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2001-763 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: P20010763 Date Issued: Wednesday, December 19, 2001 This is to certify that work requested to be done as shown by Permit Number P20010763 has been completed. Tax Map Number: 523400-289-007-0002-023-000-0000 Location: 23 YORKSHIRE Dr Owner: SHERMAN &EVE PARKER Applicant: SHERMAN & EVE PARKER This structure may be occupied as a: By Order of Town Board Septic Alteration Residential TOWN OF QUEENSBURY (-3J/1. 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: P20010763 Application Number: A20010763 Tax Map No: 523400-289-007-0002-023-000-0000 Permission is hereby granted to: SHERMAN&EVE PARKER For property located at: 23 YORKSHIRE 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: SHERMAN &EVE PARKER Septic Alteration Residential 23 YORKSHIRE Dr Total Value QUEENSBURY,NY 12804 Contractor or Builder's Name/ Address Electrical Inspection Agency SIGNORELLI & SON 589 WEST MOUNTAIN ROAD OUEENSBURY,NY • Plans &Specifications 2001-763 SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS $25.00 PERMIT FEE PAID - THIS PERMIT EXPIRES: Saturday, October 12,2002 (If a longer period is required,an application for an extension must be made to the code Enforcement Officer of the Town of sbury befo e the expiration date.) Dated at the Tow o n n1. .-- 5 ctober 12,2001 SIGNED BY J 4 for the Town of Queensbury. Director of Building&Code Enforcement H Application for SEPTIC DISPOSAL PERMIT CD STAMP RECEIVED Z Location of property for installation: ,2 3 ` 45//d e ,0/�l lieO Owner's Name P1litli key PERMIT IIUMBER 10 3 Yei,oks4ede hReve. c6Vtri Owner's Mailing Address: prl / �//, FEE PAID `�5, Z Installer's Name: 0�� J' 47'4e (`i Phone #: 90 l�� /� _ C4 tZi v RFC �` ` Hlt D Number of bedrooms (if residential): V OCT 11 200i Total daily flow (residential -compute @ 150 gal. per bedroom): TOWN OF QUEENSBURY BUILDING AND GODS Topography: Flat I I Rolling I-1 Steep Slope —%df`'S ripe, a-.-- ---__ Soil Nature: Sand I Loam n Clay Other /Depth: Ground Water: at what depth? feet Bedrock or Impervious Material: at what depth? feet Percolation Test: Not Required I-1 Required/Rate min. per inch Domestic Water Supply: E Municipal I' Well [-1 Other If domestic water supply is a WELL: water supply from any septic absorption is feet / C%Se r uJet/ f s //a PROPOSED SYSTEM: Septic tank: gal. (minimum size: 1,000 gal.) Tile Field: each trench feet. / total system length feet. / fAei'64 Seepage Pit(s): number of / size each: ft. x ft. SC) / Size of stone to be used: # / depth or thickness feet. 6'-„1 6KJ /N/ OA14"1 HOLDING TANK SYSTEM: (if required) e eJti'P,g_ ,, ,,// f,1jS/.4_/( 2 Number of tanks: Size of each: gal. ,JLD(41 i-6141 �`1e/S Alarm system and associated electrical work to be inspected by a certified agency. 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 o f the Town of Queensbury Sewage Disposal Ordinance. Signature o fresponsible person: Z� Date: /Q—l/O( C_Sd — /CRU TOWN OF QUEENSBURY uti9n BUILDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date/ Permit #0/7- --76 SOIL TYPE: Sand-Loam-Clay- Results of Percola ion Test- (if applicable) Rate-M nute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length Length of each trench Depth of trenches Size of stone / SEEPAGE PITS: Number Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Tank Tank to Dist. Box Dist. Box to Field/Pit Openings Sealed? Ye No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROP RTY: (circle one) Front - Rear - Left Side - 'ight Side Middle Front - Middle Rear COMMENTS: \V€Pt b��. SYSTEM USE AIsPRO`VE J ESQ NO � Arrived: - I Depart /Bu' ing Inspec r TOWN OF QUEENSBURY rl V BUILDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name RR(L61 Location --CS YoR,I, Kkte(-- OR Date 4A, b ) Permit # e) ( — 767) SOIL TYPE: Sand Loam-Clay- Results of Percolation Test- (if applicable) Rate-Minute/Inch TYPE OF SYSTEM: 9 ABSORPTION FIELD: Total LeAgXh j Z. Length of each trench ), Depth of trenches Size of stone L _C S., SEEPAGE PITS: umber-\ Size - t. x 1 ft. Stone size 1 PIPING: 1 Size Type Bldg. to Tank Tank to Dist. B x f Dist. Box to Fi l d/P ,.. ' --47v.i77-6 Openings Sealed /Yes No . Partial LOCATION/SEPARA IO • Foundation to T.6 feet Founti-ata-on—to A.sorpti on . _ feet Separation of Pits __ feet Conforms as per Plot Plan No L ION OF SYS EM ON PROPERT . ,ri' c e one) Fro - Rear -11 Side - Right Side iddle Front - . . .le Rear COMMENTS: f , • _ O Fi & -� 0I.< O � 1� • RcfLiCL A-LL I D 1 C C--r5 3IP 5 0'M A-0gbVA-L SYSTEM.USE APPROVED: YES 110 Arrived: Departed: d� 3LA / Building Inspector �J �.•rnf ry►.,.� • TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name -ipakkoz_.: Location L_. Date Ic0 15/0 'emit #1:Xo1" lk23 SOIL TYPE: Sane oam,-Clay- Results of Per olatioh Test- (if applicable'' Rate- �Nnute/Inch TYPE OF SYSTEM: grkiLTt+4A,- ABSORPTION FIELD: Total\ Lel h 5 -' l Length of each t enchl 1 Depth of trencts Size of stone CAL SEEPAGE PITS: Numb Size - ft. • ft. Stone size _� PIPING: Siz Type Bldg. to Tank Tank to Dist. Box 7527576 Dist. Box to Field/Pi I` Openings Sealed? 0 No Partial LOCATION/SEPARATIONS. Foundation to Tank _feet Foundation to Absorption . feet . . Separation of Pits ,feet Conforms as per Plot Plan es No LOCATION OF SYSTEM ON PROPER i c one) ro - Rear - i .ide - Right Side Middle Front - is .le Rear COMMENTS: RAC.v-L. . ��. 40 54: 0 , l'u �L � 2 L,4-7kc- Te> 1/✓ _�<< -o SYSTEM USE APPROVED: YES NO Arrived: Departed: Building Inspector eat i I-.-� . IF - Y • • c ale i4.6u.c .c_ ��i���� -\va f:F d - OCT 1 1 2001 k �$�` TOWN®F C�IUEENSB � ‘01 t "I have seen or observed, or believe I saw evidence of, It all objects such as houses, wells, trees, fences, etc., shown on this document. ! also represent that I have 11d personally measured the distances set forth on the diagram " yi_., SIGNATURE DATE ►pide41'�' pip'-fed . 1M'K- site - 02 > IM Jaive I( . G,. • TOWN OF QUEE -4:Sr-URy BUILDING & ` .y 4 7 r37. F • REVIEWED BY DATE , ...._ a .._-- V PM i , e _5- //lei d/ L