97-279 ---1
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
June 3 97
Q1611'4/ t -
This i s to certify that work `requested to be done as shown by Permit No. 97279
has been completed.
This structure may be used as a SEPTIC ALTE RATTON
Location 5 OAKWOOD DR.
Owner MORE, STEWART & DOROTH?
By Order of Town Board„ ., •
TAX MAP NO. 69 . --3-3 TOWN OF QUEENSBURY : ,
sj)ati,;,1506. "7
•
Director of Building & Code Enforcement ;.,
BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 No. 97279
TAX MAP NO. 69. —3-3 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MOORE aTEw.ART & O-THY
OWNER of property located at 5 OAKWOUn llg 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
5 OAKWOOD DR.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
QUEENSBURY SEWER
3. CONTRACTOR or BUILDERS Address
JAY SWEET
0
4. ARCHITECT'S Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( )Masonry ( )Steel ( 1
7. PLANS and Specifications
SEPTII•C ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES June 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 June 19 97
SIGNED BY for the Town of Queensbury
Building and Zoning Inspe or
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No. 7'-gC
9
Dept. of Community Development
Building &Codes Office
742 Bay Road Fee Paid ;67
Queensbury, NY 12804
Location of property for installation: _- r`),,c la)0 6 I
Property Owner's Name: ,06 v e 7t t.i 4 S`I 2 w cL,-j y/rid I'
Property Owner's Mailing Address: 694-,L641 o a J
Installer's Name: ..c e e,,,ASS 4 v S c,)�� Phone # 7r-_:,92-,.3�cc7
Number of bedrooms (if residential): A Total daily flow: ,_;0 _
(residential -compu,e @-1-76- ,4 •:-",.)
Topography: )( flat, rolling, steep slope % of sly.- - ,qr
Soil Nature: sand, loam, clay, other I depth:--.� Oki% 'Q,,.
Ground water: at what depth? feet / Bedrock or Impervious Material: at whatl'feet
Percolation test: ,N<' 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 absorption is feet. .
•
PROPOSED SYSTEM •
• 57
Septic tank: /-1 gallon (minimum size: 1,000 gal.)
lie rtfta
Tile field: each trench i/b feet / Total system Ienggth: / , feet ..,64S .
Seepage pit(s): number of _ / size each: ft. by ft.
Size of stone to be.used: # ' / / depth or thickness /a l/ 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 pinsuant to Section 136-29 of,the Code of the Town of Queensbury, any permit or
approval granted which is based upon or is grated 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: t,C� 2.0-e-gio ..5-'.,-2 be— 7 7
r
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 1 y SA-a_oc\ni,
Location cOfikG1ed6
Date(c-A- 17 Permit #()V-7 2).:TC1
SOIL TYP : Sand-Loam- lay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEMS: a
ABSORPTION FIELD: Total ervgt
Length of each tren I ' is ,v 9
Depth of trenches
Size of stone -
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size -
PIPING: 51ize Type
Bldg. to Tank xo'T
Tank to Dist. -- `J� O
Di st:—B o Fi el d/P k
Openings Sealed? 4 No Partial
LOCATION/SEPARATIs
Foundation to Tank ,,//:: feet
Foundation to Absorption °''C.) feet
Separation of Pits feet
Conforms as per Plot P1 an Yes No
LOCATION I- YSTEM ON PROPERTY:
(circle 0
Front - 'ear - Left Side - Right Side
Middle F . t - Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: 11111
NO
Arrived: %0 .d,51/
Departed:
Building Inspector
,..
,
,
/ -7
q )-/-a '')S
I\ '
• . '••
•
',/ DC -,--r r:1\i 4—.--
0
lc 07.:._
,• '
.•, •
. . e
I •ttyFIY
i 00i-Ot6g C(-141A), 1 -1
, • -T0‘71..11.:(;)1. `j.0
,--19:-..‘'9'6.7-'0-1DE
, ---- -- - - --- ... . _•
i RECE,WED
•
jUN .041997 .
TO OF OUEZ-N23URY
BUILDING AND CODE •-•• 1 '1
‘.
...1/ .
, • ./`•
• 1 Z- - - .. _ •
i-
,..
...
-7) ,
.., 1 We nee et ebesevelost Mal tem evidence et
44 c) all objects sok es lieesse,elk tem heft et.
r___ en This dons*I she cepresseteet I M.
TOWN OF QUEENSEURY
\--N IIMI171,11111711111*pie
UiLDii\-IG EL. CODE': ')EpT,
-6,- . ,i,„---• --z-... , . .
•
REVIEWED BY -
DATE 0 .._. 9:7 • 4 ,
__
.
•
_. ..