Loading...
2001-178 00A TOWN OF QUE ENSBURY wow 742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20010178 Date Issued: Tuesday, April 24, 2001 This is to certify that work requested to be done as shown by Permit Number P20010178 has been completed. Tax Map Number. 523400-048-000-0003-047-000-0000 Location: 829 BAY Rd Owner: THOMAS & VERONICA GEPPNER Applicant: THOMAS & VERONICA GEPPNER This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY f742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 TO Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010178 Application Number: A20010178 Tax Map No: 523400-048-000-0003-047-000-0000 Permission is hereby granted to: THOMAS &VERONICA GEPPNER For property located at: 829 BAY Rd in the Town of Queensbury, to construct or place at the above location in accordance with application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning Ordinance. Type of Construction . Value Owner Address: THOMAS &VERONICA GEPPNER Septic Alteration Residential 829 BAY Rd Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency CONDONS SEPTIC & DRAIN SERVICE Plans &Specifications 2001-178 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS $25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Sunday,April 20,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbury before the expiration date.) Dated at the Town of Queensbury; Friday,April 20,2001 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit-Septic Disposal System ' Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: Location of installation: 3)-� `' AP. Office Use RE File Permit No (- ji Tax Map No. / / / Fee Paid ej.©� Owner's Name:/�iCii4 , ���N/fQ. APR 2001 Address: O .2R y(�`7 TOWN GF QUE NSiiURY Bt11LD�U _ � Oc�DE �.. r 2. INSTALLER'S NAMEOP/VC/04) S �F ,���1 PHONE NO. 7�I �!I f V 2- 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s)and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 980 or older �� x 150 gal/bdrm = 95 980- 199F x 130 gal/bdrm = 1991 -present x 110 gal/bdrm = Garbage Grinder Installed yes / no x Spa or Whirlpool Installed yes� / no K 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) To p$raphy Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Flat sand at what depth Oat at depth municipal o ing oam feet feet well Steep slope clay if well; water supply _%slope other from any septic-system depth:- absorption il ft. other Percolation est: (To be completed by licensed professional engineer or architect) Rate: /9' minute per inch 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder, Spa or Whirlpool Tub.���K 0�'.��'G=(o//���� Septic Tank: /66 0 gallon(min. size 1,000 gal)F/f_&79 Tile Field: each trench - - ft. Total System Length:' , J / l , Seepage Pit(s): number of size of each: ft. by Pt.. Size of Stone to be used: # / depth or thickness feet Bed System Size: x `.----___, Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) 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. a ' (6,-(., 0,i\-\aLe-v y--- 7,f-- al Signature of responsible person Date er-- TOWN OF QUEENSBURY ( l :OO BUILDING & CODE ENFORCEMENT W Z,' 742 Bay Road eensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION f / (, Name Se cler / Location Date 7-1 Ol Perm # 'C SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank ' L/ S pa Tank to D —Rox /tea 'etSRO 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: S tie( e.41 SYSTEM USE APPROVED: YE ` NO Arrived: f`4; Departed: Building Inspector /71/.0g1 GNF& 7(/'?'• g9:14'--je's 7 73_5-,/ 8.,1q 3,4?' k .t, a/71. 57// ' '__Cc/e)-24/`c ./.700?)(n) ,Q=<vi c-.,:/•,,t_t. f c-1 E .5307 4), y 7 2c v 1.L-E- (oRAtft)r /4e E - 79eFS-(--72- Op rd/ - 44y icyo / $N.0 i cli , 7/to - 1 it' 0 I I .,, t 767 ° I. cc. e te 2 cci FE .. f 100K10? r--tt ru top ( \ _ ,______________-------- 7 3 Co ocr,x .., (A) 4 C° 0 r--' pp \ ,s& 1.Ii(N1/4 I N 3TP P\ • Afl , : have seen or observed, or believe 1 saw evidence of, . • ,-,t)lects such as houses, wells,trees,fences,etc., . TOWN ,....A.:: ...''-',,, r:"" -'' : ,•:7- ii,--,,,,, , -. ,Nti on this document. 1 also represent the I have . .'sonally measured the distances set forth on the diagram." DJ LIA NG & Cl.',It-,':':, ry--- ,,„7!_ii: SIGNATURE DATE ' ' / Al .,- TOWN OF QUEENSbo' 'Y BUILDING AND CODE • c Pols 1,0q0/ii /0 A fi l i"IL/Iv s-',0,,, •1 \ ( \ t --- . - 'r.- 'cif t A . . f I I 1 - i . .. . i , • i W..„ 01 W, f* I ,- i *:6"t‘• '