98-637 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date October 13 19 98
98637
This is to certify that work requested to be done as shown by Permit No.
has been completed.
. This structure may be used as a SEPTIC ALTERATION
Location 446 RIDGE RD.
Owner OSTERBERG, MARNA
•
TAX MAP NO. 57 . -1-6 --By Order of T n oard
( Q
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No 98637
TAX MAP NO. 57 . —1-6 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to OSTERBERG. MARNA
OWNER of property located at 446 RIDGE RD. Street,Road or Ave.
in the Town of Oueensbury,To Construct or place a SEPTIC ALTER ATTON
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
446 RIDGE RD.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDERS Name
I.H.S. SEPTIC
3. CONTRACTOR R BUILDER'S Address
STREET
QUEENSBURY, NY 12804
4. ARCHITECTS Name
5. ARCHITECTS Address
6. TYPE of Construction—(Please indicate by X) SEPTIC
1 I Wood Frame ( I Masonry ( )Steel ( 1
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 October 1319 2000
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Oueensbury before the expiration date.)
13 October 1998
Dated at the Town of Oueensbury this Day of 19
SIGNED BY for the Town of Queensbury
130'ding and Zoning Inspector
Y Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury C _
Dept. of Community Development Permit No. `v
Building &Codes Office a.a
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: RI �f C ��
Property Owner's Name: cA r— ft c-. •6 >7(°r 6- r
Property Owner's Mailing Address: / . ily L t c. (9 ci
Installer's Name: j i VC )• SCP/ •,(. Phone # 7 2 1/?l
Number of bedrooms (if residential): Total daily flow: ?O'C)
(residential - compute @ 150 Igal1}
Topography: rolling, steep slope % of slope �++
Soil Nature: sand, l l , clay, other / depth:
ilGround water: at what dept feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: *not req ' , required [rate min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic tank/t)O t) gallon (minimum size: 1,000 gal.)
Tile field: each trench. S O feet / Total system length:a_6 a feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: #___I___ / 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
Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: _ I Date:M /O` '''9 ir'
" e2AC:1!
r TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name Q \ �Y \� Yt‘,ti:
Location 11 `�
Date (2) -C1 Permi t (_Ea_103:7/
SOIL TYPE: (and-Loam ay-
Results of Percolation Test-
(if applicabl ) Rate-Minute/Inch
TYPE OF SYS n ,� '
ABSORPTION FI D: Total th/ "
Length of each tre �i
Depth of trench s A
Size of stone __
SEEPAGE PITS: Nu e �
Size - . x ft.
Stone size
PIPING: Sije T pe
Bldg. to Tank
Tank to Dist. Box •A. d
Dist. Box to Field/P. X N
Openings Sealed? 461) No Partial
LOCATION/SEPARATI' ‘
Foundation to Tank 443_
feet
Foundation to Absorption feet
Separation of Pits -et
Conforms as per Plot Plan 4igPPNo
LOCATION OF SYSTEM ON PROPER
(circle • - '
Front Rea Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: a
NO
Arrived:
Departed: --45
Building Inspector
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