98-660 CERTIFICATE OF COMPLIANC
TOWN OF QU£ENSBURY
WARREN COUNTY . NEW YORK
Date October 21 19 98
98660
This is to certify that work requested to be done as shown by Permit No . _
has been completed .
SEPTIC SYSTEM
This structure may be used as a
� ��L
Location 3 RYAN --
MURRAY , JAMES & AIMEE
Owner
TAX MAP NOW 134 . - 6 - 33 By Order of Town Board
TOWN F Q ' UR��!
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE S TOWN OF QUEENSBURY hia. „ �18660
TAX MAP NO . 134 . - 6 - 33 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MU EE
OWNER of property located at
3 RYAN ST . Street. Road or Ave.
To Construct or place a SEPTIC SYS
at the above
of Cabo in a application together with plot plans and other information hereto flied and
at the above location in accordance to app ge
pliance with the Town of OueensburY Building and Zoning Ordinance.
approved and `incom
t' 3 RYAN AVE *
QUEENSBURYr NY 12804
2. CONTRACTOR or GUI LDEWS Name
SANITARY SEWER
3 AiriiI% 1111111 11111111 11111111 1 1 111 111111 1
i or BUILDER 5 Address
i DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCMI1t%T s Name
S. ARC"ITECT'S Address
S. TYPE of Construction — (Please indicate by xl SEPTIC
( i woos! Frame I I Masonry l 1 Steel I I
7. PLANS and Specifications
SEPT;q SYSTEM
G, 'rrot+osod *%K
SEPTIC SYSTEM
October 21 2000
25 18
$ PERMIT FEE PAID - THIS PERMIT EXPIRES
411 a longer period is required an application for on extension must be made to the Building and Zoning inspector of the
town of ,tlueensbury Aefore the expiration data.) October 19 9 8
21
Day of
Dated at the Town of QueensburY this
1g
for the Town of pueensbury
SIGNED By qu3tdirq and Zoning Ir►fpeotor
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No. V�`4
Dept. of Comununity Development
Building & Codes Office r
'742 Hay Road Fee Paid
Queensb'ury. NY 12804
Location of property for installation:
Property Owner's Name: f1 tM -E ry 14 ` ' r
Property Owner's Mailing Addr/e�s`s: 3 �` `�'' �-�
Installer's Name: " a N + T�'''�a phone # 6) 1 - 7 ,x s ?
Number of bedrooms (if residential): _ Total daily flow: '` �
(residential - compute 0 150 pl.lbdrm.)
Topogmphy: r4- flat, mlling, steep slope % of slope
Soil Mature: .4 sand, loam„ clay, other 1 depth:
Ground water; at what depth? feet / Bedrock or Impervious Material: at what depth? — feet
Percolation test: X not required, required [ rate min. per inch 1
- — - Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank IQ 0 gallon (minimum size: 1 ,000 gal.)
Tole field: each trench vr0 feet I Total system length: ' c' � 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 tams: Size of each: gallons
AJw= syel=a tad associated alacb-=d work to be inspected by a ca�Ssd asecie '-
]?or YOW pvoteoden, plaaae ante that parouent to section 1365-29 of dw Code of the Town of Queambugyp ww Pamixt or
approval gated winch is bread apou or is ,granted a: raluna a UPW nap maternal or foams to malm a
material fwc t or dance ]mown by or on bebadf of an aGppticaat, shall be void.
I have read, the regulabons with respect to this appheabou and agree to abide by dwee and an xequaraments of the Town of
Signature of responsible person: fie: 9 I q P
TOM OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay R
queensbury NY 17804
i
(sls) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
I
Name
Location /�"'�
Permit � �I
Date
SOIL TYPE: nd-- oam- Clay-
Resulis of percolation Test-
( if applicable) Rate-Minutelinch�
TYPE OF SYSTEM: Total Lengt -
ABSORPTION FIELUr. ��
Length of each trench
Depth of trenches
size of stone er UM Id
-
SEEPAGE PITS : ft . ft .
Size - -
Stone size pe
PIPING:
Bldg , to Tank
Tank to Dist . Box f,
Dist . 'Box to Fiel /Pi No artla
Openings Sealed? es
LOCATItINISEPARATIONS : -L feet
Foundation to Tank feet
Foundation to AbsorPLion eet
Separation o+ Pits Ian es No
LOCATION OF SYSTEM PROPER
( circle Rear - Left Side - Right Side
Front middle t Middle Rear
COjqK0TS
sxsTEM
USE APPROVED : NO
Arrived:
Departed: -----�
Building Inspector
QAY
d
Z> "T a `" x
{
;? `air
/ P
i =
"I have Seen or observed. or bmis t sew
an objects such as houses, weds, trees, #40a16 Oft-,
shown on this document. I also represent that hors
ally meas distWes set forth- the dial
SI
GNATURE
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