1999-228 .•
• CERTIFICATE OF COMPLIANCE
TOWN Or QUEENSBURY
WARREN COUNTY, NEVV YORK
7 May 99
Date 19
99228
This is to certify that work requested to be done as shown by Permit No.
has been completed.
•SEPTIC ALTERATION
• . This structure may be used as a
23 WESTLAND AVE. •
Location ,
SCHNITZER, DAVID St LINDA
Owner ,
'. TAX MAP NO. • p . -1-2 5. • By Order of Town Board
TOWN OF QUEENSBURY •
airM
, • "
Director of Building & Code Enforcement
. ,
BUILDING PERMIT
TOWN OF QUEENSBURY 99228
VALUE_.. $ - 0 No.
TAX MAP NO. 80. -1-25 . 31 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to SCHNITZER,.- DAVID & LINDA
OWNER of property located at 23 WESTLAND AVE. Street,Road or Ave.
in the Town of Oueensbury,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 Town of Oueensbury Building and Zoning Ordinance.
1. OWNER'S Address is .
23 WESTLAND AVE. .
QUEENSBURY, ":NY" : 1.2804 .
2. CONTRACTOR or BUILDERS Name
I.B.S. SEPTIC
3. CONTRACTOR or BUILDERS Address
2,, LOWER ;WARREN•.STREET.`.
QUEENSBURY,. NY. -.12804
4. ARCHITECT'S.Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( I Masonry ( )Steel ( 1
7. PLANS and Specifications
SEP '.IC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 May 7 2001
,$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
Of a longer period is required an application for an extension must bemade to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
7 May 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY for the Town of Queensbury
Buc nd omrqInspector
^ 1
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury RECE D Permit No. t 9_aa ,
Dept_ of Community Development �9
Building Bay &Codes Office
742Li��,
Bay Road MAY 0 7 1999 Fee Paid , S ""-
Queensbury, NY 12804
TOWN OF QUEENSBURY
BUti.D14G AND CODE
L
ocation of property for installation. �''C' 5 l � � c.-c Gh v�1 Tzer
Property Owner's Name: � /l(D �'C 5C 4 Ai/ l®
Property Owner's Mailing Address: 3 $ (�e� -d /¢vc_
Installer's Name: I? 'I J?, Se J rpi i Phone # 7/ 1?"--g/ 9 f;K
. Number of bedrooms (if residential): 3 Total daily flow: Qa'
(residential - compute @ 150 gal./bdrm.)
Topography: , rolling, steep slope % of slope
- Soil Nature: sand, loam, clay, other /depth:
Ground water: at what depth?/154feet / Bedrock or Impervious Material: at what depth? feet
Percolation test:,'not required, required [rate min. per inch]
Domestic water supply: municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM ,cam
e k/f / +A
Septic tan/190e gallon (minimum size: 1,000 gal.)
Tile field: each trench feet / Total system Iength: feet
r
Seepage pit(s): number of D— / size each: . ft. by e , ft.
Size of stone to be used: # / depth or thickness ( feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Gidarm system and associated electrical cork to be inspected by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or
ayr ruval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance known by or oh behalf of an applicant, shall be void.
I have read the regulations with respect to this applic 'on and agree to abide by these and all requirements of the Town of-'
Queensbury Sanitary Sewage Disposal Ordinance.
Signature of responsible person: C' Date: ;Ids- ),,,(2
\ �
)P TOWN OF QUEENSBURY ( pn^—
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location 1 _
Date 7 Permit # ' oWe
SOIL TYPE: and-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches _
Size of stone
SEEPAGE PITS: Numb:
Size - - ft.
Stone size
PIPING: ize Type
Bldg. to Tank -n
Tank to Dist. B.x
Dist. Box to Feld i t • « a4C-
Openings Seal d? es - Partial
LOCATION/SE' IRATI
Foundation to Tank F/r .. feet
Foundation to Absorption r feet
Separation of Pits -et
Conforms as per Plot Plan 400Pto
LOCATION OF SYSTEM ON PROPERT':
(circle one)
Front - Rear Side
Middle Front iddle Rear
COMMENTS: - -
•
SYSTEM USE APPROVED: C-YES lO
Arriv
Dep t - ,.
Build g n ector
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