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2000-189 • -ertificta e o t f Complianulle Town of Queensbury Warren County,New York Nay 51 2000 Gate This is to ccrtif that wor re nested to be one as shown by Pennit No, has been cogleted, SEPTIC ALTERATION This structure may be used as a 151 HUDSON POINTE BOULEVARD Location Owner OUAYF ROBERT & EL,AINE TAX MAP NO. 148,-S-95 By Order Town Board TO Off' QUEEN UR.Y jjff�jry/ .. Director of Buildi g&Code`. nforcoment BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 0 Building Permit No. 2000189 TAX MAP NO. 1.48 . -3-95 Permission is hereby granted to GUAY, ROBERT & ELAINE Owner of property located at 151 HUDSON POINTE BOULEVARD 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: 151 HUDSON POINTE BLVD. QUEENSBURY, NY 12804 Contractor or Builder's Name: SPRAGUE POOLS Contractor or Builder's Address: 294 BROADWAY FORT EDWARD., NY...,..12828 Electrical Inspection Agency Type of Construction: SEPTIC Plans and Specifications: SEPTIC ALTERATION AS PER- PLOT PLAN SPECIFICATIONS Proposed Use: SEPTIC ALTERATION 25. , April 12 20.02-,-_ . .. . PERT Il�EPAID:---T-FUS.�-PER-NH-T--E--XPIR-E-S---:-�------ - (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.) 12 Apri 1, 2 0 01 Dated at the Town of Queensbury this -MV-of. SIGNED BY for the Town of Queensbury Code Enforcement Officer Application for-Perillit—Septic Disposal System .Town(,?f Qteeensbilly 742 Bay load Qrteensbwy, N)' 12804 (.518) 761-8256 I. OWNER INFORMATION: ............................I......................................................................... ................ Location of installation: Z�o 06 Office Use � y Tax Map No. File Pornsit No., Fee Paid Address: -Q A-ALo" 12 rg J Ud/ 2. INSTALLERS NAME Poo 5 PHONE NO. 2V2 7D 3. RESIDENCE INFORMATION: (circle year of dwelling, indicate 11 bedrooin(y)and multiply// Q/. bedroolyis with applicable gallons per bedroom to equal total dcd1jyjlo1%,) Year of House:. No. of Bedrooms x Computation = Total Daily Flow 1980 or older 150 gal/bdrui = 1980- 1991 X 130 gal/bdrin = 1991 -present 3 X 110gal/bdrfii = APR 12 2000 Garbage Grinder Installed yes_ 1 no Spa or Whirlpool Installed yes no OF QUEENSS� 71LD'NG fi -\ND 001 4. PARCEL INFORMATION: (circle applicable information &indicato ineasurcruelits) era by S a tire Gro ind Water _-DecttcLcLk or linp-savious Material Domestic Water SulU2jy 'lore P*Iat .1471id al Wiest depth at VVIIL71 depth oiling c Vain feel &11-111-17--i-1 I=,-,F 5 Steep slope clay fief i-ve-7T­ slope other C'-'JaLb 13 8;dat'a if ivell; wtater supply depth: fi-oln any septic-system absotyition is_ft. other Percolation Test! (To be completed by hcensedprojLssional engineer or architect) Rate: Ininute per inch S�9- to-&"t- - L' YPL,L/ --two n Bat U 5. PROPOSED SYSTEM: For New Construction: All individual sewage disposal systems must bc designed by a licensed professional engineer or architect(unless installed ilia Plaullilig 13oardaj-provcd subdivision). Add 250 gallons to the size of llic septic tank and teach held for cacli Garbage Grinder, Spa or Whirlpool Tub. Septic Tank: 10DO gallon(min. size 1,000 gal.) Tito Ficsi c" trench Total System Length: ji. See Pit(,): number of each: fi. by Size of Stone to be used:. It TV fthrrItT1W depth or thickness "'t Bed System Size: X Alternative System: length and/or 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 inspec"tion agency. 7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON(please read) For your protection, please note that pursunut to Section 136-29 of the Code of the Town ofQueensbury, any perinit or approval granted which is based ull'ou or is granted ill reliance upotiiny material suisrepresciitatiou or flailore to make a material fact or circumstance kil6wa by or oil behalf of all applicant, shall be Void. I have road tile regulations with respect tot],is application and at,*roo to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. 0 /0 o ate Signature of r6s 3,Zn�p�erso� '+4 r f\ V J (D (D Q) ' CL 4 41 W 4- W �' i C N 0 tY \1 . Q 41 N r W U OD a i v14J 0 OIL I IL M� � � or. r. � r. I r �loin a) MI W 1� Q i +7 4J (D } '� a 1 tr- Q W p. X n„J J r U: . ( W L6 u +� i a aX r, 3~ W v �r- .j � Ch Q C U LL 0 roccoz UQ '� r� + 4a�i I� CA 4- u rocn +Jc� W u�Woro � Q w a '� � 4- �1 N ~Ll � fl� ' Qp �QCa) 0 � � W + C ( C. r- M Q t}. �r a a VI ,r. Q Y w V) i 0 in a LL C .W th # Q, -° 0 s Q Q)Z 41 n �- VV L Q�- U4JrW , W a 0 0 WQ M4J0a. CHCn� -P n:3aC c�< 1- 0ro W � gn ,� U a cn4- Nc aNWNat� roc cn a Uc� � SQ � .� 0o � I' 0 4 0 0 W -r �Hr� ��Na0a © N00U, » ,r o S• � 4 acn000l� �al� oo �►w�. cnU.���, M c S4, kyr t ���, f 12 5N , seeo or o eruedGo'b f ieue I sa ri cocc of, all objects such s house'Isr,gees;fek 00 o,, 'a shown on+his Omni,I a so represent that 1*8 prsonally mur the dis no Set forth oa the diagram" ,�1 SIGNATURE DA E 14 OF QUPEN ' 1 8 IDING& 0 REVI rV 00 1 I HEREBY CERTI� THAT THIS MAP WAS PREPARED FROM AN ACTUAL FIELD SURVEY. THIS CERTIFICATION SHALL RUN ONLY TO THE PERSONS FOR WHOM THE SURVEY WAS PREPARE:, AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENT; AGENCY AND LENDING � INSTITUTION LISTED HERE, !. CERTIFICATIONS ARE NOT!TRANSFEREABLE TO ADDITIO?';AL