2001-487 lour
TOWN OF QUEENSBURY
` 2 1 2 1
��� 742 Bay Road,Queensbury,NY 1 804-5902 (518) 76 8 0
Community Development - Building & Codes (518) 761-8256
CERTIFICATE . OF COMPLIANCE
Permit Number: P20010487 Date Issued: Friday, July 06, 2001
This is to certify that work requested to be done as shown by Permit Number P20010487
has been completed.
Tax Map Number: 523400-301-012-0001-029-000-0000
Location: 44 HELEN Dr
Owner: . RUSSELL & RUTHANNE BRADY
Applicant: RUSSELL &RUTHANNE BRADY
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
• Director of Building&Code Enforcement
TOWN OF QUEENSBURY
t-• rj" 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010487 Application Number: A20010487
Tax Map No: 523400-301-012-0001-029-000-0000
Permission is hereby granted to: RUSSELL & RUTHANNE BRADY
For property located at: 44 HELEN 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: RUSSELL &RUTHANNE BRADY
44 HELEN Dr Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
SANITARY SEWER
DAN DRELLOS
PO BOX 224
GLENS FALLS NY
Plans &Specifications
2001-487
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATION
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday,July 05,2003
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbu before thee -xpiration da e.)
Dated at the Tow of Q ns'j'�' • T , u y 05,2001
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
Application for Permit—Septic Disposal System
Town of Queeiisbili y 7.12Bay Roar!Qrreeusb►u:►; NY 1280.1 (518) 761-8 256
1. OWNER INFORMATION:
Location of installation;4-./VAtilWel() Office Use
Tax Map No, / / Milo I'otnrit No. . �I- "1 ��
Owner's Name: g e-6( " 4�.A-P y l'no Paid
J j
•
Address: C,f/7' ,&,‹_, �fl =
(7,..,
2, INSTALLER'S NAME : -- 1.,. •.Y ,c," 7L
PHONE NO.
3, RESIDENCE INFORMATION; circle year of dwelling, >
( J I lt„ indicate !!bedroom(s) and multiply 1f o/'
be'droums with applicable gallons per bedroom to equal Nita/daily flow)
• Year of House: No. of Bedrooms x Compuhlion = Total Daily blow. " CI. ENE
`i'
• 1980 or older Y x 150 gal/burnt = 6 D D JUL 0 3 2001
1980— 1991 x 130 gal/bdrm = TOWN OF QUEENSBURY
1991 —present x 110 gal/bdrut = BUILDING AND CODE
Garbage Grinder Installed yes / no X'.
Spa or Whirlpool Installed yes / no A/
4. PARCEL INIOR.MA•I'ION: (circle applicable information & indicate nroasuicnrents)
'--- y. ,+ra 1i !tura CtsuirdWater Bedrock_or_Impeivious Material _..._incstre_ titer Simply.
l* rP! al whatdepth at what depth
oiling lualn fret feet
Sleep slope clay fil well
slope other if well; water.supply
fi'v►JJ any sc�j,lic-,sJ;tile»J
depth; absw j,liun is fi,
Percolation Test: (1 o.be Completed by licensed pre fissional engineer or architec) other_
••
Role, 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 annovcd subdivision), Add 250 gallons to the size
• of the septic tank and leach field for each G:ubage Grinder, Spa or Whillpoul Tub.
6
i(
Septic Tank: /�gallon (min. size 1,000 gal)
• Tile Field: each trench fl. Total System Length: II.
Seepage Pit(s): number of size'of each: 10 fl. by og fl•
' . Size of Stone to be used: II, 1 / depth or thickness ch.l
•
Bed System Size: x
Alternative System: 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.
1
7e 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 nrisiepresentation or railuto to make a ntatetial Incl.or
circumstance known by or on behalf-of-mu applicant, shall be void.
I have road t regulations with 'es metto this application and agree to abide by Iheso and all 'requirenr its of o'town of Quo its uty Sanitaiy. ,rage Disposal tJhclinan •e.
• ALA
gn tore of rasp Ible perso Da e
TOWN OF QUEENSBURY I h : 1- .S
BUILDING & CODE ENFORCEMENT
742 Bay Road �-�
Queensbury NY 12804
(518) 761-8256 CpCi i
SEPTIC DISPOSAL SYSTEM INSPECTION
Name2,,,,,,,q,,,,,
Location �-��� N
Date 1 - oô #Cy6 1`Li e
/Permit 7
SOIL T E: Sand4am-Clay-
Results of Percola 'on Test-
(if applicable) R..te- lnute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length �i-
Length of each tr:nch )j\�
Depth of trenches �,.' `#�
Size of s one Wei
SEEPAGE P S: Number- I °
Size - i ft. x ? ft.
Stone size
PIPING: Size Type
Bldg. to Tank
ckb -d:_uj 1-0WAITO
Dist. Box to /'its V
Openings Sealed? Yes No . Partial
LOCATION/SEPARATIO` S:
Foundation to Tank feet
Foundation to °Abs{rption . — feet . .
Separation of Pi s feet
Conforms as per 'lot Plan es LB—
LOCATIOR9 OF SYSTEM ON PROPE .
(circle one)
Front Rea' - Left Side Right Side
Middle Fro t -- Middle Rear
COMMENTS:•
SYSTEM USE APPROVED. YES NO
Arrived' (Y L
Depar ed: AlO !a ,- 1.-
/ r
Or B 'ding In ctor
00
0
0
Of
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TOWN OF QUEENSBURY
BUILDING_ & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ), eflad
Locati ono' Mej(-7/Y1c.-_ ("1 -
Date -5 v J Permit # IC)/ -1/gy
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate- i to/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total ngth
Length of each tren h
Depth of trenc es
Size of stone
SEEPAGE PITS: Num• -r pt)
-
Size - _ ft. ( ft.
Stone size _ 3
PIPING: Size Type
Bldg. to Tank ` 3k -7
Tank to Dist. Box ' c - - N
Dist. Box to Field 'it r, .
Openings Sealed? `:s No artia
LOCATION/SEPARATIONS:
Foundation to Tank F i feet
Foundation to Absorption z yl- feet
Separation of Pits VA(N,I{1k__ feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Fr - ar - Left Side - Right Side
Middle Fron#_ Middle Rear
MMENTS:
\G' y-Q6 D R
SYSTEM USE APPROVED: NO
Arrived: AP
Depart:., : .i
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JUL 0 3 2001
TOWN OF VE317, v►v5
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TOWN OF ti•>} :_ -
BUILDIF..',.‘. ; 4.,.V, - ,f,.., .g,
REVIEWED BY t .- l4I. . _
r .. 7 ,
TA
i DATE '
I rV dz-
"I have seen or observed, or believe I saw evidence of,
al ects such as houses, wells, trees, fences, etc.,
shown ,art this docu, • I also represe that I have
pers na ly measured 7 istanc s orth on th dia ram."
\\` OtA.....c.c. 73 c)/ _ •
, SIGNA RE DATE