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98-483
E, OF COMPLIANCE TOWN OF QUEEMSBURY WARREN COUNTY , NEW YORK r Uate August 10 19 98 98483 This is to certify that work requested to be done as shown by Permit No6 has been completed . SEPTIC ALTERATION This structure may be used as a -J 83 MONTRAY RD . Location BYRES , KEITH & SU SAN Owner ""— -- By Order of Town Board TAX MAP NO . 7 • - - 2 9 TOWN OF E SBU R Y ___--Director of Building & Code Enforcement BUILDING PERMIT TOWN OF +QUEENSBURY No. VALUE $ 0 TAX MAP NO . 70 a - 2 - 29 WARREN c0UNTY, NEW YORK 7] K PERMISSION is hereby granted to BYR Street. Road or Ave. OWNER of property located at 83 MONTRAY RD . in the Town► of Oueensbury. To Constrisct or place a and at the above location in aocordance to application together with plot Plans acid other information hereto flied approved and in compliance with the Town of Oueensbury Building and Zoning Ordinance. t. OWr1ER"S Address is 83 HoNTRAY RD . QUEENSBURY , NY 12804 2. CONTRACTOR w $UDDERS Name I . B . S . SEPTIC 31. CONTRACTOR WARRENR 2 STREET QUEENSBURYr NY 12804 4. ARCHITECTI !dams 5. ARCHITECT"$ Address 5. TYPE of Construction iPleaae indicate by %1 SEPTIC 11 Wood Frame 1 1 Masonry 1 1 Stefi f l 7. PLANS and SPeclficatione No- S. Proposed Use SEPTIC ALTERATION August 6 2000 25 r19 S PERMIT FEE PAID - TlilS PERMIT EXPIRES Itf a to#gW Period is mquired an application for an extension "%M be rnede to the and Zonirq inspector of tMe town of iluaansbury before the expiration da e.l Augus 1998 Gated at the Town of QuaerisbtsrY this Day of 19 191 for the Town of Oueensbuty SIGNED BY euildbM e ietrOeetar Application for SEPTIC DISPOSAL PERMIT Town of Qury Dept. of Community Development permit No. Building & Codes Office 742 Bay Read Fee Paid $ �� Qaeeusbury. NY 12804 Location of property for installation: Property owner's Name: Property Owner's Mailing Address: AUG � Installer's Name: r c - Phone # Number of bedrooms (if residential): _ Total daily flow: (residential. - compute 0 150 gal.fbdrm.) Topography: r' ' rolling, steep slope o of slope Soil. Nature: sand, loam, clay, other I depth: Ground water: at what deptht'L feet ! Bedrock or Impervious Material: at what depth? � feet Percolation test: not required, required rate min. per inch ) Domestic water supply: km cipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank�Aod gallon (minimum e: 1 ,()00 gal.) Tile field: each trefich - -- - feet I Total system lend: feet Seepage pit(s): number of � / size each: ft` by ft. Size of stone to be used: # ©`-') � f depth or tbickness � feet HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gaIlons Alarm syste®n and aaWC=ted electrical work to be inspected by a certified agency. For your protection, plea now 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 m reliance ugau any atauterial nrisrePresectstua Or failure to make a material al fact or circcanstance known by or on behalf Of as applicant, shall be void. I have read the regvlations with respect to thus application and agree to abide by these sand all requ mvinects of the Town of Queenabtrry Sanitary Sewage Disposal t7 dii — Signature of responsible person: TON OF QUEENSBURY f BUILDING & CODE ENFORCEPE NT 742 Bay Road Queensbury NY I2804 (5I8) 761-8256 SEPTIC [DISPOSAL SYSTEM INSPECTION Name Location Date - Permit # 1 SOIL TYPE• San Lo -C76 j Results of Per olatio est- ( if app7icab ) R - inute/ Inch TYPE O 1'S j ABSORPTION IELD: Total Lqrn h - Length of each trench ) Depth of Tench s Size of tone SEEPAG PITS : umber- Size - ft . x ft . Stone size PIPING: Bldg . to Tank yp Tank to Dist . Box Dist . Box to Field/P ' ., Openings Sealed ? Yes . No artia LOCATION/SEPARATION , Foundation to Tank / feet Foundation to Absorption feet Separation off' Pits feet Conforms as per Plot Plan es No LOCATION O YSTEM ON PROPER ( circleCear Front ` Left Side - Right Side MiddleMiddle Rear COMMENTS: SYST04 USE APPROVED : YE NO Arrived : ) - ` Departed: Building Inspector Jr � 9 � + I i . f sA .may ,lLrfRKh ir , d6 � [' . 1 f � � al 1 , i 7[}WN Oi QUEENSBURY BUIUHNG DE RRTMENT Biased on our li"AW exarninetioR ,aosnpfisnce with our COMMMU $MR ' he ,►+ n ind' pjam and sPeOft3flORs are In 'Un 0"piilime wftf► the coda TOWN OF Q V EE 5 UR Cu DATE AUG /0 M8