98-382 S -
CER T'I FICNrE OF COMPLIANCE
TOWN OF QUEENSOURY
WARREN COMITY . NEW YORK
Date_ July 2 19 98
• Ca .r 98382
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 27 ZENAS DR . - -
Owner LUDWTG , JAMES & JOAN
By Order of Town Board
TAX MAC' NO 92 . - 2 - 2 . 66 TOWN OF QU EN "BURY
Director of Building A Code Enforcement
BUILDING PERMIT
VALUE 3 0 TOWN OF +QUEENSBURY No. _ 98382
TAX MAP NO . 92 . - 2 - 2 . 6+6 WARREN COUNTY* NEW YORK
PERMISSION is hereby granted to LUDWIG JAMBS & JOAN
OWNER of property located at 27 ZENAS 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 Oueensbury Building and Zoning Ordinance_
't- OWNER'SAddrets is
610 HOLLYWOOD AVE .
HO-HO-KUSr NJ 07423
2. CONTRACTOR or BUILOeRS Name
CONDON SEPTIC & DRAIN SERVICE
3. CONTRACTOR or BU{I.QERS Address
A. ARCHITECTS Name
S. ARCIHITECT*S Address
G. TYPE of Construction - (Please indicate by X) SEPTIC
{ i wood Frame ( l Masonry [ 1 Steel ( I
7. PLANS " Specifications
SEPT . ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 June 30 2000
$ PERMIT FEE PAID - THIS PERMIT EXPIRES 19
(tf a longer period is required an application low an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
30 Jung 1998
Dated at the Town of Queensbury this 1 Day of 19
SIGNED BY �~ X.ti � � T � � for the Town of Queensbury
Building and Zoning Inspector
Application for SEPTIC DISPQSAI. PERMIT
Town of Queensbury Permit No. { i
Dept. of Community Development
Building & {Codes Office -
742 Bay Road Fee Paid $
Queensbury„ NY 12804
Location of property for installation: 2.'-7 f W c9
Property Owner's Name: 22 t4) r 9 If/�� - 7.2 / 4r �''� WOO
Property Owner's Mailing Address: I /,o d .�'ri' rIJCITcV AL_ d 4t't U N Cl Chi �f`
Installer's Na ne:I, o d /Y ' S Lc c-V r0/, rV SF. 0,, _ Phone # %? c ' `x'r Z
Number of bedrooms (if residential) : Total daily flow: d C3
(residential - compute 150 gal.lbdrm.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other I depth:
Ground water: at what depth] feet l Bedrock or Impervious Material: at what depth feet
Percolation test: not required, required f rate min. per inch ]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTE�Ni I� r^O�r� � f,
Septic tank: 1 galllone(nummum size: 1 ,000 gal.)
Tile field: each trench 6 feet ! Total system length: D feet
Seepage pit(s): number of ! size each: ft, by JtJN ? (k. logp
Size of stone to be used: # �'' ! depth or thickness �'� -- 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 Queensbury„ 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 all requirements of the Town of
Queensbury Sanitary Sewage Disposal ordinance.
Signature of responsible person: Date:
TOMM OF QdEENSWRY .
SUiLDING S CODE EIiFORCEP"T
742 Say Road
Queensbury NY 12804
(519) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date ` Permit
SOIL TYPE: Sand-Loam- Clay-
Resul is of PercoRateon Tetinut ' Inch ..
( if apPl i cabl e )
TYPE OF SYSTEM:
ABSORPTION FIELD : To' l Le gtt�
Length of each trench
Depth of trenches
Size of stone umber-
S PITS : ft . X t .
Size - �.�_-.---
Stone size Si ype
PIpiNG:
Bldg . to Tank Tank to Dist . Box
Dist . Box to Field/Pit o Partial
openings Sealed ? Yes
LOCATION/SEPARATIONS: f eet
Foundation to Tank Absorption � r feet
Foundation to Abso►^P eet
Separation o* Pits a No
Conforms as per Plot plan LOCATION OF SYSTEM ON PROPER
( circle VRearLeft Side - Right Side
MiddleFront Middle 'Rear
CATS
SYSTEM
USE APPROVED : YES No
Arrived:o
Departed:
�� Bu- i cal ins nspector
TobM OF QUEENSSURY
BUILDING . CODE �adRCEW"T
742 say QUeensbury NY 12804
(519) 761-9256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name -
Location C
Date Permit #
SOIL TYPE- Sand. Loam-Cl ay-
s of Pea
n Test-
( if aMinute/ inch., .
( i f applicable) Rate
TYPE OF SYSTEM: otal Length ABSORPTION FIE tren h
Length of eac
Depth tren es
Size of one r_
SEEPAGE PI x ft .
Size - �~
Stone size Size ype
PIPINGto Ta
Bldg . Box � --- -- "
Tank V D i o Field/Pit
Chi st . Box eat ed? Yes No Pam.
openings
LOCATION/SEPARATIONS - feet
Foundation to Tank feet
Foundation to) Absorption -- feet
Separation of Pits s {gyp
1 an
Conforms as per Plot PPROPER
LOCATION OF SYSTEM ON
( circle Rear - Left Side - Right Side
Front _ Middle Rear
Middle Front
COM*"TS :
SYSTEM USE APPROVED
YES No
yd
Arrived --- --
Dep arted: ----
tor
Building 7nsve�w
1 o f L1. u�ocsd !!e 60n;; lv s -� �C' /tt C ,r ir�7 S6< ()/C f
Wr
16
TOWN OF
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REVIEWED BY L �-
DATE -
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