2000-284 NNE-- SOON Elio PON
C t f t 'lance
'er 1' l' C,*1a e o COMPI
ToYYnofQtieensbury
Warren County,New York
May 11, 2000
Date
2000284
This is to certi that work ropested to be done as shown by Permit No,
has been cotnpteted,
SEPTIC ALTERATION
This structure may be used as a
16 SHER11OOD DR.
Location
Owner WADLEIGH, GLENN & LYNN
•
TAX MAP NO. 76 -1-17
By Order Town Board ,
OF GUEE
Director of Building & Code Enforcement
BUILDING PERMIT
Town of Queensbury,742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 2000284
TAX.MAP NO. 76 . -1-17
Permission is hereby granted to WADLEIGH, GLENN & LYNN
Owner of property located at 16 SHERWOOD DR.
in the Town of Queensbury,to constructor 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:
16 SHERWOOD DR.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
SANITARY SEWER
Contractor or Builder's Address:
DAN DRELLOS , PO BOX 224
GLENS FALLS NY 12801
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
Proposed Use:
SEPTIC ALTERATION
$ 2 5 PERMIT FEE PAID-THIS PERMIT EXPIRES May $ 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 8 Day of May . 2000
SIGNED BY ��� for the Town of Queensbury
Code Enforcement Officer
Applicaliull Cut• I'el•Irlit—Septic Disposal Systole,
a 4 I U11�11 t?f Queemybill), T.12llrry llocrcl Oleellsbul l>, NY 128U4 (.518) 761-82.56
1 -ONV ER INFORMA'1JON:
........................................................................................................
Location of installation: � Ucl CE( &.r 1)v 10 Office Use�
Tax Mail No. // Potttiit NIO. - -•'ti•-�
Owner's Naulo•_{ i L. Cam;✓v 6./A`1>6g, , q�j
................................._.............................................
..............
Address: i -Ql-
1
2. INSTALLER'S NAME ;F}-/(31: 7 i,z�j (/GALLS �+ - PHONE N0.7 92- ' ox• 7
3. RESIDENCE INI:ORMATION: (circloyear of dwelling„ indivole JJ berlrooln(t) and multiply// ciJ'
bethwonn with applicable y(r1kilrs Pei-be(lrovm to equal liner!tkrily fluty)
)olir of I.Iotlso' No. of Bcdrool 1�s xL____;oil�f►ttta�i�t� - '1'Utat Dales I. Q
1980 or older __ _3 x 150 gal/btllul
1980— 1991 - x 130 gal/btlrnl =
1991 --lueseut x 1 10 gal/burnt =
Garbage Grinder Installed yes MOVED/ ilo
Spa or Whirlpool Installed yes / Ito f MAY 0 8 ZOQO
4. PARCEL II`FopO vIA'I'ION: (circle al)plicable iurortrtatiort & ,11d,cato ntoastn entents) TOWNDI OF ltitCa AED COCJE Y
_I-o 'ral?1 _ _ I�laturo tG:_cairlid�Wwt!-._1_ cl I3etock_or ITTnc�rvivtts_M�lcria) _i7 t'./at svt tit tv/rrrf rre/,!/r rrt a/rn!c/r=!/, — ^-W'tlet_Siiltltly,
•r!1//trg t nurnic��a/�
Steep slope clay tr e
slope other if+yell; +valet•supply
fi•irm;trtry seplic-system
depth: obsutptiult i.v ft.
othe!
I'orcolatiou`Post: (7'o be cto/lrpleled by licelr.secJ pr•t fi=ssivncrJ e/rgirreer cJr crrchrtt.>ct) W��
Jlate: ntinlrle per inch
5. PROPOSED SYSTEM: ,For New Constrilction: All individual selvage disposal syslems must be designed by a licensed
pref'cssional engineer or archilcct(unless installed in a 1'lalnling 130artl;+}t}novctl Subdivision). Add 250 gallons to 111e si/.e
of the seltiic tank and leach field for each Garbage Gr}ndet, Spa or Whil11xw1'Putt.
Septic'I'ank: �i2�1D gollon (nritr. size 1,000gcrt.)
'Pilo Field: ecrc/r lrenelr_ 1V Z) JL 'Total System Lcrigth: . 2-oo
Seepage Pit(s): nit"iber of size rJ'each: /1, tJy /1.
Sizo of Stolle to be used: it / ctcpth yr thlr kne.ta _ -/ie!
Bed Systonl Size: x
Altemativo System: length crnti/vr.size
6. HOLDING TANK SYSTEM: (if required)
Numbor of tanks: / Size of each: gallons /'1'91'AL Capacity: };aliens
Notts. Alnum System and associated clecti-ical wotk must be ilispected by a'Town approved
electrical inspection agency.
7. SIGNATURE &INFORMATION FOR RESPONSIBLE PERSON (please read)
For your protectiort,please troto Drat Pursuant to Section 136-29 ortlio Code of'Ute'Tawas
oI'Qtleerlsbttry, any permit or approval granted which is based upon or is granted in
rolinitce upon any rrrttorial ntisrnprosnnlatron or failure to ntnkn a rttnletial fact or
circulttstance knowit by or on behalrorart applicant, shall be void.
I hnve rend file r•otlu lilt form with respect to this rrpplicnlion trrtd nt;tno to nlrido by tfreso and all
1'equiretuont._ to'1*0ti 11 fir Quccusbtrty Sanitary Sewage Disposal Ordinance.
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T OVE
MAY 0 8 2000
Tr.)VVN OF QUEENSBiJR1'
`iJ1LDlI�G AND CQDE V
/oca� 9l� f
TOWN 9F QUEEN U �' 4 3
BUILDIN & 4J T.
REVIEWED
DATE
Ll
2000/284 76.
WADLEIGH, GLENN & LYNN. i
16 SHERWOOD DR.-
"SEPTIC ALTERATION' ". .
'~
F"Ihave
en or observed,or believe t sw a !&=sf,
F I.LE COPY bjeets such as houses,wells,trees,fe»ce , t
TOWN OF QUEENSBURY BUILDING DEPARTM .;?ow on this docu 1 also rem rn18
Based on our Imbd examination, _ , ; pally measured istan fern on the
compfianoswb our conwnents shall
not be consUued as indicating the !
plans and siretans are in full SIGN T DATE
compliance with the code.