2001-552 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518) 761-8201
Community Development - Building & Codes (518) 761-8256
CERTIFICATE OF COMPLIANCE
Permit Number: P20010552 Date Issued: Tuesday, July 24, 2001
This is to certify that work requested to be done as shown by Permit Number P20010552
has been completed.
Tax Map Number: 523400-309-014-0001-054-000-0000
Location: 8 RIVER St
Owner: WILLIAM S HUDSON
Applicant: WILLIAM S HUDSON
This structure may be occupied as a:
By Order of Town Board
Septic Alteration Residential TOWN OF QUEENSBURY
(-. 444°ti
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Director of Building&Code Enforcement
1
TOWN OF QUEENSBURY
t
oro 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building& Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20010552 Application Number: A20010552
Tax Map No: 523400-309-014-0001-054-000-0000
Permission is hereby granted to: WILLIAM S HUDSON •
For property located at: 8 RIVER St
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: WILLIAM S HUDSON
8 RIVER St Septic Alteration Residential
QUEENSBURY,NY 12804 Total Value
Contractor or Builder's Name/ Address Electrical Inspection Agency
I.B.S. SEPTIC
2 LOWER WARREN STREET
OUEENSBURY,NY
Plans &Specifications
2001-552
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
$25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Tuesday,July 23,2002
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the To ueen,l uty. '1 i r/ y 23,2001
SIGNED BY / ff, for the Town of Queensbury.
Director of Building&Code Enforcement
•
• ' Application for Permit — Septic Disposal•System
. limn of Quee,Jsbui y 7421toy Road Queeltslruty, NY 12804 (518) 761-8256
1. OWNER INFORMATION: .
• l� UCH S � Office Use
Location of installation: U 1
File Permit,No � a
Tax Map No. / / ,-'a o 17
N.• J) • Foe Paid
c Owner's Name: (�(_ l� C>
Address: 7t? /` J'Lfr-cc)
2. •.INSTALLER'S NAME : � ' l - S(, 11 ( PHONE NO.
3. RESIDENCE INFORMATION: (circle year of dwelling, indicate it bedroom(s) and multiply II of
bedrooms with applicable gallons per bedroom to equal total daily flow)
Year of House: No, of fodrtZolLs x Colmpujation = TQtal Daily Flow
1980 or older f� y 3 x 150 gal/bdnit - `{,("0
1980— 1991 • x 130 gal/bdrrn =
1991 —present x 110 gal/bdrm = -
Garbage Grinder Installed yes / no*..
Spa or Whirlpool Installed yes / no
4. PARCEL INFORMATION: (circle applicable information & indicate measurements) •
' ••• ,uw11Y .N tlrxo_�_. ...t'o;nd.Wnlnt . _l3.Qtl.I. ck..c :.ilur,otwaV.t' _M..t►.tvt.i.�fi_ — ►tosl.rc_Wr.or.$ul►trly
No .cc,,ul at uhai depth (II ►rhrri depth nttr►rIcIpirl
oiling tnt — feel •--- f`'el rei—
. Steep slope clay • if well; water supply
%slope other from any septic-system
depth: absorption Is f?.
other
' Percolation Tost: (To be completed by licensed professional engineer or architect)
Rate: M/4 ntlntite per Inch
5, PROPOSED SYSTEM: For New Conetructlen: All Individual sewage disposal systems must be designed by n licensed
professional engineer or architect (unless installed in a Planning timid approved sulxlivision), Add 250 gallons Io the sin
of the septic tank and leach field for each Gasbag: (;tinder, Spa or Whitllxml Tub. .
Septic Tank: /06O gallop (miss, size 1,000 gal.)
Tile Field: each trench SO it, Total System Length: Ob t ./V�' L %/" U l'
Seepage Pit(s): number of size of•each: f1. by fJ.
Size of Stone to be used: II ---•_- / c/e/,I/►or thickness.__.__._._......._J e1
Bod System Size: x
• Alternative System: length and/or size
III
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 Quoonsbury, 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 rend the regulations with tospect to this application and agree to abide by those and all
requirements of the Town of Qucensbury Sanitary Sewage Disposal Ordinance..1% C6'--- C -. 7 / / -Apo1/y
. Signature of respons ble person Date
f--' TOWN OF QUEENSBURY 94/1111
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY I2804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ji . .,-, udson
Location 3 R: jrv'
54-
Date.7-0Avi Permit (--- oZ
SOIL TYPE: Sand
oam- l ay-
Results of Percolatio Test-
(if applicable) R.te- inute/Inch
TYPE OF SYSTEM: �t
ABSORPTION FIELD: Tot 1 Lengpth _
Length of each tr-nc l 50
Depth of trenche.
Size of stone ,v c r q - 0 "SA).
SEEPAGE PITS: u '':er-
Size - . ( ft.
Stone size .,
PIPING: $iyg Type
Bldg. to Tank �- 7�12.35—
Tank to Dist. Box a K
Dist. Box to Field/'--:
Openings Sealed? No Partial
LOCATION/SE.PARATIO'• .
Foundation to Tank Z-5{feet
Foundation to Absorpt:on . =3.5 feet
Separation of Pits — et
Conforms as per Plot 'Ian Yes No
LOCATION OF SYSTEM ON PROPERT .
(circle ► e .' .
Front - 'ea' - Left Side - Right Side
Middl e'Front - Middle Rear
COMMENTS:
•
SYSTEM.USE APPROVED: (;) NO
Arrived: c"._'___ib_
Departed:
` Ve
Building Inspector
[ t
Iz RECEIVED)
JUL 2 0 2001
TOWN OF QUEENSBURY
BUILDING AND CODE
i ____.____________
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0 "I have seen or observed, Or believe I saw evidence of,
0 lall objects such as houses, wells,trees,fences, etc.,
shown on this•document I also represent that I have
!personal easured the di ances set forth on the dia ram."
6-- , )e
LIS(j SIGNATURE 2 DA/TE. ...
TOWN l'7-QiIEENSBURY BUILLAG DEPCTMENT
13asf,L:d on our limited examination,
„ compliance with our commentssill
•
not be construed as indicating the
plans and specifications are in fill
compliance with the code.
C./
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V-) TOWN c,..::,,i-:-: 0,,,.._.J.E.Es y.,,i,„4-._,,B1 JR."
BUILD1NC3 ⁢ EFr.
REVIEWED B i
DATE 7 -—
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