97-194 . .
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
•
WARREN COUNTY, NEW YORK
• Date Hay 12 19 97
r' '6 , 11'1 ' 14/ 97194
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
55 WILLOW RD*
Location
HOY, CHRISTOPHER & PAPPO,
• Owner
TAX MAP NO 0 -8-23 By Order of Town Board
9. .
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
•
•
• . .
BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 No. D7194
TAX MAP NO. 90. —8-23 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HOY, CHRIST9-PER & P-APPO,
OWNER of property located at 55 WILLOW RD. Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a SEPTIC ALTERATIONinformation at the above location in accordance to application. together with plot plans andother hereto filed and
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
MARI'CE 55 WILLOW RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
ML TECHNOLOGY
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
5:'ARCHITECT'S Address .
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( 1 Steel
S PTIC
7. PLANS and Specifications
SETItIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES May 2 19 99
(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.)
Dated at the Town of Queensbury this 2 Day of May 19 97
SIGNED BY for the Town of Queensbury
But ding and oning lime or
, Aprncation for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No.
Dept. of Community Development
Building &Codes Office �'6�
742 Bay Road Fee Paid $ .-,
Queensbury, NY 12804
J
Location of property for installation: 55 Willow Road
Property Owner's Name: Dr. Chris Hoy
Property Owner's Mailing Address: 55 Willow Road, Queensbury, NY 12803
Installer's Name: ML Technology Phone # ( 518)743-0934
Number of bedrooms (if residential): Total daily flow:
(residential - compute @ 150 gal./bdrm.)
Topography: flat, X rolling, steep slope % of lope
UtTIVED
Soil Nature: sand, loam, clay, other I dep
Ground water: at what depth? feet / Bedrock or Impervious M te , a N
what d E=t'epth?UF�Y feet
7
BUILDING AD CODE
Percolation test: X not required, required [rate min per
Domestic water supply: x municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank: gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system 1en_Qth: feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # / depth or thiclmess feet
Drain Line from pool house shower to pump tank inside house
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Cklarm 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 be of an applic be void_
I have read the regulations with respect to this a lic to abide by these arc'all requirements of the Town of
Queensbury Sanithry Sewage Disposal
Date: �'
Signature of responsible person:
TOWN OF QUEENSBURY
BUILDING" & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256 Dt/tc'
SEPTIC DISPOSAL SYSTEM INSPECTION 7 ��
, r
�, .� �a
'Name '
Location
Date (7i 7 Permit # 9'7' /,7
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) R.t_ Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: ital Length
Length of each .tre h
Depth of trenches
Size of stone.
SEEPAGE PITS: Nimbe -
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:
5K00-)412 kkrso KC—p i ttrT UJ\A IA)
6/0T-te_ - •Cold o S&
C°eiei2C-c7/CA.) I o 12�cL&) Q
SYSTEM USE APPROVED: NO
Arrived:
Departed:
v/l/e-C>"
Building Inspector
N O-L-- -- , o
TONN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name a 6
Location Gtl/GGDG,-( A
Date 3"/5/97Permit # 7-/9
SOIL TYPE: San-Lo -.Clay-
Results of Percol tion Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
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
Front - Rea - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
,r(lOr A-Ak0
SYSTEM USE APPROVED: YES NO
Arrived: -7 ( 0
Departed: /0
Building Inspector
•
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804 .
518-745-4447 . '
SEPTIC DISPOSAL SYSTEM INSPECTION
Name y
Location 6_) ) /fec)
Date 5✓ Permit # 77— l?�
SOIL TYPE: Sand- oam-Clay-
Results of Perc ation Test-
(if applicabl te-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD. Total Length •
Length of each trench
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
Front - Rgy _ Left Side - Right Side .
Middle Front - Middle Rear
COMMENTS:
O� g-1\- -( "F\LL._ Liu&
•
CA 2 Pv wAip O/‘e/-T I o.a.)
(;,)Gt „ V6-4k2f • -
SYSTEM USE APPROVED: . YES N
Arrived:
Departed: 3 j (�
•
Building Inspector
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