..
I have read the regulations with icon and agree abide by these and all reTura rents of the Town of
Queembury San"xy Sewage
Signature of responsible person: Date: 4j�"
TOWN OF OUEENSBURY
BUILDING 6 CODE ENFORCEMENT
742 BAY ROAD
QUEENSHURY NY 12804
C (519) 761-9256
ARRIVE : DEPART . - INS
FINAL INSPECTION REPORT - RESILIENT
DATE INSPECTION REQUEST CEIVE
NAME
LOCATION
DATE PERMH T ##�
TYPE OF STRUCTUR `b0) �d�--
FOOTINGS� FOUN ATION BACKFI14 FRAMING
ROUGH PLUMBING SEPTIC INS U TION
FINAL ELECTRICA WOODSTOVE OR IREP LACE
N A L TES NO
CHIMNEYB VT/HEIGHT
PLUMBING N
FINISHEXTERIOR
DEQKJPO LINGS
RELIEF V VES
WATER OP IN
INTERIORM PRI S
FINISH FLOORA ;
BATH/KITCW E
OTHE9 FLOORS EVE E
OTHER FLOORSCARF ED
STAIR gLEA NC NGS
SMOKE S
RATHROO FANS
PLcUMBIN T S
U O O
ZZ
RhFIRE -PROOFING
--------------
DOOR CLOSERS
E CA
N V ANCE RS .
FINALV Y P T N
OK TQ ISS O R C C
' TOWN OF QUEENSBURY
`BUILDING A CODE ENFORCEMENT
742 Bay Read
Queensbury NY 12804
(518) 76I-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name I 1'
Location
Date 6/1 Z/5E ermi t #
SOIL TYPE: Sand- am- Clay-
Results of Perc ati on Test-
( if applicable ) Rate-Minute/ nch
TYPE OF SYSTEM:
ABSORPTION FILL Total Le th
Length of each t ench +
Depth of trenche
Size of stone
SEEPAGE PITS : Nu be
Size - ft x ft .
Stone size
PIPING : Size Type
Bldg , to Tank
Tank to Dist . Box «
Dist . Box to Fiel / it ++ --
Openings Sealed . es No artia
LOCATION/SEPA ION .
Foundation to ank XC>_ feet
Foundation to Absorp ion _ 2,1::> feet
Separation o Pits feet
Conforms as per Plot Ian es o
LOCATION 0 SYSTEM ON PROPER
( circle o e )
Front - ear - Left 5i e - Right Side
Middle rant a ar
COMMEN
SYSTEM USE APPROVED : NO
Arrived: "
Departed
LAIWItring' Insp r
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Farm.- �,Wml . 1
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DATE
TOWN OF QtfEENS81fRY
BUILDING A CODE ENFORCEMENT
742 Bay Ro I
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name.
Location
Date Permit # �f ° r
SOIL E: nd- Loam-Clay-
Results of P rcol ati on Test-
( if applicabl } Rate-Minute/ In h
TYPE OF SYS
ABSORPTION FI Total Length
Length of each trench
Depth of trenc es
Size of stone
SEEPAGE PITS : umber- t .
Size _ �! t . x _
stone size Si a ype
PIPING:
Bldg , to Tank ----
Tank to Dist . Sox -----
Dist . Sax to Fiel Pit o Partia
Openings Sealed ? Yes
LOCATION/SEPARATION : feet
Foundation to Tank -.VLL� feet
Foundation to Absorp i n - ,feet
Separation of Pits Yes No
Conforms as per Plot an
PERTY •
LOCATION OF SYSTEM
( circle one ) .. Flight Side
Front - Rear - Lef Sid
Middle Front - Mi dl a Re r
COMMENTS :
c . ► rY
SYSTEM USE A�P.PROY'M
Arrived : � _ -
Depart
7 Ing r
f
9
TOWN OF QUEENSBURY ,;,,�'�� �
BUILDING A CODE ENFORCEMENT
742 Say Road
Queensbury NY 12804
cs�s� �s�-s2ss
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
P e rm i t # aria
Date �—� -�
SOIL TYPE : Sand-
Loam-Clay-Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total Length
Length of ea h trench
Depth of tre hes _
Size of stone
SEEPAGE PITS : er-
Size - ft . x ft .
Stone size
PIPING : Size ype
Bldg . to Tank
Tank. to Dist . Box
Dist . Box to Field/Pit
openings Sealed ? Yes No a� aT
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits feet
conforms as per Plot Plan — JV�es No
LOCATION OF SYSTEM ON PROPERTY:
( circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS :
TM
ut
SYSTEM USE APPROVED: YES NO
Arrived . c ` z-
Depart F
Ong nspector
r
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r
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