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98-718 CERTIFICATE CjjJ' COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date November 13 iy ss `` 98718 This is to certify that work requested to be done as shown by Permit No . has been completed . SEPTIC ALTERATION This r cture may be used as a Location -a - STATE ROUTE 149 Owner BARBER r WILLIAM J . TAX MAP NO . 2 7 . - 1 - 3 7 By Order of Town Board � � T 7OF WF Rrr v v Director of Building & Cade 'Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY No. 98718 TAX MAP NO . 27 . - 1 - 37 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to B,}IitiB4RR. WTT T TipyM T OWNER of property located at , 326 $ STATF R011TE_1 49 Street, Road or Ave. in the Town of Oueensbury, To Construct or place a 1317112TTt^ AT-OPE"RATICM 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. OWNERS Address is 235 WARREN ST . GLENS FALLSr NY 12801 2. CONTRACTOR or 8U1 LDE R S Name BARBER , DANIEL R . 3. CONTRACTOR or BUILDER'S Address NOTTINGHAM DRIVE QUEENSBURYr NY 12804 #. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction — (Pleat* indicate by X) SEPTIC ( I Wood Frame ( I Masonry ( ) Steel ( I 7_ PLANS and Specifications SEPTri`C ALTERATION AS PER. PLOT PLAN SPECIFICATIONS S. Proposed Use SEPTIC ALTERATION $ 25 PERMIT FEE PAID - THIS PERMIT EXPIRES November 13 19 2000 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Queenstwry betore the expiration date.] Dated at the Town of Queensbury this 13 Day of November 19 1998 SIGNED BY � for the Town of Queensbury 8ui&Iarnbd Zooi InW*ctor Application for SEPTIC DISPOSAL, PERMIT Town of Queensbury Dept_ of Community Development Permit No. Building & Codes Office ns:� 742 Bay Road Fee Paid S ,,� o G+ Queenssbury. T.'Y 13804 Eocation of property for installation: �.3 45Z K�Y,,�,� Property Owner's Name: ,/rq,; Property Owner's Mailing Address: 3 f Installer's Name: Phone # j Number of bedrooms (if residential): Total daily flow: (residential - compute 0150 gal./bdrm.) Topography: flat, rollin=1 steep slope % of slope Soil Nature: sand, loam, clay, other / depth: Ground water: at what depth? feet I Bedrock or Impervious Material: at what's Q Percolation test: not required, required [ rate rain. per inch ] Domestic water supply: municipal, well, —ox. other If domestic water supply is a WEL T.., water supply frorn any septic absorption is 60 feet. PROPOSED SYSTEM Septic tmlk:/ k?o gallon (mini* um size: I ,UQ© gal.) Tile field: each trench feet / Total. system Iength: feet Seepage pit(s): number of / size each: ft. by ft Size of stone to be used: # � / depth or tbickuess feet HOLDING TANK SYSTEM: (if required) Number of tanks: Size: of eac}z: gallons Alarm system and associated electrical w =k to be **+ pDct ed by a certified agency. For your protections, please note that punwAxt to Section 136-29 of the Coda of the Town of Qoeensbury, any permit or approval granted which is based upon or is granted in reliance upon amy material rmiarepresentKdon or ia>7ure to make a material fact or circumstw2ce koowa by or on bobalf of an applicant, shall be void. I have read the regulations with respect to this application to abido by tbeea and all reqairemeuts of the Town of Queeasbtzry Sanitary Sewage Disposal ✓ f 70 Signature of responsible person: Date: TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road rq Queensbury NY 12804 (sis) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION, / Name \ � c 1 �7rn�. �3'�hf L o c a t i on �� Date Permit # r SOIL TYPE : Sand- Loam-Clay- Results of Percolation Test- ( if applicable ) Rate- Mi a In TYPE OF SYSTEM: ABSORPTII* FIELD : T al Le h Length of ach tre h 50 Depth of tr Size of stone Y SEEPAGE PITS : umber- Size - fto x 1 ft . Stone size PIPING : S e Type Bldg * to Tank Tank to Dist . Box XM Dist . Sox to Field/P ' Openings Sealed? es No a LOCATION/SEPARATION . Foundation to rank A feet Foundation to Absorption34L.. feet Separation of Pits eet Conforms as per Plot Plan es No LOCATION OF SYSTEM ON PROPER [ circle Front ear Left Side Right Side Mi ddl - 'Middle Rea COMMENTS SYSTEM USE APPROVED : YES NO Arrived : � 3c� Departed: Building In ector s� k° 00TOWN kL -x'f C - '� DST