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1999-207 • • Certificate of Compliance Town of Queensbury Warren County,New York Date, May- 5 9 9 This is to certify that work requested to be done as shown by Permit No. _ —__ 9 9207 has been completed. This structure may be used as a S£PTI Location 1044. RIDGE. RD. _ Owner DE VRIES, SUZANNE By Order Town Board TAX MAP NO. 5 4 . -1-19 T F QUEENSBURY at"--, :'='-e----"'""u"'" Director of Buildin & Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY Na 99207 TAX MAP NO. 54 . -1-19 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to DE VRIES, SUZANNE OWNER of property located at 1044 RIDGE RD. Street,Road or Ave. in the Town of Queensbury,To Construct or place a SEPTIC AI TERATI.ON 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 1044 RIDGE RD. QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDER'S Name CROMWELL, CHRIS 3. CONTRACTOR or BUILDER'S Address 80 CLOTHIER ROAD CORINTH, NY 12822 4. ARCHITECT'S Name 5. ARCHITECTS Address 6. TYPE of Construction—(Please indicate by XI SEPTIC ( )Wood Frame ( I Masonry ( I Steel ( 1 7. PLANS and Specifications SEPTI6o.ALTERATION AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION $ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES May 3 192001 (it 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.) 3 May 1999 Dated at the Town of Queensbury this Day of 19 SIGNED BY for the Town of Queensbury Building and Zoning Inspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept. of Community Development Permit No. r-i t o) Building &Codes Office 742 Bay Road Fee Paid SO • Queensbury, NY 128(34 J Location of property for installation: 1 Uri OC�� lc�✓� Property Owner's Name: Sit Di.j Property Owner's Mailing Address: 1 T L-t CI (LID G,_- L -4-70 Installer's Name: . S' kc-T7 - Phone # b 5 G/-9 E° cf Number of bedrooms (if residential): 2— Total daily flow: (residential -compute @ 1 , rit)ilt Topography: ✓flat, rolling, steep slope 90 of slope APR Soil Nature: sand, t/loam clay, ,a°14 F 1999 other Idepth: ��„ �< '- SJL3I✓pt: CODE Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? fief Percolation test: ✓ not required, required [rate min. per inch Domestic water supply: municipal, ;�weIl, other If domestic water supply is a WFT.T , water supply from any septic absorption is feet. PROPOSED SYSTEM i Septic tank-/OOV 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 pew or awiuval graved 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. Sin lature of responsible person: Date: Acr,/y� TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name � (//2165 Location �i/ c Date 5//J`7 Permit # n-207 SOIL TYPE:/// Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total -ngth Length of each t ench Depth of trenche• Size of stone SEEPAGE PITS: N mbe Size - . x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Blx Dist. Box to Fi -ld/Pit Openings Seale.? Yes No Partial LOCATION/SEPA' .TIONS: 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: eioe ,()/94=5.0/e e /ti}Co — \(- (--(SYSTEM USE APPROVED: YES NO Arrived: 41 Departed: ililip Building Insp tor TOWN OF QUEENSBURY -- BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 el (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION \,) . Name • I1.9._._, Location/1)49 RO (Rc Date 5-T t Permit # c)ce\—a_.37 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: otal ngth Length of each t ench Depth of trench s Size of stone SEEPAGENITS: mb Nu Size - - , x ft. Stone size PIPING: Size Type Bldg. to T nk Tank to , st. Box `fr 5'.p.e 65 Dist. BOY to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation tb Absorption feet Separation of Pits _ eet Conforms a per Plot Plan Yes No LOCATION 0 SYSTEM ON PROPER • (circle on Front - Re - Left Side - Right Side Middle F nt - Middle Rear COMMENTS: 00—RC 6 4-1= e-—0 K Ai' ' V;00014 /Nsm-C.c._ I?P Cee..//U 'tQ 10PA ver 19 1t-,- SYSTEM USE APPROVED: YES N Arrived: 2„try5„-- Departed: Building Inspector TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name _, `' Y Location j 1 6 c- Da CAC) -j-07 ) Pniijt # S IL YPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: otal Le th Length of each rench Depth ppf tre hes Size of t e SEEPAGE P . -N umb_e Size - ft. x ft. Sto size ING: S ' e Type Bldg. to Tank " 35--- Tank to Dist. Box Dist. Box to Field/Pi Openings Sealed? - No Partial LOCATION/SEPARATIONS. Foundation to Tank /2.-- feet Foundation to Absorption feet Separation of Pits _ eet Conforms as per Plot Plan 40 No LOCATION OF SYSTEM ON PROPER . (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: ( IZ774 : -14^)l 4-Pc r 0/tiL C 1AJL6,j /9/0- - 0K SYSTEM USE APPROVED: YES ;5) Arrived: Departed: -1/71v Building Inspector TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 6.; -/ l Location • ` Opa Date . Permit # 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: Sizfr Type B g to Tank ank to Dist. Box Dist. Box to Fiel ' /Pit Openings Sealed? Yes No Partial LOCATION/SEPARAT ONS: Foundation to Ta k feet Foundation to Ab.orption feet Separation of Pi s feet Conforms as per 'lot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: PcCIY itt(— R -CikcC1( SYSTEM USE APPROVED: YES 0 Arrived: ° Departed: =��(-� Building Inspector Devries 54.-1-20 \Th istl ewoc 54.-7-31 54.-7-3 • / iii 111 X 'u 013) 54.-1-19 will (Oki._. ._‹), .-lk ow , 1" ) ,600 6„,k__ . )0 ` vox) I :AK eP k T ®NAY _ / ilill _ _ 54.-1-18 54 -3-4 1 A SCALE: One Inch Represents100 Feet N Produced by the Town of Queensbury, NY, Planning Department a 03/03/1999 1, /— ,0 1 9 BEk TOWN 3 ¢S E E U RY MAR t 1999 i TOWN 0d..Jr r. S e*inv I LD l a J & (-0D—X), PT. BUI .ING.AND • 'DL REVIEWED EY _ r G - ` ^' DATE f?