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2000-283 ^' y.,,•'^"1•.+ `V•'���..'w"J'e�^F�r�w...,, �r N M• .. , i at i ° v , op lance m C-er"ti, ica e o C I.r Town-ofQueensbury Warren County,New York May 5,1 2000 Date 'his is to ceftify that work requested to be done as shown by Permit No. has been completed, 4 SEPTIC ALTERATION This sfivctur6 may be used as a 3 LAUREL LANE { Location Owner HECK, ANNE JOHN TAX MAP NO, 121e -1-534 By Order Town Boar' TO OF QUEB SBURY Dire tor ofBuil ing& CokEnforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518)761-8256 VALUE $ 0 Building Permit No. 2000283 TAX. MAP NO. 121 . -1-53 . 4 Permission is hereby granted to HECK, ANNE & JOHN Owner of property located at 3 LAUREL LANE 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: 3 LAUREL LANE 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: SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS Proposed Use: SEPTIC ALTERATION 2 5 PER FEE PAID—THIS PERMIT EXPME5 May $ LVIIT 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 S Day of May 2000 SIGNED BY C= i . for the Town.of Queensbury Cade Enforcement Officer Application foi• fcrniit—Septic Disposal Systeltt IUIvll of Queen.vbiny 7.12Bo iRwid�l(et�IJ.CGNI;I{ NJ' 12804 (.518) 76/-82.56. I. OWNER INFOR1b1A'i-ION: .............................................................................................................._.-. Location of installation:_�, (Z L� G, � Office Use Tax Map No, )/� / Itilo 110111tit No. � '�� Owner's Name:y V 1� ,�) ���� Iteo Paid a,5—U� Address: _ ............................................................ 2. INSTALLER'S NAME � _ tic v/cam PHONE NQ. x--2d 3. RESIDENCE INFORMATION: (circle year 0-dwclliug, irrdivale 11 bedromn(1) anti multiply Il (T/' betb-ommy with ailplicable 1'[111olls per Beth-ooln to ethlal IOI(JI d[T11J�lIf7)P) �(nar of I-lous% UP. of 13etlroot 11 s. x Coiilptttaliotl — 'W;�MAIy Itivy 198 or older J� x 15(1 gal/burnt = �y a 1980— 1991 x 130 gal/bdrin = �� 1991 —plresclit x 1 IU gallbtlrur = z, a 8 2000 Garbage Grinder Installed yes / lie pE TOWN QUEEIVSBURY Spa or Whirlpool Installed yes / Ile, BOIL OF AND CODE 4. PARCEL INFORMATION: (circle al)lTlicable infoririatiou &indicate ntoastncments) tturo Gsilitcl^Wzil�r I3ecliocic ot�i►/l�si_v_ivits Mtitetial _I� cc rn)r/ at whnl c%pI/T ut»hrrl rR•Tth Ss1+14_..._�Watcr Stiilitly 12v1!/TT, I nun)ic•t,<rt �-�--T-- �. U[JTTr ieep slope (Jy °fo slope other If well; Jvvter supply depth: from criry septic-s)yvtem crbs'oiption i.r fi. 1)01-cOlatioll Test: (To.be c.4lmpleted by licet}sed!)IY fG'SSIUltC7I e/rglllee!'t7t'trl'ch%tGCtl other Merle: /itllirtle per Inch 5, PROPOSED S VSTEM: ror Neiv Cullstitilctiort: All individual semige disixmil syslents mist be desiglicd by a licensed prol'cssional cngincer or,architcct(uulcss inslalied in:1 I)hlnning Board ilptomd subdivision). Add 250 guill(ills Ill iiie..;iZe of the septic lank and leaell field 1101'each Gaf bags Grinder, Spa or Whil tpoul'Cub. Septic Tank: (3D D gnllvn(niter, size I,000 gol.) Tile Field: etich trench /"'��' fl. rot.tt System Leeiglh: Seepage Pit(s): iminber of 2- size gl'ectch: Size or Stolle to be used: l/ � J clop/h yr th/ckt)ese __?i `__.l[•t Ded Systoni Size: x Alternative System: length an l/ot'size G. HOLDING TANK SYSTEM: (if required) Numbor of tanks: ! Size of cacti: gallatls /TOTAL Cipacit.y: gallons Note; Alarm System and associated electrical work must bo insl)ected by a Towll approved olcctrical inspection agency. 7. SIGNATURE cvc INFORMNI'lON FOR RESPONSIBLE PERSON (please read) For your protection, please cote titer pursuant to Section i 3G-29 of tiro Code of Uie'T n ow of Queensbuty, any t7wittit or npprovnl grallted wilieb is based upon or is grantctl ill reliance upon nny,int)torial enisrapresonlalibn or thifura to rtutke a itiatotial Biet or circuittstance known by or oti belialfofall applicant, shall be void. I hnvo rand file rotlulntioris vvifft lospect to this nplrlicntion and nt;Jao to nt)idt) by fboso and all requii•ematits oCtlto'1'ovvu arQttcansbtlry Sallitary Sowago Disposal Urdinatice• Sig ature of respon Ible person Date 0� f 19 � 3 `►i " i""� (� "�1 '�#�`°a © -I Cl� '�t� V'f (l� U? L7 C�t �� �! l� t"' � f l< ©dp a, 00 (D 0 0 0�0ti �.�a � Nto � 0. TONMN 'UZOT-ho M C+ C} m-i ct tD > 3. c+ a Ct W zN .JM W W a CF 0 00 0a Cf ►* �! 11 fi0 0 O 04 X 0 N V 0 � r. G Cis " 0 Ci' zV1 CT' 17 I f t ' 1 J' " +" Off/0 0 � Z © 0. a s No 1 Pico yis 10 0� C c ` N40 (A rh t H (g nx . Ns 0 1 (D ° 0 �; 0 rt n Cis m (D (D c+ O. O (D O .j F C rZpn o -� )oca qm- i CO D ati °G la�� Ioo�� mao IV d TOWN 4F QUEENSBURY "I have seen or obse u believe all objects such as h ued,or belaaua I DUI INS PT, s on t , ses,wells,kee; his dacu, t,I also r row von;-4 REVI D BY P so ally measur distaeha DATE �it� m. SIGN D 20002V `121.-1.�53,4 HECK,,ANNE' & JOHN' 3 LAUREL LANE ; 86 M ILTERRTIOR