2000-407 � � p
/C t f a e of omlo,
e r 11 C; C vi
lance ,
"Cows of Queensbury
Warren County,New York
Date June 160 2 0 0 0 0
200@407
'his is t certify tha wcr i requested to be done as shown by Pert No,
has been completed,
This structure may be used as a SEPTIC ALTERATION
M�
Location 29 JUKE DR
Owner ... ..M,� RT LMV
TAX MAP NO, 7 2. -3-2 �- rder Town Bo#
TO �� r
Director of Building&Codc Enforcement
BUILDING PERMIT
Town of Queensbury,742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
. VALUE $ 0 Building Permit No. 2 0 0 0 4 0 7
TAX MAP NO. 72 . -3-2
Permission is hereby granted to SWEET, ROBERT & AMY
Owner of property located at2 9 JUNE DR..
in the Town of Queensbury,to constructor place aSEPTIC 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:
; 9 JUNE DR.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
EANITARY SEWER
Contractor or Builder's Address:
IAIN DRELLOS PO BOX 224
CLENS FALLS NY 12801
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
Proposed Use:
SEPTIC ALTERATION
25 June 13 2002
$ PERMIT FEE PAID—nus PERMIT ENPIRES
(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 thi 13 Day of June 2000
SIGNED BY -�Zzsatr�i for the Town of Queensbury
Co M7154forcemeni Officer
Application foli permit—Septic Disposal Systoll,
7i)11,11 qf QueensbUI)l 7.12 HOT/?(1(11/QUellf/s/5my, NJ' 12804 (.518) 7614256
I. OWNER INFORMNIJON,
...................... ...........I............................. .................................
Loctitionofilistallatioll:_Z.9 Office Use
Tnx Mal) No. Kilo Pot I I I it
Owilar's
T4 p_�.yam trot I�atd
Addrosm: A—t— ............I.............. ........................................................................
2. INSTALLER'S NAME
NO.,PHONE
3. RESIDENCE INFORMATION: (Circle )vat-or(iw;4N41,, intlicale bedrotnil(j) 11jul
beh-
coonts with applicable I,,11alls per bedroom to e(III.,1 1()t4 rA j
M,
Yopr of I-lo Iso; No. of Bedrootlis CQDE�
_N III -- 1 11 10
1980 or older x 150 8.11/6(11111 = da
1980- 1991 x 130 gal/b(II-111 =
1991 -prosent x 110 gal/b(II-111 =
Garbage Grinder Installed yes bll-
Spa or Whirlpool Installed yes Rio •-6—z7i
A. PARCEL INFORMATION: (circle nliplicnble iliforilttiou &illflicita fit".stlicluctitn)
11.
npklky —S 0—
<Zm I-- D 11? SC r fit It-herf depth— crt what tlepfll
MP-1/ing IUfrlrt
Steep slope clay -fte! uv//
v0slope other If"vell; water supply
from tri1j'septiv-sj'slem
absotplion is
I'017COlatiolllist: prtOther
Rate: minute per Inch
5. PROPOSED SYSTEM: For,11civC0113tvidion: All individual selvage disix)sal s3,s(enls I11t1s(t)C(1cSi911Cd.by licensed
Ptolbssiolml engineer or architect(unless installed illa (11.11111ilIg BOMA 111vioved subdivision). Add 250 gallons to the size
of(Ile septic(ank and leach fiel(l for each Garbage Grinder, Spa or Whil 1poulTub.
Septic Tank: 0 gallon (ham size 1,aoo gcll.)
file Field: eac/.I trench '15-0 Jr. Total System I-ClIgib:
Seepage Pit(s): nsimber of size qf'each:
SizooCstollotobaused: depth or thickiyess
Lied Systoltu,Size: x
Alternative System: length and/o/.size
G. 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 approvetl
olectricil inspection agency.
7 SIGNATURE I &INFORMATION FOR RESPONSIBLE PERSON (please read)
For your protection, pl".so uoto(11,1t Iyu,sunut to Sectiou 136-29 orthe Code ofthoTowil
or Queensbury, arty imtruit or approval granted which is based upon or is granted in
1-01inlica t1post any luatovinl 1 .1
-oti behalrorm, applicant,circumst-mice known by or shall ba void.k*yr I` il"'a let 11-ke a " afelial flact or
I linvo sond 1110 rogulst(iolls %vills Nospect to flais 11pplicnii"11 culd n1,100 to Si0ifill by theso and all
require tuat 'a'l*o%v11 0rQ"001isbu1Y Sanitary Sowngo Disposal oldill.111ce.
8 Unature of respo, I le person ate,
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RECEIVED
R 1'] St� 12 5� �9�C_
If
JUN 14 2000 _ I
Dr� TOWN OF QUEi ENSBUR
BUILDING AND CODE
0'
TOWN Q;QUEENSSURY BUItDIN ERARTKNT
Based on our limited examtn lion,
compliance with our comma is shall j
1,
not be construed as indicat' the f
plans and specifica#ions ar in full Y
compliance with the code.
TOWN OF QUEE SBURY
BUILDING & S PT.
REVIEWED BY
-777
DATE
"I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells, trees, fences, etc.,
shown on this document. I also represent that I have
personally 'red the dis trances set forth on the diagram."
NATURE DATE `