99-665 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
November 1 99
Date 19
99665
This is to certify that work requested to be done as shown by Permit No.
has been completed. SEPTIC ALTERATION
, This structure ma be used s a
119w RIDGE Ru.
Location
Owner
TAX MAP NO. 52 . -1-54 By Order of Town Board
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 9 9 6 6 5
TAX MAP NO. 52 . -1-54
Permission is hereby granted to RATTO, ANDREW & CATHERINE
Owner of property located at 119 0 RIDGE RD.
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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
MC DONOUGH RATTO 1190 RIDGE RD.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
CONDON SEPTIC & DRAIN SERVICE
Contractor or Builder's Address:
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
SEPTIC ALTERATION
$ 2 5 November 1 2001
PERMIT FEE PAID—THIS PERMIT EXPIRES
(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 this 1 Day of November 19 9 9
SIGNED B - for the Town of Queensbury
Code Enforcement Officer
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
ci Dept. of Community Development Permit No. I �!1
Building &Codes Office r'e
Th
742 Bay Road Fee Paid
Queensbury, NY 12804
Location of property for installation: // QO ,? 046 E
Property Owner's Name: Ari,ar / ?p.7 Td OCT 1 1999
Property Owner's Mailing Address: Il D
O iQ (1)6 E /Q ,
Installer's Name:Gtochte f �/ r C d 74.4./J'U-s6R- Phone #
Number of bedrooms (if residential): 2 Total daily flow:
(residential -compute @ 150 gal./bdrm.)
Topography: (flat, rolling, steep slope % of slope
Soil Nature: (� sand, loam, clay, other /depth:
Ground water: at what depth?54 .
" feet / Bedrock or Impervious Material: at what depth feet
Percolation test: x not required, required [rate min. per inch
Domestic water supply: municipal, X well, other
If domestic water supply is a WELL, water supply from any septic absorption is /2O feet.
PROPOSED SYSTEM
a/I/Cr -fE
Septic tank: 104d gallon (minimum size: 1,000 gal.)
Tile field: each trench . feet / Total system length: -.24:1v 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 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
Queensberry Sanitary Sewage Disposal Ordinance. / Q
Signature of responsible person:T(2,
/ 001/4 (.11'\ /Date: /
\? InTOWN OF QUEENSBURY
BUILDING b CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date — Permit # I-((05
SOIL TY E Sand oam-Clay-
Results of Percolation Test-
(if applicable) fete-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length/ `JI/D -
Length of each trench i &0,06
Depth of trenches `
Size of,stone Z
SEEPAGE PITS: Number':
Size - \. ft,,-,X ft.
Stone size=
PIPING: Size Type _j
Bldg. to Tank /' 5G b yo
Tank to Dist. Box A k ae)
Dist. Box t4 Field/P. --m-
Openings Sealed? es No Partial
LOCATION/SEPARATION
Foundati to Tank __LP„._feet
Foundati n to Absorption feet
Separat on of Pits eet
[I)Confo s as per Plot P1 an es No
LOCATI OF SYSTEM ON PROPERT .
(circle •-(s
Front '�- - Left Side - Right Side
Middle F . - Middle Rear
COMMENTS:
46— U U t Lr Y /11n)
ta.( /26,64 4r1()A) ' r?)<
SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
--._4122f>
Building Inspector
AnJol Iila:--r%a - 7 Y5 7(.1 5-r Ca1vdoy'r cep A e c *--))4/41/r SFMaI �.._
!1 6 A ( r k�, 'Z L GNAW 4Ue1 7f �S y
(iFe Ns3 of r N.y 1)-h' e&vs Foils /1 Y i '-&c f
I
IOU
, c2 �'.
( ,, r k , i 0 /
, 3'
;
( '!
�V�.4 � 3d-pt II. - o
, e1- 9ir 6,
NN�Vi , ,
::._,,,./
codgAo� , . - �, ,,6,--
A , . . ,,. ,, „,,,_
stp,c, , ,.
. ,.., ..„
\ , , : -- . ,,, _ . i , ., .. „,.„ ..„.„,,,,._
® .. _, 1999
`)C e. have seen or observed,or believe I saw evidence et
:)sects such as houses,wells,trees,fences,etc.,
Sr, this document. l also representths##hawe
f i measured the distances set nth en the diagram."
\ \/ g:elf, 1,-tal /I,---/q., 7
i'"NATURE DATE
litiA . et\\
0 \
11 9O P l ) , f '/ti s m : - Tie'am Oi'1'F/oA epia — riz 4/0r,// 0N / . .