Loading...
2002-789 TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE. Permit Number: P20020789 Date Issued: Wednesday, September 18, 2002 This is to certify that work requested to be done as shown by Permit Number P20020789 has been completed. Tax Map Number: 523400-296-014-0001-006-000-0000 Location: 88 MONTRAY Rd Owner: DEBRA L. EGGLESTON Applicant: DEBRA L. EGGLESTON This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY 0 Director of Building&Code Enforcement TOWN OF QUEENSBURY 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20020789 Application Number: A20020789 Tax Map No: 523400-296-014-0001-006-000-0000 Permission is hereby granted to: DF,BRA L. F,C'TGLESTON For property located at: 88 MONTRAY Rd 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: DEBRA L. EGGLESTON 88 MONTRAY Rd Septic Alteration Residential Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency JAY SWFFT NY 12904-0000 Plans&Specifications 2002-789 Residential septic alteration per plot plan and specifications. $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Wednesday, September 17,2003 (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 Tow Queens ; e ay, September 17,2002 r p; SIGNED BY for the Town of Queensbury. f 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: .......................................................................................................................... Location of installation. Office Use Tax Map No. File Permit No. Fee Paid Owner's Name: I .......................................................................R. .. ... ...... . ..... Address: 2. INSTALLER'SI NAME PHONE NO. SEP 7 7 20oZ 19!alr� F C)UE- 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 4 bedroom(s) and multiply 'ENSBLjRy ,AID(-0j bedrooms with applicable gallons per bedroom to equal total daily flow) Year of House: —No. of Bedrooms x Computation = Total Daily Flow ( 9 8i i- o - x .. 150 gal/bdrni qoto—1991 x 130 gal/bdrm 1991 —present x 110 pL/bdrm Garbage Grinder Installed yes Spa or Whirlpool Installed yes 4: PARCEL INFORMATION: (circle applicable information&indicate measurements) TgRogmply Soil Nature Ground Water Bedrock or Impervious 'Material Domestic Water SURRIY <EW at what depth at what depth un 'Rolling loam feet _feet —Wen— Steep slope clay tfwell water supply upp %slope other from any septic-system depth: absorption is other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inok 5. PROPOSED SYSTEM: For New Cons tM2figfi: 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 Cirinder,Spa or Whirlpool Tub. Septic Tank: /T gallon (min. size 1,000 gal) Tile Field: each trench ft Total,System Length: SeepagePit(s): number of size ofeach: ­ft. by_ft Size of Stone to be used: depth or thickness feet Bed System Size: x Alternative System: 0r f--t v,-cL s 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 inspe6tion 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 misrepresentatioA 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. Sign k"rof esponsible person Date l��n•n�aiCTlt> bTAC'17SI� �7�Y Nn(���17d a��14©LL X'�4o.1l*u T Sa311v+V mols L c�t�bc�,,cty t I. ix, r•.,r,st �7M r..__~ ���" •U.;rtVit. rar —t��J�1 UNod ts�� �— leis) • ("1�1:lllal I�Ol,l•,�C'}1OwflV ' �, xil�ti:►ctcl�/ .t.�lc{r:rl:) 11:::rtclss�l ;s.h:n»� ltui: s.esn�it� P 0 TOWN Or ZY -BUILDING-4Z9 6 a REVIEWED BY DATE f .� T4W'c1 ts* `,` n{,shall itetl exarri�naUan, ,;.)sac an our llmaur carom° cam�lianca With rS;;t a canstcued as ink�e rt s i Stan. a P the code cv,rr fiance r � ►D t ' -r "I have seen or o)ser+red, or believe I saw evidence of, all 0�3}F.,cts}S€ cj,, as hou,\.'$, t:E't1S, tre ps, fences, et , silC'�%i1 {)n this :ir. • i' it hal { have es"SCi?%i}I`, 6iss'3 St11: . `.. 'us Fi ir:r�y onthe diagram." r,rGNA URE �TC .y TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT rT 74-._ Bay Road v Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location _ M( Date Permit # � SOIL 4PEJ n oam-Clay- Results o Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench L Depth of trenches Size of stone �IE�` P�ATufL SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank !� Tank to Dist. Box Dist. Box to Field/Pi t t�'� JU `vix Iv)fi , Openings Sealed? Yes No Partial LOCATION/SEPARATIONS- Foundation to Tank 'rfeet Foundation to Absorption D feet Separation of Pits et Conforms as per Plot Plan ` Yes LOCATION OF SYSTEM ON PROPER (circle one) Front - Rear - t Side - 'ght Side Middle Front - Middle Rear COMMENTS: l SYSTEM USE A PROVED: OYES 0 Arri d: De r ed: r uil —Ing I