2002-250 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-55902 (518)761-8201
Community Development-Building&'Codes (518)761-8256
CERTIFICATE
OF COMPLIANCE
Permit Number: P20020250 . Date Issued: Wednesday,May 01,2002
This is to certify that work requested to be done as shown by Permit Number P20020250
has been completed.
Tax Map Number: 523400-301-008-0002-040-000.0000
Location: 6 PROSPECT Dr
Owner: MARGARET LEONARDI
Applicant: MAR.GARET LEONARDI
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN-OF QUEIENSBVRY
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5 902 (518)761-8201
Community Development-Building& Codes (518) 761-8256
BUILDING PERMIT
Permit.Number: P20020250 Application Number: A20020250
Tax Map No:' 523400-301-008-0002-040-000-0000
Permission is hereby granted to: NLARGARET LEONARDI
For property located at. 6 PROSPECT Dr
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: NIARGARET LEONARDI Septic Alteration Residential
6 PROSPECT Dr Total Value
QUEENSBURY,NY 12804
Contractor or Builder's Name f Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Spetifications
2002-250
SEPTIC ALTERATION AS PER APPLICATION
r.
$25.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Tuesday;April 22,2003
(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.)
n
Dated attlKY0>1R�0ren ZZOay,April 22,2002
\ f 7SIGNED BY ..4 for the Town of Queensbury.
V %a
Director of Building&Code Enforcement
516 ;745.4437
FIL E�tvo.638 04,02 '02 AN 11:25.'ID-:TOWN OF QUEENSBURY FAX:518. 745 "4437 PAGE I
Application for Permit-Septic Dl. System.
e Town O,f Qxteepsbury 742 BOY Road Quaenabury.NY 12804 (518) 701-8256
1. a R ORMATICJN: ..„, .,......_.
Location of installstion.; (2
File Permit No.
Tax Map No. � �—,
Fee Paid zoaz
Owner's Name 2 /� ........ 8.-TV ... ..._
Address:
2G; CZ! cd UILDING AND CODE
2. INSTALLER'S NAMES r r /XA `' 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)
1980 or older x 150 gal/bdrm m
1980-1991 x" 130 gal/bdnn
1991 present x 110 gal/bdrtn
Garbage Orinder Installed yes } / no
Spa or Whirlpool Installed yes s / no
4. PARCEL INFORMATION: (circle applicable information do indicate measurements)
a at what depth at what depth t
Rolling oam __feet ifest
Steep slope clay ljwell;water supply
_%slope other from any septic-systam
depth: absorption is .
other
percolation Test: (To be completed by licensed professional engineer or architect)
Rate: minute per inch
S. PROPOSED SYSTEM; For New Construction: All individual sewage disposal systems must be designed by a licensed
professional engineor or axc itect(unless installed Ina Planning Board approved subdivision). Add 230 "gallons to the size
of the septic tank and leach field for each Garbage chinder,Spa or Whirlpool Tub,
Septic Tank: 0 o gallon In. size 1,000 gal.)
Tile Field: each trench 11 Total System Length: Jt
Seepage Pit(*): number of �} / size of each: __.L=__.. by
5ixo of Stone to be used: # 3 f depth or thickness �^�'"" feat
B.ed System Size: x
AIIteraative System: length andior size
6. HOLDING TANK SYSTEM: (if required)
Number of tanks: ! Size of each: gallons /TOTAL Capacity: gallons
l
Note. Alarm System and associated electrical work must be inspected by a Town approved
electrical Impection agency.
7. SIGNATURE lk INFORMATION POP,RESPONSIBLE PERSON(please road)
For your protection,please note that pursuant to Section 136-29 ofthe Code of the Town
ofQdeoixsbury,any permit or approval granted which is based upon or is granted in
reliance upon any material misrepresentation or fsilure to make a material thct or
circumstance known by or on behalf of an applicant,#hall be void.
I ha
veegulations with respect to this application and agree to abide by these and all
rehe Town of bury Sanitary Sewage Disposal Ordinance.
na re of r" ponsible person Dab
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"I have seen or observed, or believe I saw evidence of
all objects such as houses, wells, trees, fences, etc.,
shown on this do clament' I also represent that I have
Person"", measured the
distances s t forth can the diagram."
SIGNATURE ------ ,� `� -
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DOCRE CEIVED
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TOMNA6FI. 1,4kiURY
BUILDING 4 EPT.
APR 22 2002 REVIEWED BY
TOWN OF OUEENSBURY DATE 2✓4''
BUILDIMC3 AND CODE