98-265 i
CERTIFICA ►.'I' CA COMPLIANCE �
TOWN Or-- QUEENSBURY
WARREN COUNTY , NEW YORK
DateMay 22 19 98
98265
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 -----
Location 6 HEINRICK ST .
Owner STUART , w . SCOTT & LAURIE -
By Order of Town Board
TAX MAP NOw 90 . - 4 - 38 _. TOWN OF QUE/ENNSBURY
Director of Building & Code Enforcement
11
BUILDING PERMIT
VALUE s 0 TOWN OF QUEENSBURY No. 98265
TAX MAP NO . 90 . 1111111141111111138 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to STUART r W . SCOTT & LAURIE
OWNER of property located at 6 HEINRICK ST . Street, Road or Ave.
in the Town of Queensbury, To Construct or plaoe 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. p WrtNE Rs Address is
6 HEINRICK ST .
QUEENSBURYr NY 12804
2. CONTRACTOR at BUILDERS Name
SANITARY SEWER
r NMEM9 Bt,170-1&Vd'2r2 4
GLENS FALLS NY 12801
4 -ARC:;C'tE'.:TS ::erne
5. ARCHITECTS Address
6. TYPE of Construction — {Please indicate by x) SEPTIC
I I Wood Frame I I Masonry f ) Steel t 1
7. PLANS and 'Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
No.
0, PI Use
SEPTIC ALTERATION
25 May 20 2000
S 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 f,A►eensbwry bete" the expiration date.l 1 9
20 May
Dated at the Town of Queensbury this aY of 99
SIGNED By for the Town of Queensbury
Building and Zoning 1
Application for SEPTIC DISPOSAL PERI+v'IIT
Town. of Queensbury Permit No.
Dept. of community Development
Building & Codes Office Fee Paid $
742 Bay Road
QueCusburr. IVY 12804
Location of property for installation:
Property Owner's Name:
MAY 19
Property Own 's Mailing Address:
+(�, }�.� i,..s /2.r G Imo-
Installer's Name: , Cam, + ��" ' �^- Phone # �7 9 .2-
Number of bedrooms (if residential): Total daily flow:
(residential - compute a 150 gal.Ibdrm.)
Topography: a�� rolling, steep slope % of slope
Soil Nature: `''�saud, loansv clay, other I depth:
Ground watev at what depth? feet I Bedrock or Impervious ll,,Tater:ai: at what depth? feet
Percolation test: �t required, required [ rate min_ per inch ]
- - - - Domestic water supply: L/ municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tattle ?Ot>:D_ gin (minimum size: 1,000 gal.)
Tile field: each trench 4�' feet I Total system. Ienath.: ' 2 0-a feet
Seepage pits): number of �"' . ' / size by ft-
Size of stone to be used.: # depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: g
.Alarm systeim and asseciated electrical work to be inspected by a: cesfzried WDOY-
For �, please note that parsoant to 5ecewn 136-29 of the Code of the Town of Qoeaus�Y, anY permit or
approval granted whwh is based upon or is gsanoad = reliance Upon any maul or fuIUM to maim a
mabmial fact or aircaa kw wn by or on behalf of an applicant; dhall be void.
I bava read the regulations with respect to thus appiwab= andagreeto abode by these and an requ remeots of this Town of
QueembusySSuitAry SOVAQ6 l7iapoaai 0,,,,i7 Signature of responsible person:
Date: �.3�r'9" ----'9�-
TOWN OF QUEEKSBURY
BUILDIM,6 a, CODE ENFORCEMENT
742 Bay Road
128C14
Queensbury ,
(518) 761-8256
SYSTEI4 INSPECTI
SEPTIC DISPOSAL
i
Name
Location
Date ` Permit #
SOIL �an - ay-
Resin is of Percolation
st
{ if applicablee )) 4
TYPE OF SYSTEM: Iota ength
ABSORPTION FIE each ench
Length o '
Depth of trenches
Size of stone Numbe
SEEPAGE PITS: fte
Size - f t . x
Stone size ize yPe
PIPING: 14
Bldg . to 'Tank t
Tank to Dist . Box „ _
Dist . Box to 'Field Pit o artia
Openings Sealed? e
LOCATION/SEPARATIONS* feet
Foundation to Tank - � feet
Foundation to Absorp et
ti on
Separation of
Pits y fe„ Yo
Conforms as per Pl of Plan
LOCATION OF SYSTEM
ON PROPERTY -
{ circle one) Ri ht Side
Front Middle ron _ Middle Rear
coWENTS =
SYSTEM USE AppROY No
6
Arri y
Depa ed :
d n ctor
rruTtrcic_ � T
V 4a
C� MAY 19 1998
ISBURY
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