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2002-680
1 ." TOWN OF QUEENSBURY Foirs742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201 Community Development - Building& Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20020680 Date Issued: Friday, August 30, 2002 This is to certify that work requested to be done as shown by Permit Number P20020680 has been completed. Tax Map Number: 523400-239-012-0002-079-000-0000 Location: 15 HARDING Ln Owner: THOMAS HARDING Applicant: THOMAS HARDING This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY Director of Building&Code Enforcement TOWN OF QUEENSBURY tors 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020680 Application Number: A20020680 Tax Map No: 523400-239-012-0002-079-000-0000 Permission is hereby granted to: THOMAS HARDING For property located at: 18 HARDING Ln in the Town of Queensbury,to construct or place at the above location in accordance with 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. Type of Construction Value Owner Address: THOMAS HARDING 15 HARDING Ln Septic Alteration Residential Total Value LAKE GEORGE,NY 12845 Contractor or Builder's Name /Address Electrical Inspection Agency COOKS SEPTIC NY 12804-0000 Plans&Specifications 2002-680 Residential septic system,tank replacement only, 1250 gallon. $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday,August 13,2003 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of Queensbu before the ex nation date.) Dated at the Town f T Q u u .'(,August- . ; 13,2002 3 SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for Permit—Septic Disposal System Town of Queensbury 742 Bay Road Queensbury,NY 12804 (518) 761-8256 1. OWNER INFORMATION: 2:54-i 4/2 2 - 761 Location of installation: t Pcie.01.10 LA) Office Use ( File Permit No. -260 6 a( Tax Map No. • Owner's Name: It-to tt&QS (, 11*r2 (Cv Fee Paid 7 S.0 Address: L 5 I1 2AiG 1.4). L. G. l xSI/3-- ( 5 - cect.j.©........._.. 2. INSTALLER'S NAME : l—00fZ5 PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply# of bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: No. of Bedrooms x Computation = Total Daily Flow 1980 or older x 150 gal/bdrm = 1980— 1991 x 130 gal/bdrm = 1991 —present x 110 gal/bdrm = Garbage Grinder Installed yes / no Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply � s at what depth at what depth municipal Rollins feet - - feet well '--Steep slope e ay if well; water supply %slope other from any septic-system depth: absorption is ft. other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. PROPOSED SYSTEM: For New constriction: All individual sewage disposal systems must be designed by a licensed professional engineer or architect(unless installed in a Planning Board approved subdivision). Add 250 gallons to the size of the septic tank and leach field for each Garbage Grinder,Spa or Whirlpool Tub. t� Septic Tank: `_ gallon (min. size 1,000 ga2.) /ff/°k �c PL C v&AJ d''U L / Tile Field: each trench ft. Total System Length: ft, Seepage Pit(s): number of size of each: ft by ft. Size of Stone to be used: # / depth or thickness feet Bed System Size: x Alternative System: length and/or size 6. HOLDING TANK SYSTEM: (if required) Number of tanks: / Size of each: gallons /TOTAL Capacity: gallons Note: Alarm System and associated electrical work must be inspected by a Town approved electrical inspection agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) 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, chau 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. FA" 0 Signature of responsible perso ate 5' Town of (Zucengl,ut-y : Sewers ;Intl Sewage Disposal (:11api(•r Appendix (: •. AllS()ttJ''1'I()N Ii'11;1,I.) . SEI'A 1tiVl'1ON HEW.? ItEMM I':N'I'S ...\\. .,.\. ....____SIAUNI‘i .1. —' \.. e...,: ?). ---".--;(1:: E=1") POW ► \1 ) 1. ,./ ..-••• / .44 12't ;Pr" 1 i• ' ,a� ' II ' E G . E ClILouSE G QE L_ . , • -i.-. `: J. � 1 i art tl 1 ) '' 1 ll�tIK. \ WI _, __ /��1, , ram.. rne1x Pi A.Lb 7. SIGNATURE &INFORMATION FOR.I FU AW-4 rzt\zvri une“..' ..,....„ "' TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENTw 44.41 742 Bay Road Queensbury NY 12804 (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION OF Name flydff Location _15 411,41 1.4„1„._ Date I30J0 Permit # 2O6Z. 6476 SOIL TYPE: Sand-Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/ 'nch TYPE OF SYSTEM: ABSORPTION FIELD: Total Len.th Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank ( _ Tank to Dist. Box �� she Dist. Box to Field/P t— h/L. Openings Sealed? ?(es No Partial LOCATION/SEPARATI, Foundation to Tank feet Foundation to Abs,irption feet Separation of Pi ,s feet Conforms as per 'lot Plan -- No LOCATION OF SYS ON PROPERTY: (circle o Front - gear - Left Side - Right Side Middle Front Middle Rear COMMENTS: E I SYSTEM USE APPROVED: YES ' NO Arrived: /N4) Departed: (J Building Inspector - _ - ,ii # • 7, 4 J- < s - -e- 1 • &•L...-. . . . ce• o TOWN Pi: QUE S•0 URY ' \•k - -v. . ,,.%---7, BUILDING & f • •1: ;. D' P ' ' - 3 'N At,„ REVIEWED:ilk!, irffdefir . - , ,* DATE ii; 0 2..___/ ' . , .. , • . . / /c _.. . 1°- 4' ,,,, . . : . • • 1. . • .. . . 0 . ' ‘1 cK''. N cELL -- - 7 PLAC-6- ("37 I j5—`) • 9‘ (k) NI %) , 0 t41 sto A, e,„, ' 12..k\1 T -AdK N tv 0 - A iki" ave seen I observed, or believe I saw evidence of, Z 1!‘•••$. blew su h as houses, wells, trees, fences, etc., -.....t.. V - on tn. document. I also represent that I have /5 3 ,( : :so 1 ,onally 1,easured the distances set forth on the diagram." - ..... -"4 et' --- L ' 11f li • 1/41 :• t cll lk A - iv ColAT ,(1‘ fll • fr C A R on/. 0 ' ' ) . ¶ 61 (1‘; 6) i z- z 9- i 993, . ro• 9 03/fir lb, •4‘: , .• A. PA [IL f' 4/gp4 . 1r N‘ : 771- 4-3-Z 3 cl b .$'.o•• ;AID ;it;'4. 6 i Q: S # -> 85-44" • 5- cp . - 'I 'a — 41,-c• Alcca A • kb 4 4-. tr, '.., 'r a . s-rce 5 E V • 1*- r',°) , ,q : A 111:111i. N. • , , x? % et ..... • , .... e. In ow .- •.•. . • • . "i- • , 414--fzi.,,,Z 747,egtr-i.t.Glel .0 4 • / -• 0 .\- • s-• \ , ' kA ,,, r_s . . /1,7 /-- o F 4.,IN v,s' of, . •\P • 777 W 6.11/4 S 0. ' HA R DI AI 4 • q). 5119W/A/4. .-meet) q4,e466- iVok Zoo/ 61). 6' , P14 P/5 509fe 0 6404 A-1,9p-ex EeivEs r "ii-yEte, P.4"49 , • - • 169,eeis .aqy-hqiee 4eoec,E. -Ode'Elv-reu'e,' fif-r• 0 • . S . ivov. zap,/ cou4reie i t-A- cog t-/.9_c. / 7,:', 8R44 y7.0 A/ AN 0 EtAd 7:e1c Co eirbegt / 441/4“, SoRt/Eic4S • , 52 lic Co a,t-i,4c-k bk.LK. G Eo. Al _.. 7 TOWN OF QUEENSBURY BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518)761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION . ZOQZ-62 y C) Name J•JtaoLT Location is 0-0 1„dirl, ff,uvA) Date 4? Permit # ri/r)(t/C) 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: Size Type Bldg. to Tank Tank to Dist. B x Dist. Box to Fie_ ct/Pi t Openings Sealed? ;` Yes No Partial LOCATION/SEPARATE` Foundation to T k feet Foundation to A sorpt n feet Separation of P'ts feet Conforms as pe Plot Plan ^ Yes No LOCATION OF SY ON PROPERTY: (circle one) Front - Rear - Left Side - Right Side Middle Front - Middle Rear COMMENTS: PRoPo'; -jr� hoc r�v� —OK lv vi,8 itxo- A-2u&, 7- iPti-eo&,ecoove(c SYSTEM USE APPROVED: YES ( ITO Arrived: r Departed: �__,A________, �` f�j Building Inspector 7 /- <-- / &L..— (----• , , TOWN PF: QUE - SA URY 1 7%,.."•--- , ' BUILDING & • elIC D' P - . 3 • ,P, , REVIEWED BA . T iiirAtfit '..e... , . DATE 40 0 ? _./ . i. .5... . I, • . ° cN e . r t Ci ---0 64 0LAC6- (').7 I.15 it;k, t N Da/gLL I ti 1 9 1 r A .‘V., € r6-. i q‘ I (Ow V PI , V- ii..• '`.. ik 14 t• • t•• ii f.; rel tc 24/ GI) • NI %) 4 j• G A- _, ,[1U I 2 50 -•. 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