97-447 - _ __ -.. .�__ _
CI�R TIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Dta r17'a^�y. -,� 19 cf"7
1')- -
• This is to certify that work requested to be done as shown by Permit No. 94
"
has been completed.
This structure may be used as a SEPTIC ALTERATION
Location 125 SUNN s :1TDE RE), NORTH
Owner BISHOP ; W SLE Y
By Order of Town Board
• TAX MAP NO. 5O. ^-1-48 TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 97447
TAX MAP NO. 50. -1-48 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to BISHOP, WESLEY
OWNER of property located at 125 SUNNYSIDE RD. NORTH Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a SEPTIC ALTERATTON
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
146 SUNNYSIDE NORTH
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S 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
( I Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
SEPT .IC ALTERATION AS PER PLOT PLAN SPECIFICATION
8. Proposed Use
SEPTIC ALTERATION
25 August 7 19 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(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.)
7
Dated at the Town of Queensbury this 7 Day of August 9
19
SIGNED BY for the Town of Queensbury
Building and Zoning In ttor
Application for. SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit.No.9 71-4 17
Dept. of Community Development
Building &Codes Office'p 0
742 Bay Road Fee Paid
Queensbury, NY 12804
es -- t(„ /_`tom
Location of property for installation: 1 3 (S pi n €S; J. p /OL
BUG 06 1997
Property Owner's Name: j1)L.çL& .. .-y (5 o I --v
Property Owner's Mailing Address: / (f (.X h h S�1 -� �E, ` " '` j� a tl
Installer's Name:0u pc gq r SP CO e✓' Phone #
y
Number of bedrooms (if residential): / Total daily flow: I f
(residential - compute @ 150 gal./bdrm.)
Topography: flat, roiling, 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: "V not required, required [rate min. per inch]
Domestic water supply: municipal, )c well, other
If domestic water supply is a WELL, water supply from any septic absorption is/a-r feet. .
PROPOSED SYSTEM
Septic tank/ Z gallon.(minimum.size: 1,000 gal.)
' Tile field: each trench feet / Total system length: feet '
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # / 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 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 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: Date: 7' -- 7 7
TOWN OF QUEENSBURY 1 ,v O
BUILDING & CODE ENFORCEMENT
,. 742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 6/5/i0P
Location , U, '4/5/eO" /t/I.
Date 8 Gj7 Permit # Q)-"' 10
SOIL TYPE: Sand-Loam-Clay-
Results
of Percolatio est-
. (if applicable) Rate to/Inch
TYPE OF SYSTEM:
ABSORPTION FIEL'I Ts , Length _
Length of each tre :ch
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 one)
Front - Rear - Left Side - Right Side
Middle Front - .Middle Rear
nCOMMENTS:
'C-Pi 4-6 74-.A)g C9,vLy
Si re-e(6 ,0 K
SYSTEM USE APPROVED: YES NO
Arrived: /O S
Departed: f(. 00
Building Inspector
?id?)
TOIIN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name r- 6/5-x 'io
Location �vovn/f5✓/.0 /i
Date i 6A7 Perini t # -444(2-
SOIL TYPE: Sand-Loam-Clay- 17--14'7
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total - .th
Length of each tre ,ch`
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 one)
Front - Rear - Left Side - Right Side
Middle Front - Middle ,Rear
COMMENTS:
�R�I1L �6P L 469riat c-AT c )L
•
ekatir
SYSTEM USE APPROVED: YES. NO
Arrived: P �b
Departed:
CiteC
Building Inspector
t
"at
,
. re mu , - law ' _i . ....t ,
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"If have seen or observed,or berme!saw evidence of,
- all objects such as houses, wells,trees,fences,etc., 1.....
shown on this document.I also represent that I have *
per bully measured distances t forth on the diagram."'
SIGNATURE DATE
-_
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0
0
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1( c- %LS' Pr—f- r:
,
/ AUG 0 6 1997
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' DATE
11 V\ LI 1 J e_ 4 •