96-048 •
CI'JI�TIFICA�i'_C OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 1" 19 9,
+ L Ybb
This is to certify that work requested to be done as shown by Permit No. 96048
has been completed.
This structure may be used as .a SEPTIC ALTERATION
Location ROUTE 9L
Owner SCHRINER, JOHN
By Order of Town Board
TAX MAP NO. :10. -1-20 TOWN OF QUEENSBURY
Winr\
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 96048
TAX MAP NO. 10. —1-20 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SCHR.INER, JOHN
ROUTE 9L
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
68 NORTHVIEW AVE.
WYNANTSKILL NY 12198
2. CONTRACTOR or BUILDER'S Name
CRANDALL, CHRIS
3. CONTRACTOR or BUILDER'S Address
R.D. #1, BOX 1376
LAKE GEORGE, NEW YORK 12845
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
SEPTIV. ALTERATION AS PER PLOT PLAN. SPECIFICATIONS-
8. Proposed Use
SEPTIC ALTERATION -
--,
$ 25 PERMIT FEE.PAID•-THIS PERMIT EXPIRES March 1-__ 19- 98 :.
(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 Queensbury this Day of March 19 96
SIGNED BY for the Town of Queensbury
Building and onmg Inspector
Application for SEPTIC ,DISPOSAL PERMIT 0
•
STAMP ltl;c•r.lvr.0
Location of lnoiletty Inr installation: wtih"<PI RA." 94. O
Owner's Name JOAti/!/ ./C ,Pc;,171h/* PliRMIT NUMIIER
Owner's Mailing Address: L211—ND/3ThV/i14/ /41-1/ ' (0-1 II g
Lv yii/A-4„rs,yr[L 4/% /a/ ?g- trl
Installer's Nat„,,: Rr/f c itPiY 1 Itc,nc II: 72-a Y3G ECEIVEJ
ed
Number of bedrooms (if residential): . FEB 2 71996
Total daily Ilow (residential - compute (Gn 15(1 gal. per bedroom): TtlSMJ t 3F taIIF 1=;dSk i!f$Y
.L 9Ult.DlNc AND CODE
Topography: [ [I'I:tt f_j Rolling [-[ Steep Slope 4b of Slope
CC /Ree F'/GL
Soil Nature: 1-1 Sand [_[ Loam r-j t.My [ 1 Other . /Depth: ""
Ground Water: at what tiel,tlt7 feel -
Bedrock or Impervious tiaterial: at what depth? li•cl '
I'et•colation•Pest: [---[ Not Requited [ [ ltequiteel/Rate ruin. pet inch
Domestic Water Supply: 1A Municipal [^] Well -(—[ (tlher
1
If domestic water supply is a WELL: water supply from iuty septic alisi,rl,lion is I��rfeet
II'Rc.)I'OSRI.) SYS'1'1?M:I l .. .
Septic tank: �0- gal, (minimum she: I.111t() gal.) teR_Cv.. �� E.S.Abl-`l ,�-_TA'iz\--Ai�{ .
Tile Meld: earl) 1 Av il /, ll sy • tg It et•
V-I It
Seepage 1'il_(s): nuinber of size each: ft. x . ft.
Size of stone to be use h i/ / depth or tirka as feet. •
/--
11OI..Dl NK SYS'Il?M: (if tc tied) 1 ••
Number of tacks: Size o'-ern)-i eat.
11 it/arnt.sy.tle'ni rirlrl rr.ssoeial(r/ clei:ir,c t/work to be inspected by.a certified agency.
For yoitr prri h'ciiurt,'please note that pursuant to Section 1 6-29 of the ('ode oldie 7btrn of
Qucertsbiery, any pei•ntit or a p proyal granted which is bused upon or is granted in rciianc•e upon
any material lttl.rte,,71'c.t'endation of filth,ra to make a material fact or circumstance known by or On
behalf ofcut appliruni, shall be void.
l have read the regulations with respect to this a',plicntion and agree to abide by these and all
reyttirentents o f ilrm. Town 0J'Qucertshitry ,Sanitary ,Sewer 'c Disposal Ordinance.
Signature of res furnsib'e person: ' F� Date: as 02 — 9�,
TOWN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION ,
• Name ike13G K, 644:klie
Location ' f. 9'1, g-oigi
Date - (2I1Qgt Permit #
1
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation T st-
(if applicabltie) Rate-Mi ute/Inch
TYPE OF SYSTEM:
ABSORPTION FIE D: Tot /Length 6 (/,j fit)(
Length of each trencf�
Depth of trench s / J
Size of stone / I
SEEPAGE PITS: N u:er-I
Size - ft x I ft.
Stone size 6
PIPING: Site Type
Bldg. to Tank 4 �jL1Or 40
Tank to Dist. gox ' ' 1,1
Dist. Box to 'ield .—
Openings Sea ed? 0 No Partial
LOCATION/SEPARATI$ '.
Foundation to Tank ` /0 feet
Foundation to Absorption feet
Separation of Pits �.. feet
Conforms as per Plot Plan ^ 41110 No
LOCATION OF SYSTEM ON PROPER
(circle ,s04
Front Re.f''- Left Side - Right Side
Middle ront - Middle Rear
COMMENTS:
Ti6c/A O/JI " / OO Cow, ,
ir-LDS 113 'Lkc_(�.
SYSTEM USE APPROVED: (1110 NO
Arrived: .3 . / 0
Departed: 97.
Building Inspector
- .. •R7 PRo 1 '�!-y 6 /7 •
-
. - •. Ja 1-rN F - S e,�'fl//V:-/T -
_ �, -- - - - �� AKD�Tf-I v/rW,: A v� ,
- 14 y�A-,Y771-' -r/GL•- /v, �/. /?/ ?'-
. u . 717/4/1/.Z.:" ' c,-,0 l„2 ig.,-3 .-- '/; 3 ,, • '
iii ,,
� mid
-. 17. _ , . . -- ,
,y)„ , ,,,,
,., ,, ,,e x,-,,-,,, .
P. ,y- t,, e.t
is -. .-
- • ... •I i ,ri>„fr.-- n .
•
• / - LEAc _
n7-r- - --
_
o''
. .
f :�
If i.l •-, {
, . . .
. .
. .
- _ I i
FEB 2 7 �p�6
•
1 TU'=s'c, _ R-. :; =: - ' F,b • k
n.�
•
•
•
•
•
�` -
•
1 DA
., _ " . OF c!g. �Er E `J,1S URY .