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98-186 CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date Apr' 1 ?P 19 98 This is to certify that work requested to be done as shown by Permit No. 98188 has been completed. This structure may be used as a SEPTIC ALTERATION Location 12 WESTLAND AVE. Owner GIFFORD, JANE LAAKSO TAX MAP NO. 8(� . - -25 . 33 By Order of Town Board TOWN OF QUEENSBURY LG� Director of Building & Code Enforcement BUILDING -PERMIT VALUE $ 0 TOWN OF QUEENSBURY No. TAX MAP NO. 80.—1-25.3ARREN COUNTY, NEW YORK PERMISSION is hereby granted to GIFFORD, JANE LAMS() OWNER of property located at 12 WESTLAND AVE. Street.Road or Ave. in the Town of Oueensbury.To Construct or place a SEPTIC ALTRPTj 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. OWN1 2 WESTLAND. AVE. QUEENSBURY, NY 12804. 2. CONTRACTOR or.BUILDERS Name QUEENSBURY SEWER 3. CONJJAATgpCTTAf �r++��11 ILDERS Address 0YY WW 4. ARCHITECTS Name . 6. ARCHITECT'S Address 6. TYPE of Construction—(Please indicate by X) SEPTIC. . 1 I Wood Frame ( 1 Masonry ( )Steel 1 1 7. PLANS and Specifications SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS. 8. Proposed Use SEPTIC ALTERATION 25 Apr i1 27 2000. S PERMIT FEE PAID —THIS PERMIT EXPIRES 19 (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.).. 2.7 April 19 Dated at the Town of Gueensbury this Day of, 19 SIGNED BY _. for the Town of Queensbury Building and oning a Application for SEPTIC DISPOSAL PERMIT • Town of Queensbury 99— I W)< Dept. of Community Development Permit No. 0 Building &Codes Office 742 Bay Road Fee Paid $ Queensbury, NY 12804 J Location of property for installation: / ,1/ei f / n d A C -- \f� 10} Property Owner's Name: Oa t,- --Nsg2,67— ( f1 r-- �. APR 27 1998 Property Owner's Mailing Address: SCQ Gist -_-- TOWN, ," D Installer's Name: ( ��,c is"Vic.r y 7 feLJ-ter Phone # 7 f I D Z c/ I Number of bedrooms (if residential): ,__ Total daily flow: LIS—a- (residential - compute @ 150 gal./bdrm.) Topography: )C flat, rolling, steep slope % of slope Soil Nature: X sand, loam, clay, other / depth: Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? feet Percolation test: y not required, required [rate min. per inch ] Domestic water supply: X municipal, well, other - If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank:760 o gallon (minimum size: 1,000 gal.) Tile field: each trench SZ% feet / Total system length: ,2 v d feet • Seepage pit(s): number of / size each: ft. by ft. Size of stone to be used: #-z 2- I depth or thickness 76 er feet HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gallons CA1arm system and associated electrical work to be inspected by a certified agency.D 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: c cl � ' Date: 5 ... ,......... a......,_ YY—/y6, 2 7 7998 7 r Tov,,•1.,i0,:.- __. OINc::.AND CGD7-- • . • 7-- ...""a"."1""""8""4"1"*".."1"111#1114**411614s. -." have sew itabwvat or Mimi iswakidialiiit . II objects wilt et Um vile,Nit%att. , /Am on this essamt.I do forsestilit • . a mews* ' diatom lotto Viedlogioe ;"1 tin I,. 10161. ... \ i. itowlows. .Nity.. V'. .-r matitairiemetafts1011011411001111140M0140.0010110 , i'.)e . I °La. k ( ,,. 4 . . . - ,.. ‘2 0 .1,9 ‘ TOWN Of 0),il .;E E Vei''i U iri B U il D'Ig N G A ') -- —. c. REVIEWED 1, . . DATE --7 1.444 e--. . e 11114,001010 setiotsvAlsoolo two Alippordit avid Ant oval flit Mal rkt RS *WM immix Ws)Mani aid1 4sfifita l'Ao400.4*4601000ttiitillostat* .4.0400•441artme solooperigine- ..^44toiverhawamm rag ; voliewmpro4-• ,-, . : .V\ Ainr) 1.., OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Cksy g-C+N/' 1) Location 1_9, LAC41 arv.Q Date 11/' 7W'Permi t # qg -" gip SOIL TYPE (-i am-C ay- Results o Percolation st- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION' FIELD: Total Le gth c4 Length of ach trench c_ ‘ Depth of trenches _ Size of stone ' _.Z SEEPAGE PITSV Number- Size - ft. x ft. Stone size \ PIPING: Size Type Bldg. to Tank \1(i-- Tank to Dist. Bgx / yO - Dist. Box- to Fi eel d/Pi tT - u s-g=2SWc: Openings Sealed?1 s--')_No Partial LOCATION/SEPARATIONS-: Foundation to Tank\/ j feet Foundation to Absg�f'pti on -y-o-i- feet Separation of Pits _ __feet Conforms as per ,Plot\Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle one) ,f Front - Rear ,. Left Sid- - Right Side Middle Front'- '...: a Re.r COMMENTS: / i i 2 SYSTEM USE APPROVED: CYESJO Arrived: \U-. j Departed)_-- _ -- r t.,/,,8"ui ding Insp'e or