97-489 , 1 ..• , .
. .
, .
, . . .
. . . . .
_ 011- -- -.-.- •••• ••.. ..
- . ,• . ..____
CERTIFICATE
OF COMPLIANCE
. , .
TOWN OF QUEENSBURY
WARREN COUNTY, NEW 'YORK
. ,: . Date September 11 19 97
. ..
9. 748,9
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
12 OWEN AVE. -
Location .
CAVI, GLEN Et ROSEMARY
• Owner
TAX MAP NO 81 5 By Order of Town Board
. . - -5
TOWN OF QUEENSBURY
, .
. , Director of Building & Code. Enforcement. . .
H .
. .
. .
..
. . .
, .
, .
.....,,, . .
•
' .
4,. . . .
- • .
• . . . . .
. .- . .
: .
. ..
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 974fi.9
TAX MAP NO. 81 . —5-5 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CAVI , GLEN & ROSEMARY
OWNER of property located at 12 OWEN AVE . 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.
12 OWEN AVE.
QUEENSBURY, N.Y. 12804
2. CONTRACTOR or BUILDER'S Name
CONDON'S SEPTIC & DRAIN
3. CONTRACTOR or BUILDERS Address
0
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC'
1 1 Wood Frame ( 1 Masonry ( )Steel ( )
•
7. PLANS and Specifications
SEPTIN3. ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 August 26 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.)
Dated at the Town of Queensbury this 26 Day of August Day97
SIGNED BY f)Q clltTt.c\ for the Town of Queensbury
Building and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No.� /— -` g7
Dept. of Community Development
Building &Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804 � __n
t I
Location of property for installation: /X OCO Pl?/ A V f A U G 2 6 1997
/C' M/
Property Owner's Name: (/'j
Property Own er's Mailing Address: IL d W&i/ AP Ce
Installer's Name:QW N,t7,V S' 4 t`c 'CAP#l/ Phone # ?pi--6-5-yt,,-
Number of bedrooms (if residential): 3 Total daily flow: yo
(residential - compute @ 150 gal./bdrm.)
Topography: X flat, rolling, steep slope 70 of slope
• Soil Nature: x sand, loam, clay, othc/depth:
Ground water: at what depth?VA—feet / Bedrock or Imperv:cus Material: at what depth?/' feet
Percolation test: X not required, required [rate mina per inch ]
Domestic water supply: X municipal, well, c•=..e.-
If domestic water supply is a WELL, water supply from any septc absorption is feet. .
Y
PROPOSED SYSTEM im (54114p
Septic tank•1/ad gallon (minimum size: 1,000 gal_)
e
Tile field: each trench 5-0 feet / Total system_length: d 0 feet
Seepage pit(s): number of / size each: ft. by ft.
•
Size of stone to be used: # Z- / depth or thickness ___/__ feet .
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
r
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 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:V, Date:?--
?:-)12 ,10?..c2_5\r\. (518) 761-8256
O 0
TOWN OF QUE NSBURY ,, rY'
BUILDING & CODE ENFORCEMENT .
742 BAY RD., QUEENSBURY NY 12804 4l-Y�ir �r�y'
INSPECTOR'S REPORT: ARRDEPAR d �
4111
REQUEST FO: INSPECTION RECEIV D:
NAME 116 4671 i i► Jr
LOCATION � •r3-3 6." l
DATE 3Q i PERMITn 967 r[ g c
TYPE OF STRUCTURE: APS l r
RECHECK APPROVED �`
N/A YES NO
FOOTINGS/PIERS
MONOLITHIC POUR FORM
REINFORCEMENT IN PLA''
THE CONTRACTOR I PO, . E FOR
PROVIDING PROTE TIO ' FROM FREEZING
FOR 48 HOURS FOLLOW NO THE PLACE-
MENT OF THE CONCRET:.
MATERIALS FOR THIS PURPOSE ON SITE
FOUNDATION/WALLPO.•
REINFORCEMENT IN PLACE L
FOUNDATION/DAMPPROOFING
BACKFILL APPROVAL
PLUMBING VENT/VENTS IN PLACE
ROUGH PLUMBING
PLUMBING UNDER SLAB
FRAMING:
JACK STUDS/HEADERS _
BRACING/BRIDGING
JOIST HANGERS
JACK POSTS/MAIN BEAM
AIR AIR I�ILTRATION BARRIER BARRIER
HE ING ROUGH-IN /
SULATION:i 0� 0/J
FOUNDATION WALLS INTERIOR R- _
FOUNDATION WALLS EXTERIOR R-
FLOORS R_ J///://:
WALLS R_ Vci
CEILING R.'0
DUCT WORK OR PIPING IN
UNHEATED SPACES R •
-
—, TOWN OF QUEENSBURY
' BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804 /) 911V\
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name e,DJI
Location _ 1 c - 0A ei
Date Cl 1 47 Permit # 97-/Ig9
SOIL TYPE 1-Loam-Clay-
Results o 'ercolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM: r
ABSORPTION FIELD: Total Le hi ?)
Length of each trench i tt C7
Depth of trenches 15
Size of stone
SEEPAGE PITS: N" mbe -
Size - ft.
Stone size
PIPING: Siz Type
Bldg. to Tank ___
Tank to Dist. Box 4 12DO go
Dist. Box to Fiel . to. y
Openings Sealed? No . Partial
LOCATION/SEPARATI.`
Foundation to Tank �j ' , feet
Foundation to Absorption feet
Separation of Pits _ eet
Conforms as per Plot Plan VONo
LOCATION OF SYSTEM 0 PROPER
(circle o
Front 'ear - Left ide Right Side
Middle F . - Middle Rea
COMMENTS:
SYSTEM USE APPROVED: NO
Arrived:
Departed: 9a1::,
f_ r/
de(/
Building Inspector
(0 tPtti (_0 V l C.:0 kii D 0 ill S J E-;00=-4. CO v- -4-1PC#9-(07-1 •,-- CPC ,
t 1_ 0 tv EA) 2_-
.....Q°E ell's 30,7 tu.l. .t.L.t, 50, SigNS Fdi5 -/V-y 1 -8-0(
014
„3 TOWN OF QUEENSBUZY
__.. (
BUILDING P CC sor ip r 97.
i
'2-1- ' ')f : -) ‘ aP u .
\ . REVIEWED BY ,e,idik( ..,
DATE y
4:3 1,(4.46if
•4 ..tic;\
is
1.-.
K S
.,icgti
\t, q
. .
, 3 ZPA "I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells,trees,fences, etc.,
shown on this document. I also represent that I have
personally measured the distances set forth on the diagram."
SIGNATURE DATE
I
------ - ,
il, ouJerk) AVE