Loading...
98-458 CLI-i: TIFICATE 01P COMPLIANCE TOWN OF QUEENSBURY WARREN C'©UNTY , NEW YORK l pate August 10 19 98 98458 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 LOT 52 HOMESTEAD VILLAGE MOBILE �Y Owner HOMESTEAD VILLAGE L . P . - - TAX MAP NO . 93 % - 2 -- 11 . 1 By Order of Town Board TOWN OF QUEENSBURY Director of Building A Code Enforcement BUILDING PERMIT ► , tf�, �, TOWN OF QUEENSBURY No. TAX MAP NO . 93 . - 2 - 11 . 1 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to OWNER of property located at LOT 52 HC71atFem>.r rn sat • r ..+- B _ 0-i!t. Rued or Ave. in the Town of GueensburY, To Construct or place a ITERATION- at the above location in accordance to application together with pilot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t. OWNER'S Address is 4294 ROUTE 5 CALEDONIA , NY 14423 2. CONTRACTOR or Bt1SLDERZ Name ADVANCE EXCAVATING 3. CONTRACTOR or SUILOER'S Address +t. ARCHITECT"S Name S. ARCHITECT'S Address G. TYPE of construction — (Please indicate by x1 SEPTIC ( 1 Wood Franne [ I Masonry ( I Steel ( 1 milli i. PLANS and Spoo fications SEPT,AC ALTERATION AS PER PLTO PLAN SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION 25 July 27 19 2000 $ PERMIT FEE PAID - THIS PERMIT EXPIRES (if a longer period is mgvired a sipplxp riri on l daa )xtendo+n muse be made to the &wildIng and Zoning Inspector of the sown of Oua+nsburY 27 July 1998 Dated at the Town of Queensbury this Day of ig SIGNED BY • 1�y . � _lor the Town of Oueensbury BuikUng and Zoning t napeCtor yApplication for SEPTIC DISPOSAL PERMIT Town of Queensbury I Dept. of Commtmity Development Permit No. LI S Building & Codes Office 742 Bay Road Fee Paid $ Queensbury, NY 12804 Location of property for installation: _ flc�ht _ 5 �� Property Owner's Name: Property Owner's Mailing Address: / ,r Installer's Name: 140 YA I�,! � ! C.dA V - Phone # 521 Number of bedrooms (if residential): _ Total daily flow: (residential - compute 150 gal.lbdr n,) Topography: ✓.flat, rolling, steep slope %o of slope Sail Nature: sand, loam, clay, other I 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: —4,,,f 0rnunicipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: G`�G gallon (n='mum size: 1 ,000 gal.) Tile field: each trench Y feet / Total system length: 2j7Y-`t feet Seepage pit(s): number of ! size each: ft. by ft. Size of stone to be used: # 0 J 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 136r29 of the Code of the Town of Queensbury, any permit or per--- -al granted which is based upon or is granted in reliance upon any material nmBrepresentation or failure to mako a l fact or circumstance known by or on behalf of an applicant, shall be void. sad the regulations with respect to this apphcaation and agree to abide by these and all requirements of the Town of ury Sanitary Sewage Disposal Ctdinaxipe. JF •e of responsible person: � L Efate � T1 f1p SEER FORCE""T ` BU;LDING CODE Bay pY ad (5-m I 742 4 Queensburyea g256 SEPTIC UISFCISAL SYSTEM IRSpECTYOM `,� k -- Location ermit # r ` Date _ ay Sand_Loam- SOIL TV T st_ of Percolation Min (� u t licable) IYPE TIC 11m: Total L. ngth _� ----- AgSO h of each trench Lent of trenches Dept f stone Size E pITS: ftumber- ft , SEEFA ft . x �— Size 1ze__ __� ��� ize yPe Stone p;pl%Gt ank Bldg • t 5 t . 6+ox -- ---� Tank to to F i el dIP t - -� - -0 artri a Dist . Box a le I AYtATI es ppenings feet LOCATICK/ Tank -�� feet Foundati on tion �� - -�- feet Foundation to Abss es No Separation of of Plan Canfarn►s as Per ON pROp'ER LOCATION Op SYS ( circle ones- Side - Right Side Rear - of Rear Front Front - Midd Middle Rear _�r] �L ► v p� �►, 6 � ► � K© SYSTEM USE APPROYM ' Arri V ed flee a uz ding ec'tor i TOWK OF Q13EEKSBURY WILDING &C(M -8ay �adRCEMENT Queensbury lKy 12B04 is ia) 761-82-% SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date<2.- Permit 1--���, SOIL TYPE�;an am-Cl aY- `� `-i Results of 'Percolation i ne ttellnch ( if applicable) TYPE OF SYSTEM: oe Total tengt ABSORPTION FIELD : �—�- Length of each trench Depth of trenches size of Stone r, SEEPAGE PITSW ft . ft . Size Stone size ice ype PIPINGto Tank 11 Bldg . Dist . B 4•► `S Tank to Id/Pit artial Dist . Box to F 7 e Nq openings Seal ION LOCATIONISEP feet Foundation Tank `�� feet Foundation tn, Absorption feet Separation of Pits �y Conforms as per Plot PppP>=RT1[ : LOCATION OF SYSTEM ON ( circle one) eft .Sid Y' Right 'Side Front Rear e ea Middle Fron ' COHKMTS= s- BoAC \4 SYSTEM 135E APPROVED = Arrived: ; D ep a u ector �h se rued, or believe I saw evidence „ AS houses, wells, trees, fences, etc.q jocu:ment. I also represent that I tam '1 — -- jhsured the distances set forth an the do~ SlGNATU lop t ,�+�p j too �-- I a 4 1 fi rr r DATE �,f/�