98-220 CERTIFICNrE 01. COMPLIANCE
TOWN or oUuNSBURY
WARREN COUNTY , NEW YORK
} Da to May 5 19 98
98220
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 ALTERATION
Location 9 AMES PLACE
Owner WOLCOTT , JAMES &
By Order of Town Hoard
TAX MAP i3CJ . 1 1 5 . - A 2 0 . 2 TOWN OF QU URY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 98220
TAX MAP NO . 115 . - 4 - 20 . 2 WARREN COUNTY* NEW YORK
PERMISSION is hereby granted to WOLCOTT JAMES &
OWNER of property located at 9 AMES PLACE Street, Road or Ave.
In the Town of Oueenslwry, To Construct or place a SEPTIC ALTERATION
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 Oueensbury Building and Zoning Ordinance.
1. O WNE RS Address is
ANNE-MARIE 9 AMES PLACE
QUEENSHURYr NY 12$04
2. CONTRACTOR or SUILDERZ Name
CONDON SEPTIC & DRAIN SERVICE
'L CONTRACTOR or BUtit]ER"S Address
4, ARr.l4lTFCT4S Name
5. ARCHITECT'S Address
6. TYPE of Construct ian — (Please indicate by X) SEPTIC
( I Wood Frame 1 I Masonry 1 I ,Steel ( f
7. PLANS and Specifications
SEPTQC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8_ Pr000sed Use
SEPTIC ALTERATION
25 May 5 2000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES t9
(if a longer period is required an application for an extension must be made to trig Building and Zoning inwoctor of the
town of Quoonsbury before the *xpiration date.)
5 May 19
Dated at the Town of Queenstwry this Day of t9
SIGNED BY - for the Town of Oueensbury
`�UdA arrd 2ani l etor
Application for SEPTIC DISPOSAL. PEP*2*%'IIT
Town of Quacasbury Permit No-9
Dept. of Commuaity Develop=eat
Building �& Codes Office 7]
742 Bay ,Road Fee Paid S
nsburr, NY 12804
Locacon of property for installation:
Property Chvrzer's Name: i ,17F_f` f C CS -f ?� MAY 5 199EI
zv
Property Ow
,n
�e
2r's M iiincr Address:
In fstaller's Name: nr,)c�d -1 -�-r c t{ o 11 141 'bane , /�'!�' - �` 2-
0
Nt=ioer of bedrooms (if residential) : Total dairy flaw: 5
(residea al. - compute Q 150 rxl.lbdrm,)
TopoTaPhy: that, rciii.n.g, stee-D slcue a of slope
Soil Nature: sattd, loaaz, cry, otL= ( deptix:
Gro=d water: at want de=h? �_ feet / Bedrock or L-=Oem-V=.s Ma.terai: at west d=rh teat
P ercoiaton test: not re~ *._ __e , required ( raze mzn. Pe: inch J
- - - T)om esz c water sutroly: mt n csva ,
If dcmest=c water su001v is a S.vrLL., war..^"_ sanely =ors a:,ay se c aiosontica is feet_
PROPOSED SYS��� �����►!!�
Sevdc tartly gal ct: (rr-Tm u= size: I ,Cco Z_)
T to field each trench feet I T ors.? 57v a= 'M?*b.: 4`1-/ d feet
Seepage Pit(s): tl=her oc / sWe : ft. by
Size of stone rQ be :iced: m `�— I deb ch or tic
-- HEOLDLNG T A.NK SYSTEM: (if require
,Number Of Size c: 1Iacs
Alberta a ratan and asa[�c:atad electricral uxrrk to be b. a certified agwcy.
Far yore Protecroa. Please aota dent PUr50211t m Sz'^"-_::.-" 136-29 of '+tea cedes of t�c Town of Quee sb=y. acy germmst ar
ac crovalgr3=rjed wbicb is based upon or is 3ra=ad its reLiancea tzpc= z=y M3. '. stc�prrse* *L or € aura �Q ms3no it
maze,ral fah: or c% cea staaca known by or as be6uLf of an =Flk c. shall be vr�
I l^a� a dad }�a regeilst ovs wish re9oact ra this apol3�..a..i z:,= arm ag=• to ahvA a iw =heee mod &U , equine + c=3 cx" t a Town of
sbx=- saz2tary Sewage Disposal CYr�.
Fe _ Z2. mate:
n i' C� `-
Siv a;;rV of resposible rson.-
I
-� TOWN OF QUEENSBURY
BUILDING R CODE ENFORCEMENT .
742 Say Road +
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL. SYSTEM INSPECTION
Name --
Location
Date Permit #�
SOIL TY (DSandoam- Clay-
Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM: �-E-
ABSORPTION FIELD : Tot 1 ng;h 4E
Length of each tr ch +
Depth of trenches
Size of stone
SEEPAGE PITS : Mum er- ft
Size - ft . x
Stone size Ve
PIPING : S
Bldg . to Tank r
Tank to Dist . Box
Dist . Box to Field/
Openings Sealed ? Ye o arti
LO CATION/SEPARATI / f t
Foundation to Tank _
Foundation to Absorption _ e�
Separation of Pits
Conforms as per Plot Plan s a
LOCATION OF SYSTEM ON PROPER
( ci rcl e
Front - e - Left Side - Right Side
Middle rout - Middle Rear
COMMENTS
SYSTEM USE APPROVED: YES No
r'
Arrived: �_ • J
Departed : .
Suiiding nspectar
SAX III c f
uFfivs3ury r - �fN; Falls y t st/
rto�
Ry
OF EEN
TOWN OF qUEEN
U. I �._ ii {{ MAY o 51998
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DATEFILE
COPY
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