2002-073 'r EENSBURY
TOWN OF OU
742 Bay Road,Queensbuty,NY,12804-5902 (518)761-8201
Community Development-Building& Codes (518)761-8256
At
CE'Ro"C"I"IFIC " '"E OF COMPLIANCE
Permit Number: P20020073 Date Issued: Wednesday,January 30,2002
This is to certify that work.requested to be done as shown by Permit Number P20020073
has been completed.
Tax Map Number: 523400.308-015-0001-058-000-0000
Location: 3 PINELLO Rd
Owner: ARTHUR ALMY
Applicant: ARTHUR ALMY
This structure may be occupied as a:
By Otdet of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
Director of Building&Code Enfotcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20020073 Application Number: A20020073
Tax Map No: 523400-308-015-0001-058-000-0000
Permission is hereby'granted to: ARTHURALMY
For property located at: 3 PINELLO 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: ARTHUR ALA
Septic Alteration Residential
14 GIBSON Ave
HUDSON FALLS,NY 12839 Total Value
Contractor or.-Builder's Name Address Electrical InspectionAgency
I.B.S. SEPTIC
2 LOWER WARREN STREET
OUEENSBURY.NY
Plans &Specification's
2002-073 LOT 7 PINELLO RD
SEPTIC ALTERATION AS PER APPLICATION
$25.06 PERMIT FEE PAID - THIS PERMIT EXPIRES: Wednesday,January 29,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To 110 Tu January 29,2002
SIGNED BY W for the Town of Queensbury.
Director of Building&Code Mforcernent
Application for permit=Septic Disposal System
7oWr1 of QtleellSbtl/Y 742 Bay Road QueensGury,1VY,128t74 (Sl8) 7G1-82 �""
I.' OW_ NER INFORMATION:
c}:� mAN
ao OQ tEENS BURYLbcdn;ofinstallation: TOVi office use .
'Tax Map':No. / :/ File I'vrBrnitl1/y 1�COO
Owner'a NaRne Fee Paid ctK'�
Addrost.:. .......... . .... ....................... ....�-
02
. . -
to-
2. INSTALLER'S NAME r PHONE NO �--
3. RESIDENCE INFORMATION: ,(circle
year of dwelling,indicate-99 bedroom(s) and rnultiply-N_qr
bedrooms with applicable gallons per bedroom to-equal total dailyflow)
kbar of House.. No of Bedrooms x Computation' Total Daily Flow
1986 or older x ISO gal/bdrm
I980— 2991 x, 130 gal/bdrni =
`1991,—p resent :
.. tf,. x '110 gallbdrm- =
Garbage Grinder Installed- yes ! no
Spa or Whirlpool "Installed yes 1. no -#
4. PARCEL,INFO
RMATION: "(circle applicable information 8c indicate measurements)
_ 1_t'9 Q.�Outt4l Vlat9.r_ _,Ii941roGk yr_It�2pvi-�ST_l!$..�1_P44ri.�i Wator_Supl!lY
I.7trt .K cirt at ► ur ele1lr of !v/fir de/rtlr rrttrr:lc rpa
l!►r turn:
Steep slope' cliry rfwetl; water suplsly
- 3o slope . ' other from any.repiic-system
depth: absorption is fl.
other
Percolatlon'Test: `(To be'completed by licensed professional engineer or architect)
Rate: n1thfile per Inch
S, PROPOSED SYSTEM For New Condtruetlon: All individual sewage dis sal systems must be designed by n licensed
Po Y
professional engineer or architect (unless insintled in a Planning Board aliprtiveti subdivision). Add V50 gallons to the sire
of the septic lank and leacli Iicld for cacliGarbage Urinder,"Spa or Whirlpool
. 'Septic Tank: gallon(mitt. size I,O110 gnl.)-
Tile Field each trench 'Total System Length:,
. .. }- . j1
Seepage Pit(s) nrmber'af, size ofeach: fl: by
.;
Size of Stone to be=used:- // . 1 cle/ulrvtr/!r/cktress" -- -._Jvcr"
Bed System'`Size: z
yrt length,and/or size
Ahernative$ ems - -
6. H_ OLDING TANK SYSTEM .(if required).
Number of tanks: /" Site of each gallons" [TOTAL .Capacity gallons
Note: Alarm System and associated electrical work must-be inspected by ' Town approved.
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read)
For your protection, please riote.that'purstiant to Section 136-29 oftlia Colo of the Town
of Quoonsbury, any permit or approval-granted which is based-upon or'is grantedirr
roliatrco upon ally ninterinl ri�isrehresonta[ivn or fiilhrre to make'a iwiatcrial fact or
circtirnstanco'known by or on behalf ofan`applicant, shall be void.-
I}lave road floe regulations with rosppct to this application and agree to'sibido by Utosei.arid all
requirements of the To f Queensbury.Sanitary Sewage Disposal Ordinance.
d
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