Loading...
2002-730 TOWN OF QUEENSBURY42 BayRoad,Queensbury,NY12804-5902 (518)76t-8201Community Development-Building&Codes (518)761-8256 7 CERT IFICATE OF COMPLIANCE . Permit Number: P20020730 Date Issued: Monday, September 30,2002 This is to certify that work requested to be done as shown by Permit Number P20020730 has been completed, Tax Map Number: 523400.303-020-0001-040-000-0000 Location: 15 PHILLIPS Ave Owner: EVERETT&FLORENCE ECKERSON Applicant: EVERETT&FLORENCE ECKERSON 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 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development-Building&Codes '(518) 761-8256 BUILDING PERMIT Permit Number: P20020730 Application Number: A20020730 Tax Map No: 523400-303-020-0001-040-000-0000 Permission is hereby granted to: EVERETT& FLORENCE ECKERSON For property located at: 15 PHILLIPS Ave 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: EVERETT&FLORENCE ECKERS Septic Alteration Residential 15 PHILLIPS Ave Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/Address Electrical Inspection Agency IBS SEPTIC IVAN BELL 2 T,OVvT.R WARREN STRFFT OIJFFNSBIJRY.NEW YORK Plans&Specifications 2002-730 Residential septic alteration per plot plan and specifications. $25.00 PERMIT FEE PAID-THIS PERMIT EXPIRES: Thursday,August 28,2003 (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 o August 28,2002 t4 ) F SIGNED BY for the Town of Queensbury. Director of Building&Code Enforcement Application for-Permit Septic Disposal System - Town 6f Queensbury 742 Bay Road Queensbury,NY 12804 (518)761-8256 1. OWNER INFORMATION: S C 1 Gj phi l ji S AV6_ _Location o£in_stallation• Office Use - Tax Map No. 363 f ., -File Permit No.�v� '73 - LerS on Fee Paid ,1 Owner's Name:/ �'"~1-•" / ,r P �....,.......,. '-^ w Address: 1 J n h bty'r Ct U6 AUf, $ 2w 1 TOWN OF,,' Ef _P ` 2. INSTALLER'S NAME : L $ 'C�Pi�PHONE N;t}= ` : .!;" 5 Y 3. RESIDENCE INFORMATION: (circle year of dwelling,indicate#bedroom(s)and multiply#of 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 _ x 150 gal/bdrm = O D 1980-1991 x 130 gaYbdrm = 1991-present '_ .x 110 gallbdrm = Garbage Grinder Installed yes /no Spa or Whirlpool Installed yes_/ no 4:• PARCEL INFORMATION: (circle applicable information&indicate measurements) mre Cr Water Be c or rvio s Material D rn 'c W a t . a ph municipalmng eet well Steep slope clay tf well;water supply °r slope other from any septic-system depth: absorption is other Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch S. PROPOSED SYSTEM: For New Contraction: All individual sewage disposal systems must be designedby a licensed professional engineer or architect(unless installed in a PlanningBoard approved subdivisipn). Add 250 gallons to the size , of the septic tank and leach field for eaA Garbage Grinder,Spa or Whirlpool Tub. Septic Tank: A�-_gallon(min.size 1,000 gal.) Tile Field: each trench ft Total System Length: R Seepage Pit(s): number of size ofeach: f.by_ Size of Stone to be used: #__�� t depth or thiclmess feet • t . Bed System Size: x Alternative System: length andlor size 7 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 pu Ds, to Section 136 29 ofthe 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. Signature of responsible person Date 0 0 0 0 C1b W. a ..� H �, .�� �.�, (D 0 '� Uf a0'.J, n:3 "0CCn(D0ZQ10NMNb :3L4 "0-ho M rf 0 � m 0 �a.Or a oo 7' �I > -h, >or+ (OH 0 (D 00M rtw W QM C rw (D 0 0 rh C+ C+ oto Cu 0 C+ '► v, m o *i 11ti 0 tv 0 H Hr as C: Vt 0 ^i.J,-Jo M(n 0 0 `"li � <0 H '".1 V "" 1 t� m 0mZ a � � � tn(A -J' �� rD Hc+ � m<n -h '+ 44 H H -� su ro v► m m C+ �o -s ro 1 x © :r M 3(D z lip -jooX0 a a rD as o 0vc a M n - 0 rh ti U1 ro X M 0 0 N -�• 3 (D �/ 0 to 3 ct „ W, C+ 1 0 ( 001 0)�o ®Z 0 r- C (Doj N G 1 � cD 0 c+ C+ (+ oj �, "I have seen or lobs rved be!" eta: sa� rice'of,r, . , w evide' o be!" all obiects such as houses, Ivells' �fees ces,e, ek, shown n c t h, pr�seij�t t,, ... is ficument. I also tit h t I (a v e! 4 i'easured the dis per�orld' antes set fi�rlth 'oil the d',,liagram. % SIGN Ali DATE 7 I�! I" � �� IIII jib I ��� � I lil � ll II ! ' NJ Ui }'o Yl I ( I 1 I'r�"'I � I� ' ! I' ...+. I IQ i i {W.. I I I � I T'l 1;� !W