98-276 V
i
CERTIFICATE OF COMPLIANCE 1
TOWN OF QUEENSDURY
WARREN COUNTY . NEW YORK
Date May 29 19 98
98276
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 11 MOOR'WWD DR ,
Owner MAHER , MARK & LORI JJ
By Order of Town Board
TAX MAP NOw 76 , - 2 - 7 TOWN Or QUEENSBURY
Director of Building & Code Enforcement
l
1
BUILDING PERMIT
ZT3t7.1 {F: C TOWN OF QUEENSBURY
TAX MAP NO . 76 . — 2 - 7 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MAHER r MARK & LORI JO
OWNER of property located at 11 MOORWOOD DR . Street, Road or Ave.
in the Town of Oueensbury, 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 Queensbury Building and Zoning Ordinance.
0"VTV&ftbOD DR
QUEENSBURYr NY 12804
2. CONTRACTOR or GUI LOEfi'S !Name
QiUEENSBURLIY SEWER
3. COttt"C�1 ll 0eWS Addrasa
—4. ARICIIIH I Ga:.TIIS fame
S. ARCHITECT'S Address
6. TYPE of Construction — SPlaass Indicate by Xi SEPTIC
I Wood Frame I I Masonry { I Steel 11
T. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
No.
a. Ew�e __
i Lose
TIC ALTERATION
25 May 22 2eOG
$ PERMIT FEE PAID -- THIS PERMIT EXPIRES , 19
iif a longer pweriod is required on applical Ion for an extension must be made to the suildinv and Zoning inspector of ttwe
town of Oueensbury befare the enpiretion date,1 2 May 19
Dated at the Town of Queensbury this of 19
SIGNED BY _. _for the Town of Queensbury
Buildireg end Zane I
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept. of Community Development Permit No,�
Building & Codes Office tD l)
742 Bay Road Fee Paid $
Queeivsbury, NY 12804
Location of property for installation: hi Tj,,{ D Ye �]
Property Owner's Name: �d V l .�" - - j (Q "
Property Owner's Mailing Address: cz, lit --
Lnstaller' s Name: Phone #
Number of bedrooms (if residential) : Total daily flow:
(residential - compute (g - 150 gal.lbdrm.)
Topography: flat, rotlina, steep slope rc of slope
Soil Nature: sand, loam, clay, other 1 depth:
Ground water. at what depth`' feet I Bedrock or Impervious Material: at what depth? . feet
Percolation test: - not required, required [ rate min. per inch ]
Domestic water supply.- municipal, well, other
if domestic water supply is a ',NTLL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Sept c tanlfGr'r zp' aIlan (minixnurn size: l ,QC10 ,)
F
Tile field: each trench YOZ, feet / Total system length: feet
Seepage pit(s) : number of f size each: ft. by ft.
Size of stone to be used: #4f- ;j= I depth or thickness f ' feet
HOLDING TANK SYSTEM. (if required)
Number of tanks: Size of each: gallons
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 Queeusbury, any permit or
approval ;granted which is based upon or is granted in reliance upon any material misrepresentation 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 su requirements of the Town of
Queensbury Sanitary Sewage Disposal Ordinance_
Signa".lre of responsible person: _ __ � �, bg,_t Date: or
A L f T
TOWN OF QUEENSBURY
531 Bay Rd . , Queensbury NY 12804
518- 745- 4447
Building & Code Enforcement
/INSPECTOR ` S REPORT
do 0
rape y ocation
Owne or Tenant
Building Sewage Sign Other
Remarks :
NG .vS �Q
CONTACT THIS OFFICE WITHHIN
loeo
�� f Building Inspector
OF QUEEMSBURY rt/
BUILDING 6 CODE ENFORC17MWT
Qeee 742 BaY Road
Y NY 128"
(518) 761-8256
SEPTIC DISPOSAL SYSTEM! INSPECTION
Name
Location
Date
Permit #
SOIL Typo Sand Loam-C7ay_
Results of Percolation Test_
( if applicable ) Rate-NfnuteJInch
TYPE OF SYSTEM!;
ABSORPTION FIELD : Total Le t � �
Length of ea trench
Depth of tren es
Size of stone
SEEPAGE PITS: Num
Size - f `
Stone size` x ----� ft .
PIPING:
Bldg , to Tank TxP ' YPe
Tank to Dis Box
Dist . Box o Field
Opening Baled ? es
LOCATI /SEPARATI o art
S
Foundation to Tank : .,•'''�--�fe
Foundation to Absorption ' et
Separation of Pits Bet
Conforms as per Plot Plan feet
LOCATION OF SYSTEM ON PROPER s No
( circle one )
Front - Rear - Left Side - .
Middle Front - Middle Rear ght Si e
COWENTS :
SYSTEM USE APPROVED : YES
NO
Arrived:
Departed . 1
j
BurldTng nspectar
" have sou or obw wbdkvwlseewlsw et
�• all objects such ens Wong k wsk yeft $NOp„MG„
shown 00 " d0CWW 1 Sn e -pr+m eR ! k"
nafy nwo�red did�as set ftM ae the daramor
DATE
y PLOT PLAN
SEPTIC SYSTEM
Notice : The following statement must be " Stamped " on your plot
plan . This sheet of paper may be used for purposes of drawing your
plot plan . After drawing such plot plan , please read the statement
and sign it . If you choose to use other paper for your plot plan ,
then office will stamp those ,plans for your signature .
To" OF
a � OLV C i
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FILE COPY
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