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2000-121 "� u✓ „ryq..,er�J• H h-�nY�.('-..,�• ,r,',.tilWir�+' WC'ertificate 7 ComIp"% liduce Town of Queensbury Warren County,New York April 1 , 2000 .Date - 2000121 This is to certify that work requested to be done as shom1 by Permit No, has been completed, . SEPTIC ALTERATION This structure may be used as a 10 VISTA -COMI �".�.. Location SHEARER, KEV N Owner "TAX NAP NO. 72 0 -1'-3 By Order Town Board 7rector of Building &Code hiforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 0 Building Permit No. 2000121 TAX MAP NO.. 7 2 . -1-3 Permission is hereby granted to SHEARER, KEVIN Owner of property located at 10 VISTA COURT in the Town of Queensbury,to construct or place a SEPTIC ALTERATION at the above location in accordance to 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. Owner's Address: 10 VISTA COURT QUEENSBURY, NY 12804 Contractor or Builder's Name: MORNING STAR Contractor or Builder's Address: Electrical Inspection Agency: Type of Construction: SEPTIC Plans and Specifications: SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS Proposed Use: SEPTIC ALTERATION $ 2 5PERMIT FEE PAID—THIS PERMIT EXPIRES March 21 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 this 21Day of March 2000 SIGNED BY for the Town of Queensbury Code Enforcement Officer 'ermit-Septic Disposal System 213ay Road Queensb ury, NJ' 12804 (518) 761-8256 I. OWNER INFORMATION: .........................._............................................................_........................................ . office Use 3 Location of installation: /O V j-S fC Tax Map No. � File Pit No.��l� —f J 7?/ / Permit Owner's Nam©; K 'e-y; n S h�e cx.-r e� Fee Paid .............................................................................................................................. Address:__J 0 2. INSTALLER'S NAME l�j(�vt t``t�' S f� ( PHONE NO. 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate#bedrootn(v)and multiply ll c?f' bedrooms with applicable gallons per bedroom to equal total dailyflow) Year of House: _ No. of Bedrooms x Computation = Total Daily flow 1980 or older 3 x 150 gaUbdrin = 1-1,5o GC,( 1980— 1991 x 130,ga1/bdrui = 1991 —present x 110 gal/bdrntt = MAR 2 � 200Cf Garbage Grinder Installed yes— / no ✓ Of CY-1P:r-�4C-BURY C3t 3iLr7ii�iL 'AD 00 Spa or Whirlpool Installed yes / no 4. PARCEL INFORMATION: (circle applicable information &.indicate measurements) Topography Soil Nature Ground Water Bedrock or Impervious Material Domestic Water Supply Flat rid at what depth at what depth __- Rolling oam feet feet ^-— Ste o clay if well; water supply /o sly alder from any septic-system depth: from is f1. other - Percolation Test: (To be completed by licensed professional engineer or architect) Rate: minute per inch 5. PROPOSED SYSTEM: For.New Constriction: All individual sewage disposal systems nmst 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 Garbage Grinder,Spa or Whirlpool Tub. V54-15f++JC:> Septic Tank: lot�,c-5 gallon (min. size 1,000 gal) Tile Field: each trench— 63(�,_f? Total System Length: j q2 Jr. Seepage Pit(s): numberof size ofeach: ft. by _t. Size of Stone to be used: /1.. 7 / depth or thickness Z_ feet Bed System Size: x Alternative System: length andlor 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. 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 TOWN OF QU'EENSBURY BUILDING -& -CODE ENFORCEMEWU 742 Bay Road - Que*2!ns1bpur-y MY- X2804 S PTI C DISPOSAL SYSTEM I NSOECTI ON Name Location D a t e ��, — j 4::: � P e rm 1 -t X SOIL TYP _ Sand- L m- Cl a, - Resul -ts O-F Per-co? at ` Test__ ( i f app 7 i cabl e ) -Ra a-M! to/Inch TYPE OF SYSTEM= _ ABSORPTIOW FIELD : Total L ngth Length of each tr, nch * x xy, Depth otrenches Size Of` 4tone SEEPAGE P - Nu b - Size - x -Ft _ Stone size PIPING : Size - Type Bldg _ -to Tank ` Tank to Dist - Boxes .gip D - st _ Box to Field Pi _t Open -i ngs Seal ed ? Yes NO Part3 al L_OGATION/SEPARATI S FOunda-ti on to Tank -feet Foundation tO A so p ti on � -> --feet Separrati on of P ! is feet Conforms as per - PZ t Plan es �_ LOCATION OF SYSTEM ON PROPER _ Front' - ear - Le-Ft Side - Right Side e ea r COMMENYS = _ A3 V SYSTEM USE APPROVED = YES O A r ir--i yr ie c��a� ► Dop ced - f d At I� 11 I 4J lo. >- it W H �y { . 'Vr%CL , N Z w I or w WAD u I 04-) EU U} Q I' S.0 4J (U Q �� 0 W or U C � r.. ,'� � II � � � a� � (� 4J W W c °° 1 0 1 S. P z U) 0 W I u o ' or' N 0 U Q1 y Q ul a r"' "o c zW a roPP F- c S- 0 WO On M �, � 0 �S ro N a 0 0 r" � � v w Q 1 00 r C� S. Ul � X r M C IA 4J 0. W N If- > ui u� t• Q) M-S�u 0 p r-W H U C 0 I ac 0' 0 4- av, Q. N (1.0� LL 0 N C cn >~ p 0 4-� o �, S. � � r 0z � I� fv ro� p � 'oh� roN � av'- 0LLIroc � 4- u � � �H cly F- or+ u� c� ceGroQcn► o � W qW 0 �r 0,14- O l N �.y P X ,n `''-. 0 0 0 OW. $I- �"/"f MI ►W ir- 04 0 4. 'r 0 0 (t it or 1r b■I o V) LL 0 W w �� � 0 M��'�yI P +J � 6..,i fV a � 1" COfr1.1 �t r U 4J CIO L .0 00 4J CM m m ro � Ow �- C� +a r— (U lY P IC Q (D Z - , 'r '0 '0 S. 0 U 4JCL > W N m 4) -j :1W00)41 (DCO. Q) ct-40.YPC 1~ Cro4• C'o � r � a V) E U 4-) Fq 04- LLOM C O.NW N 0CL -0 C 0 NU 0 7 QCUfr 0'0 �: it 0 0 W Qlor- P' tU ()or'W -r +)Hr- roor" 0.000000 U Sword � M � y SHEARER ,` 'I have observed,'or believe I saw vidence of, all objects such as o wells,trees,fenc ,etc., shown on this document I'also represent th have >w Personally measured th distances set on t diagram," 72.4-2 ' 72.4-1 SIGN A R DaT , �g 6� • 72.4.3 d 1✓ ti 72.4-16 72.-1-� Wry� ' _ Aul: DING a . REVIE D BY , W B .. , DATE s . SCALE.One Inch Represents 30 Feet " Produoed.by the Town of Queensbur ,NY,Planning Department 03/16/2000