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2001-592 TOWN OF .QUEENSBURY 742 BayRoad,Queensbury, 12804-5902 (518) 761-8201 ��� Q rv, Community Development - Building & Codes (518) 761-8256 CERTIFICATE OF COMPLIANCE Permit Number: P20010592 Date Issued: Thursday, August 23, 2001 This is to certify that work requested to be done as shown by Permit Number P20010592 has been completed. Tax Map Number: 523400-295-013-0001-038-000-0000 Location: 40 AVIATION Rd Owner: DANIEL & JOY LE GAULT Applicant: DANIEL & JOY LE GAULT This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY (''"*"" j 4 4. 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: P20010592 Application Number: A20010592 Tax Map No: 523400-295-013-0001-038-000-0000 Permission is hereby granted to: DANIEL &JOY LE GAULT For property located at: 40 AVIATION Rd 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: DANIEL & JOY LE GAULT Septic Alteration Residential 40 AVIATION Rd Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency • CONDONS SEPTIC &DRAIN SERVICE Plans &Specifications 2001-592 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS $25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,August 09,2002 (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 Town of Queensbury; Thursday,August 09,2001 SIGNED BY for the Town of Queensbury. •it c ,, , g ' d F '-n orcement TOWN OF QUEENSBURY 101 742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201 Community Development- Building& Codes (518) 761-8256 BUILDING PERMIT Permit Number: P20010592 Application Number: A20010592 Tax Map No: 523400-295-013-0001-038-000-0000 Permission is hereby granted to: DANIEL & JOY LE GAULT For property located at: 40 AVIATION Rd 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: DANIEL &JOY LE GAULT Septic Alteration Residential 40 AVIATION Rd Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency CONDONS SEPTIC &DRAIN SERVICE Plans &Specifications 2001-592 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS • $25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Friday,August 09,2002 (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 Town noof Queensbury; Thursday,August 09,2001 SIGNED BY k �\ for the Town of Queensbury. D�ecto of t ' de Enforcement Application for Permit—Septic Disposal System Town of Oueensbury 742 Bay Road Oueensburv, NY 12804 (518) 761-8256 1. OWNER INFORMATION: Office Use Location of installation: /`o "-1111) 7/() File Permit Ner) ' — SCDos Tax Map No. / `%/ 7- I c Fee Paid © LE��'/9-v4- -r Owner's Name: ,( Address: 51(j /`} 10-1/0 Y17 QV r1/:i 2. INSTALLER'S NAME a0,4„-s S Lr C.`1`11 4iili,q4" PHONE NO` ? ?f — Z 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 980 111991 older i-�- x 50 gal/barm = 1980 x 130 gal/bdrm = 1991 —present x 110 gal/bdrm = Garbage Grinder Installed yes_ / no k RECEIVED Spa or Whirlpool Installed yes / no y AUG 0 6 2001 4. PARCEL INFORMATION: (circle applicable information &indicate measureme IrEANNOF QUEENSBURY BUILDING AND CODE To'o.ra.h Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Fla sand at what depth at what depth munici,a Rolling oam /1,/,'`_feet v feet well Steep slope clay 7 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 tank and leach field for each` arbage Grinder,Spa or Whirlpool Tub. o G 4. �'X 1ST/IV7 Septic Tank:f 6 gallon (min. size 1,000 gal) Tile Field: each trench SC) ft. Total System Length: 2.5C ft 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 Alternative System,: length and/or size (9et 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. Signature of responsible person Date TO OF QUEENSBURY BUILDING &_CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 • (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name „.2e ----' 1_, 6 Locatio _ �P ` �, Date /5 ,d'-2)/ Permit # 1-J 9c71-- M:"° • SOIL TYP '• an ay- Results of Percolation Test- (if applicable) Rate-Minute/Inch -TYPE .OF SYSTEM: ABSORPTION FIELD: Total Length 2256 Length of each trench _5�,� �z,' Depth of trenches Size of stone . ��,• Q SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box _ �� Dist. Box to Field/Pit LL \vC ii WWJ CiRik Openings Sealed? Yes No Partial . - LOCATION/SEPARATIONS: Foundation to Tank p feet Foundation to Absorption ,;,z feet Separation of Pits _ et Conforms as per Plot Plan • es�No LOCATION OF SYSTEM ON PROPER . (circle one) Front - Rear - Left - Right Side Middle Front - fiddle Rear COMMENTS: SYSTEM USE APPROVED YE NO Arrived - Depart ui ding Insp for v) Alik. • i 5 f All /� � 1 �c! Pori i' r ?poi N w lS - ?DX -, ot-QUFE. '''- D • 4 o Q430 D - l000 eft Corvcrcf f l s w j SEr-i't. C. Ela 5't fill "I have seen or observed, or believe I saw evidence of, all olt.,fe s such as houses, ,.:yells, trees, fences, etc., shown on this document. I aiso represent that I have pw`ni,,)llu measured the distances set forth on the diagram." 62(6,--4(,01.-\ 11-1-9 SIGNATURE DATE BUILDING 8 . Ai>1 Alfc,, tif,,Ep-r. REVIEWED BY ., s ,fir DATE �.._ _. ___�__,�