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95-389 rift CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date July i 19 95 9 538 9 This is to certify that work requested to be done as shown by Permit No. has been completed. :JEF"rIC.This structure may be used as a ALTERATION Location RiOcE Owner ACKLYN BARRETT By Order of Town Board TOWN OF QUEENSBURY ------------- Director of Building & Code Enforcement •"' BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY No 95389 TAX HAP NO. 52.-1-55 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to SHUTTS, JACKLYN BARRETT 38 RIDGE RD. OWNER of property located at 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 1200 RIDGE ROAD QUEENSBURY, NY 12804 2. CONTRACTOR or BUILDER'S Name SANITARY SEWER 3. CONTRACTOR or BUILDER'S Address DAN DRELLOS PO BOX 224 GLENS FALLS NY 12801 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications SEPTIC°•ALTERATION AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION $ 25 PERMIT FEE PAID—THIS PERMIT EXPIRES July 10 19 97 (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 Quee sbury this 13 Day of July 19 95 SIGNED BY \ for the Town of Queensbury u ding oni Inspector 0 - -'. H =fir,---- Application Car SEPTIC DISPOSAL PERMIT O STAMj' RECEIVED Moo R tckt 0 Location of property for installation:Owner's Name ki E --S-' \kJ./.-/-'f PERMIT NUMBER 10 Owner's Mailing Address: 120O „t t d t"y ' — v�/ tTi ('� n r \�J� (%Kti FIEF c Co 7Installer's Name: CJr 1'houc #: 7 /QZ7. O 7 M xi Number of bedrooms(if residential): PZj Total doily flow (residential •compute 0 I5(1 gal. per bedroom): 6-0 Topography: aZFlal (-) Rolling (—] Steep Slope II,of Slope Soil Nature: r-Sand n Loam n Clay n Other /Depth: `! Ground Water: at what depth? feel RECEIVED E® ` l q Bedrock or Impervious Material: at what depth? feet JUL 1 0 1995 Percolation Test: Not Required (l Required/Rate min. pcfa N OF QUEENS BUII_DtNG AND (251.t. -,� Domestic Water Supply: CD Municipal laa Well (-i Other 4 If domestic water supply is a WELL: water supply from any septic absorption is • 0® feet PROPOSED SYSTEM: Septic lank:i 00< gal. (minimum size: I.000 gal.) 'file Field: each trench 5`9 feet. / total system length °° feet. Seepage I'il(s): number of / size each: ft. x ft. size or atone to be used: # Z / depth or thickness / feet. BOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gal. Alarm system and associated electrical work to be inspected by a certified agency. For your prntec:tion, please note that pursuant to Section 136-29 of de ('ode of the Town of Queensbury, any permit or a plirowal 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. 1 have read the regulations with res t to this application and agree to abide by these and all requirements of the Town of eens airy Sanitary.Se t Disposal Ordinance. Signature ofresponsib'e person:-.,` ' /� " Date: / — /0 9,5"' Iw11 1 — IN°block such as luocc, trok km"day shown-p this document!else wood% t bmw measured tfie&steeps art 1 en the ism." \L 7 / Q - .� SIGNATURE ©Alt RECEIVED d// et- JUL 1. 01995 TOWN OF OUEENS8URYO BULIDiNG AND CO �J C/ — mil . v O U ET-6- U. 0 • Ar-cJ � U L 4 r rr -7/1 IOW - . .24beVAI TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 531 Bay Road Queensbury NY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name l' /atjaz) Location ) O( i()c 0 Date r] _` O- V Permit # `►a' SOIL TYPE: .tkLoam-slay- Results of Percolation Test- (if applicable) Rate-Minvte/ ch TYPE OF SYSTEM: ABSORPTION FIELD: Total L: gth 7 21-3 Length of each trench 6) Depth of trenches t Size of stone • SEEPAGE PITS: Number-4 Size - ft ft. _> Stone size PIPING: Bldg. to Tank i .S�11, Uze it`pe Tank to Dist. Box % 1,, Dist. Box to Fiel • 1' y.,-; , Openings Sealed? o Partial LOCATION/SEPARAT ONS: Foundation to T nk eet Foundation to P sorption -et Separation of _ its -t Conforms as pr Plot Plan 441111 o LOCATION OF SYSTEM ON PROPERTY: (circle one)! F_r.i - Left Side - Right Sidej\ 114rr: rmI - Middle Rear COMMENTS: SYSTEM USE APPROVED: 6ii. .......!0 Arriv : D-! .rt• , Air jol Bun din" Spector