97-018 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY •
WARREN COUNTY, NEW .YORK
Date January 21 19 97
97 18.
-This ,is to certify that work requested to be done as shown by- Permit
has been completed.
This'•structure may be used as a. -
SEPTIC ALTERATION -
Location 2 LANTERN N HILL RD.
Owner CORNIER, JOSEPH & KATHRYN
By Order of Town Board
TAX 'NAP NO. 125. --4-1 t: DNa:9:11EENS R
Director of, Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY . No. 97018 •
TAX MAP NO.. 125 . -4-17
WARREN COUNTY, NEW YORK
CORMIER_. JOSEPH & KATHRYN
PERMISSION is hereby granted to
2 LANTERN HILL RD. Street, Road or Ave.
OWNER of property located at
SEPTIC ALTERATION
in the Town of Queensbury,To Construct or place a
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.
1. o1WNEEEITi5isHILL RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
I . B. S . SEPTIC
3. EONUT OETRIAV Rg/IRdEET
QUEENSBURY, NY 12804 •
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X) SEPTIC
( )Wood Frame ( 1 Masonry ( 1 Steel 1
7. PLANS and Specifications
SEPTIfy'a. ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 January 20 19 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
20 January 19 97
sbu
Dated at the Town of een this ay of
SIGNED BY
for the Town of Queensbury
Building and Zoning Inspector
�.„. Application for SEPTIC DISPOSAL PERMIT a
O
Location of property for installation: 77 1 (--‘4/1-(f„ ff,,`G JAN 2 01997 'ri
Owner's Name 7? Co n p-,./ktr i Tcivv q•;Ib-�iNPIkeNllimiti lf'ilV ID
BUILDING AND CODE 1
Owner's Mailing Address: • # 1- C, �{ r rN
/117/(_!
ril
Installer's Name: _Z ' `3+ ) , 5(',/ ' C Phone #:,
9�� /9 FEE PAID Z
—1
•
Number of bedrooms (if residential):
6 00 r/� Q � ).-.<
Total daily flow (reside d .dial -compute 150 gal. per bedroom): J r '
'Topography: •lat . I 1 Rolling [-1 Steep Slope % of Slope
Soil Nature: Sand n Loam Clay n Other /Depth:
•
Ground Water: at what depth? feet ' •
• Bedrock or Impervious Material: at what depth? feet
Percolation Test: n ' it Required 1-1 Required/Rate min. per inch
Domestic Water Supply: Municipal [1 Well Other •
•
if domestic water supply is a WILL: water supply from any septic absorption is feet
PROPOSED SYSTEM:
Septic tank:l0 0 0 gal, (minimum size: 1,000 gala) •
'tile Field: each trench 562 feet. / total system length 57" feel.
Seepage 1'it(s): number of / size each: ft. x ft. "
•
Size of stone to be used: # / depth or thickness feet. .
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gal.
•
IJ Alarm system'and associated electrical work to be inspected by cr certified agency. .
1'or your protection, please note that pursuant to Section 136-29 of the Code oldie 7oi+•n of
Queensbury, any permit or apjroia1 granted which is based upon or is granted in reliance upon •
any material misrepresentation or firilure 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 is application and agree to abide by these and all
requirements of the Town of Qucenshur S rnitary Sewage Dis osal Ordinance.
Signature of responsib'e person: Date: /`--1 d--P7
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ems_ ���
1
Location ,),J)/v,„ o va "l 1 I
Date Permit # 9 7—O/g
SOIL TYPE: Sand Loam-Clay-
Resul of ercolation Test-
(if app .c ble) Rate-Minute/Inch
TYPE OF S EM:
ABSORPTI F LD: Total Length, 2;cpf
Length each ench
Depth trenches .- °
Size f stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: ,Size Type
Bldg. to Tank 5usll,J
Tank to Dist. Box 4 ?-O
Dist. Box to Field/P.
Openings Sealed? es No Part'al
LOCATIO4/SEPARATI /�
Foundation to Tank / feet
Foundation to Absorption ?-(J feet
Separation of Pits feet
_
Conforms as per Plot Plan a No
LOCATION OF SYSTEM ON PROPE3 •
: one)
ront Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: YES NO
Arrived: .i .:f::C63)-"13.
Departed:
Building Inspector
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name CORevue-g
Location _ 14 07&/Z tl I4 c_
Date iF 7-411 ' Permit # `l 7_OJB •SOIL TYPE: Sand-Loam-Clay-
Results of Per •lati ' ' Test-
(if applicable) ' e-Minute/Inch
TYPE OF SYSTEM.
ABSORPTII ELD: Total Length
Length ► each tr:nch
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x. ft.
Stone size
PIPING: Size Type,
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits _ feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES NO
Arrived: 3 f S 5
Departed: -k 4
Building Inspector
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