Loading...
2001-137 TOWN OF QUEENSBURY F 2 Ba Roa ueen b NY 12804-5902 518 761-8201 ��� 74 v �,Q s �v, ( ) Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF OCCUPANCY Permit Number: P20010137 Date Issued: Tuesday, April 24, 2001 This is to certify that work requested to be done as shown by Permit Number P20010137 has been completed. Tax Map Number: 523400-072-000-0001-009-000-0000 Location: 2 JUNE Dr Owner: JOHN &ANNET"1'E HEWITT Applicant: JOHN &ANNET"1'E HEWITT This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY j 4 , Director of Building&Code Enforcement TOWN OF QUEENSBURY Fors 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building&Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010137 Application Number: A20010137 Tax Map No: 523400-072-000-0001-009-000-0000 Permission is hereby granted to: JOHN&ANNETTE HEWITT For property located at: 2 JUNE 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: JOHN&ANNETTE HEWITT Septic Alteration Residential C/O MTGE AUTHORITY INC Total Value 33200 W 14 MILE Rd W. BLOOMFIELD, MI 48322-3549 Contractor or Builder's Name /Address Electrical Inspection Agency Plans &Specifications BP 2001-137 Septic Alteration for 3 bedroom residence as per plot plan and specifications. $25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Saturday,April 05,2003 (If a longer period is required, an application for an extension must be made to the code Enforcement Officer Dated at the Town'!f Qu:-e sb 94hu,•s 105, 2001 SIGNED BY \ for the Town of Queensbury. Director of Building &Code Enforcement • • • Application for Permit—Septic Disposal System Town of Queens/mg 742 Bay Road Queenshurv, NY 12804 (518) 761-8256 1. OWNER INFORMATION:. �0J ° ,Ov de � 'o�Fr e Use Location of installation: i • / APPiiORpr o. / _t37 Tax Map No. 7 ` / . / • i Fee,Paid-tr>*P5 Owner's Name: J)j7 / ,i . BUILDING :; : -- -) Address: a Joie Ave, 1 2. INSTALLER'S NAME : - e e , , ' - .-r PHONE NO. S‘c'"UX?. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedroom(s) and multiply# of j 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 L./X 1j x 150 gal/bdrm = 1980— 1991 `// x 130 gal/bdrm • = • 1991 —present x 110 gal/bdrm = Garbage Grinder Installed yes /e' ' Spa or Whirlpool Installed yes / o 4. PARCEL INFORMATION: (circle applicable information&indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material ---.Domestic Water Supply i sail at what depth at what depth mtinict Rolling loam feet feet well Steep slope clay 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 Construction: 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 leach field for each Garbage Grinder, Spa or Whirlpool Tub. Septic Tank:/ti 6 CJ gallon (min. size 1,000 gal.) Tile Field: each trench . ft. Total System Length: ft. i • 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 - - - . . __- P i Alternative System: / dl4./�Y4i4 3' 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, 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. V • C-e.e,----, L Sig au e f responsible person bate6 pp IV do " TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Jq '& G6)177) Location 2.- ,1 )0AN Date ZA Permit # c ' - /3 7 SOIL TYPE Sand o fn-C'],ay- Results of Percola ion Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: i _et ✓ ABSORPTION FIELD: Total L+engyi1 O Length of each trench i. Depth of trenchesl / Size of stone 7.4)r/Gr,�'c,,•aroe SEEPAGE PITS: NUnib.e.r' Size - ftl x ft. Stone size PIPING: i S'ze Type Bldg. to. Tank ^/ Tank to Dist. Box ‘ '' 7.5=7575- Dist. Box to Field%P' 'PiE, Openings Sealed? y` No _ .Parti a LOCATION/SEPARATION.. Foundation to Tank. `i feet Foundation to Absorption -67 feet Separation of Pits et Conforms as per Plot, P1 an -- 6's No LOCATION OF SYSTEM ON PROPERTY: (circle Front - Fear Left Side - Right Side Middle h. „ - Middle Rear COMMENTS: SYSTEM USE APPROVED: ES NO Arrived: 6_1 Departed: � / (Zv Building Inspector TOWN OF QUEENSBURY � BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 rf (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name 1-1F1.6 ITT Location • ,\I Date Permit # a SOIL TYPE: Sand-Loam-Clay-o}—J37 Results of Percolation Test- (if applicable) Rate-Min Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Leng h Length of each trench Depth of trenches Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: S ze Type Bldg. . to Tank Tank. to Dist. Box Dist. Box to Field/Pit Openings Sealed? Y-s No Partial LOCATION/SEPARATIO Foundation to Tan feet Foundation to Absorption feet Separation of Pits _ feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPER Y: (circle one) Front - Rear -. Left Side - R ght Side Middle Front - Middle Rear COMMENTS: SYSTEM USE APPROVED: YES NO Arrived: Depar ui d' Inspector - He itt Senti / }s; - - 72.-3-14 72.-1-8 -14 -..,:.......- _.. Eli\ ,tom 72 . 1-13 <: :>< >> <: >;.. 72.-3-15 .....4/111:!5:0!..;11:1;1111...;:::::!!FfIri..":7:''''''............................'....::::::::...!..ilil.1.1...1::...;;...:..1..i...4..7....:::'.4.7'............i..'.i.1.11: :-.''''t ........................................................................ ...................................................................... ..................................................................... ................................................................... ............................................................... ..................................................... ......... ................................................... ........ .......................0.i'.............. i::::;.......... ................................................. ...... -1-12 72--3-16 \ 7 . r W-v-E SCALE: One Inch =50 Feet s Produced by the Town of Queensbury, NY, Building & Codes Department 04/04/2001 1 ' ,iimi ,"::f -- E PgrED - --- n 1 -,-,..--- •'" . 0 0 1 - ( APR 0 5 2001 ThwPN of QUEENSBURY UI ®IB.1AhID CODE JI "I have seen or observed, or believe I saw evidence of, all objects such as houses, wells, trees, fences, etc., _ shown on this document. I also repr sent that I have . personally meas ed the distlnc et forth on the diagr m." \ . 7z,". y . Y.30/ _ SIGNATURE DATE I 1 E j r-E= _t_. T. k.T & . i t � �c P. Il Iv G CY -._{ ` O'J. 'Ni �" > Fi t. MAC *NG .4 ;. - REVI ED BY .....__///� .. __.. .1 DAIS Lii /©! zc Lo` __ �o f e __—__._..______..