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1999-732
. . . • Certificate of • Compliance • • Town of Queensbury Warren County,New York November 29 99 Date 99732 This is to certify that work requested to be done as shown by Permit No. has been completed. SEPTIC SYSTEM This structure may be used as a 117 SHERMAN ISLAND RD. • Location Owner MC DO/kIALD, DAVID & JO ANN • • TAX MAP NO. 150. -1-6 . By Order Town.Board TOWN QTJEENSBURY Director of Building Code Enf9rce-merit • • . . _ . - BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VALUE $ 0 Building Permit No. 99732 TAX MAP NO. 150. -1-6 . 4 MC DONALD, DAVID & JO ANN Permission is hereby granted to Owner of property located at 117 SHERMAN ISLAND RD. in the Town of Queensbury,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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Owner's Address: BOX 117 SHERMAN ISLAND ROAD QUEENSBURY, NY 12804 Contractor or Builder's Name: I .B. S. SEPTIC Contractor or Builder's Address: Electrical Inspection Agency: Type of Construction: SEPTIC Plans and Specifications: SEPTIC SYSTEM: 4 BEDROOM HOUSE AS PER PLOT, PLAN AND SPECIFICATIONS Proposed Use: SEPTIC SYSTEM • 25 - . - November 29 20,01. _ $ 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.) 29 . November 1999 Dated at th own of Queensbury this Day of SIGNED B C o u e Towti of Queensbury • ode E orceme t Officer • Application for SEPTIC DISPOSAL PERMIT Town of QueensburyFFI A • Dept_ of Commurity Development '�' ��c Permit No. 7,_ • Building & Codes Office • r�®_U 742 Bay Road ' 1999 Fee Paid . ,_., — • " P Queersbuiy, NY 12804 7•^,11,r, Cyr=fir✓_ ..._er 1xlLD) f'L•�D CtJ�es. 4LLIRY 4� 8h Location of property for installation: X / I �A.,/ IC c, ",2 ^ cJ Property Owner's Name: U� v,/ Property Owner's Mailing Address: # / 1 ? c 4 c tk"Gk., / tuA.1Aci Inst ler's Name: I. If. j sCio f i L Phone # 7P - r/ " Number of bedrooms (if residential): Total daily flow: /. 0 doV (residential -compute @ 150 gal./bdrm.) Topography: Kfat, rolling, steep slope % of slope Soil Narme: Kand, loam, clay, other/depth: Ground water: at what depths et -Ne / B e.fr ocs or Lpervious Materi: at what depth? feet Percolation test:/ 'not recu eel, r uL—ed [rate min. per inch] _ Domestic water supply: municipal,2(/ well, other If domestic water supply is a�r rT T , water sutroiy from any septic absorpCcn is feet. • PROPOSED SYSTEM • Septic tank./9 gai?on (minimum size: 1,CCo al.) Tile field: ``each tench S(' feet / Tom system length: )53 feet Seepage pit(s): number of / see each: _ fr.by fr.. Size of stone to be used: # / de to or thickness feet • • H OLDU G TANK SYSTEM: (if required) Number of tanks: : Size of each: pleas . CAlarna system and associated electrical work to be I spected by a certified a =Jr. For your protection, please note that pursuact to Section 136-29 of the Code of the Town of Qr e sbuy, any permit or approval wed which is based ton or is ranted is reliance ti -a rrTterLaJ misreFesa or auure to Lake a mate:a1 fact or circt=stance known by or on behalf of an applic-2-,t, S-41l be void. I have read the regulations with respect to this application and agr-e to abide by these and all re<,,sr`mezts of the Town of Queens :y SFr:tary Sewage Disposal Ord ance. Sim:are.r e of responsible person: C /0/et—N..— Date: // t O '-/V 111iiir TOWN OF QUEENSBURY BUILDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name ALL,Location / /•`X2 (-41 476, 4A6 Date /� i ' 4niiit # 732- SOIL TYPESand-; oa -Clay- r c Results of Percola ion Test- (if applicable) Ra e-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: otal Length -Z� c Length ()leach tr nch F 6:2__.! / Depth of trenches; ,2_r Size of gone �7 SEEPAGE PITS: N mber- Size - t. x ft. Stone size! __ PIPING: Size Type Bldg. to Tank E;_rt;r - Tank to Dist. ox Lt" ,3; Dist. Box toj'el d/Pi L ,c LTA Openings Seale: ? Yes No Partial LOCATION/SEPOATIO . ��,4.-% - Foundation to'Tank — feet n Foundation tp Absorption feet Separation dig fits i;;;;i "feet Conforms asps°pert Plot Plan Ye__.No LOCATION OF SYSTEM ON PROP . (circle one Front j-ar Loft Side - Right Side Middle -, on - 'i'ddl e Rea ..... 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