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2000-395 e IA ti' fxate Comp%lia%^ ce Town of Queensbury Warren County,New York .Date June 8 , 2000 � - 2000395 I This is to ccrtif v t at work r*ested to be done as shown by Permit No. .. has been completed. SEPTIC ALTERATION This shitcture may be used as a 5 LYNNRTELD DR, Location Owner ROSE► RAYNOND & EVELYN TAX NAP NO. 81 o M2-7 By Order.Town Board "TO OF QUE Uff Director of Building&Cade'.enforcement BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VA*LUE $ 0 Building Permit No. 2000395 TAX MAP NO. 81 . -2-7 Permission is hereby granted to ROSE, RAYMOND & EVELYN Owner of property located at 5 LYNNFIELD DR. 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: 5 LYNNFIELD 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: SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS Proposed Use: SEPTIC ALTERATION 2.5 June 7 2002. $ PERMIT FEE PAM—THIS PERMIT EXPIRES (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.) 7 June 2000 Dated at the Town-of Queensbury this Day of SIGNED BY for the Town of Queensbury Code Enforcement Officer Application for pel"llit—Septic Disposal Systo,11, of Queeiil.vbuly 7,12 Bail 1?oml Queensbut:g NJ' 12804 (.518) 76 1-82.5(, 1. OWNER INFORMATION: ................11-11-1.......... .............................................. Locatioll of installation; Office Use Tnx map No. No. Owner's Name: F-00 Paid Address: ..........--...................................................................... 2. INSTALLER'S NAME 'JUN 0 6.2000 I r/-Ycv PHONE NO. 3. RESIDENCE INFORMA,riON' (circle year or dwell"" tai- QQ&M 1A 14,17iYv)and nuiltiply I/ (?/* bechwonu with applicable g (,(rl ,I.v pe �,l. e.rl equal twei1chifly.11(),p) You of -touse; No. of Bedroogis xVIIlpttt��iU�l .LQ,.lily EL ow 1980 or older 1980- 1991 150 gal/bdI III = 130 gal/Wrin = 1991 —present x I 10 gat/Wren Garbage Grinder Installed yes 1 110 Ly- Spa or Whirlpool Installed ' yes no 4. PARCEL INFORMX1,10N: able illf'orliantioll & ifidicato 1110asillemellts) 'r S LL allil-p -Y vruJt fee I feet Te// Stev/,slope Chey v0slope other sulply ph: fi-oln(my d c trbsviptlon is Porcolatiou'l'ost: Other Rale: minille Per Inch 5. PROPOSED SYSTEM: Llyr.Neiv Coils(rudion: All individual sewage disix)sal SYSICIIISAIIIIS1 tv designcd by licensed professional ClIgimer or architect(1111less il)51,11led in-1 11-11111illf; Add 25() g.111t)lls(t)1110.%iZe of file septic tank and leach field 1*01.each Galbage Grinder, 81m or whillix)UP1,1117. Septic Tank: Irio-0 gollon(in.111. size 1,000gCrI.1 'rile Field: each trade/1 57,0 it. 'retell System Leeigdj: 0-0�0 Seepage Pit(s): number size q1*vt7ch: Size orStoiio to be used: /I. clepth 4ri". Bed System Size. x Alternative System: length antl/ul-size G. HOLDING TANK SYSTEM: (if required) Number of Links: l Size of each:_gallons /TOTAL Capacity: gallons Note. Alarm System and associated electrical work amst be inspected by Town approved electrical illsim6tion 18clicy. 7. SIGNATURE- & INFORMATION FOR RESPONSIDLr--PERSON(please read) For your protection, pleaso x1oto iliac imistintat to Section 136-29 oftho Code ol'tho'rowl, ofQ11combury, any permit or approval granted which is based upon or is 1,ranted ill atorin I Ill is,cill eseeltatiott or lailoto I(:P make a ,,,aim jai 11 lutinfice,11poll any Im p Gil-c"Illstallec I—ow" by or oil behalrorat, applicant, shall be void. flact or I leave I .""I list iolls wills iospect to this 11I)JIlicillioll "aid tel-reo icy abide by tiveso"11dall req,rir017011cellsbilly Sanitary Sewage Disposal 01diflatice. Jua"ature of rasp pfifsIbloperson atop a� 600z .0 4J -0,0 0) Pr � u � 4- W w H +) N 0 r 4J a) " >1 wc ro 4-) ro c � r - r or" r{ ^' 0r CL '0 PK z 0 � W � V i t ,V ' ! Or. � W or- W �^ ! 0 B 4J .0 ' +� z V) 0. � � ' 0 E 'r0 0U• a 4 r W � ro t + +�c .0 \ Z - 0 O ro o r� Ix 0 °� 0 � 0 ,i ro z 4„-' ro W pp sQ M1 I .LJ r" ?� A r" " � (hT" W W I or > �, U J/( a ; 12 © U- a, i a U C vCL .0 L6ro (VCV) c4JOmC6 -P4J0 0 z ro ti +J 4)W . W T (0 U >0 41 4-)H tU h Or V i V)'C C C tS A Gi V�I�. N c x "�a L? C} �} W 0 'r 0 4rt �, r� N� of U C CL r W 0 4w Or 0 0 b') "!U•r'r " 0 0 /alp I/� 0 4-W 1 0 � -P 0 CO c�I��71 1 4J 4Jloo � � or 4J aOCLZ 00 1 0 4J CN 1V ro M Mr c r+ ro :9 4 .0 < a) X ¢,r- N" `0 `0 S» 0 lo" U + W W ! . CL 41 b 41 0 W0CA4J (A4) C* 0)-,� 4JC< CCro4-ICS- C `0 l" 114fd W U 4j uA41V) C0./NW +NOCLvr. U) a1c� : 30.CUOr070 V) S0 ( ro 0 0 Ci 0r ?►�MQ) a) rW � ro a000000 0 TOWN Q4QUEENIU Y --------- BUILDING' 2,0003951 81,-2-7 REVIEWED 5�SE, :RAYMOND & EVELYN ZYNNFIELU DR, , DATE SEPTIC ALTERATION p o° 7a71t,. e "I have seen or observed,or elieve I saw evidence of, all objects such as houses,w ills,tees,fenced et,, shown on this document,I alo represent that I have porso Ily asured the distances set forth on the diagram," r � RECEIVED SIGNATURE � DATE � �. JUN 0 6 2000 TOWN OF QUEENSEURY EUIIDPNG AN.