97-215 CERTIFICATE OF COMPLIANCE
TOWN OF UUEENSBURY
WARREN COUNTY, NEW YORK
Date Hay 9 19 97
97215
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 29 ZHNAS DR
Owner HRRY, JOHN f•t COLEFIN
By Order of Town Board
TAX MAL) NO. 92 . -2-2. 57 TOWN OF QUEENSBURY
/ ) /7
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY Na 97215
TAX MAP NO. 92 . —2-2 . 57 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to BERRY, JOHN & COLEEN
OWNER of property located at 29 ZENAS DR. Street,Road or Ave.
in the Town of Queensbury,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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
29 ZENAS DR.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
SANITARY SEWER •
3. CONTRACTOR or BUILDER'S Address
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCHITECTS Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( 1 Masonry ( )Steel (
7. PLANS and Specifications
SERI IC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 99
PERMIT FEE PAID —THIS PERMIT EXPIRES May 13 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
13 May 19 97
Dated at the Town of Queensbury this of
SIGNED BY for the Town of Queensbury
Budding a oning Inspector
Application for SEPTIC DISPOSAL PERMIT
(1A1 ,
Town of Queensbury Permit No. '.1_5
' Dept. of Community Development
Building &Codes Office /J
742 Bay Road Fee Paid c$L..
Queenssbury, NY 12804
J
Location of property for installation: ; 9 .7,-e 0
Property Owner's Name: \T® 4 /U FRAZA-d___
_ Property Owne 's Mailing Address: 9 2- e�k 44.
Installer's Name: fi/U CFAs/Ul kl cam, Phone # 7 9 - 7d-s" r
__ _.
- ~_ _ _ ____ _ _ ___;__.„_,__, __,__-_____>_ __ , ___ _ _____ ___ _Number of bedrooms (if residential): ":.=y�~ Total daffy flow: ��� -
(residential -compute @ 150 gal./bdrm.)
Topography: o -flat, rolling, steep slope % of slope
• Soil Nature: &sand, loam, clay, other /depth:
' . Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _feet
Percolation test: not required, required [rate min. per inch]
Domestic water supply: ( municipal, well, other
If domestic water supply is a WELL, water supply from any septic abso e.tior fe feeet. •
'
•
PROPOSED SYSTEM MAY 071997
l q� /xc�S7<,`' 6 �;,�"vs3uRV
Septic tank I'V" gallon (minimum size: 1,000 gal.) ` TOWN O} ' P►NO CODE
BDitONG
Tile field: each trench "-C17 feet / Total system length: . feet
Seepage pit(s): number of / size each: ft. by ft. •
Size of stone to be used: # 2- / depth or thickness ( feet
• HOLDING TANK SYSTEM:. (if required)
Number of tanks: Size of each: gallons
(Alarm system and associated electrical work b be inspected by a certified agency.) •
For your protection, please note that pursuant to Section 136-29 of the Coda of the Town of Queenabu y, 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 nescation and abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Dispo eeu • •
Signature of responsible person: �� _• Date: ����/ 2
1� Po
1 i 130
11.6
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 1 V LA- 6 ,2 (* LAr--,
l
Location ,-j���_/t/ .,(�� ,11—) ✓
Date; Permit # CA- �d,15
SOIL TYP . San Loam-Clay-
Results of Percolatio est-
(if applicable) Rat - 'nute/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL . Total Length Z.-
Length of each trench t-f,� b0°
Depth of trenches .7 1
Size of stone ?_
SEEPAGE PITS: Nu ber-
Size - ___ _,___.ft. x ft.
Stone size
PIPING: Size Type
Bldg. to TankV.-5N11-611.
Tank to Dist. Box q eB1—
Di st. Box to Field/Pit /�s% � ra_r--
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank C � feet
Foundation to Absorption 2 54 feet
Separation of Pits .-feet
Conforms as per Plot Plan No
LOCATION OF SYSTEM ON PROPER :
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - fiddle Rear
COMMENTS:
•
SYSTEM USE APPROVED: (--' ff0
Arrived: o
Depart... 4�,
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AO i REVIEWED B‘ // At/L14
DATE / "6-- l't ...
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