1999-328 r'
CERTIFICATE 01.E COMPLIANCE
TOWN OF QUEENSBURY
WARREN, COUNTY, NEW YORK
Da to June .1O 19 99
99328
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
Location 70 ;SWEET RD.. --
Owner SPERRY., TIMOTHY & ANN TAX MAP NO. 64 . -1-4 By Order of Town Board
TOWN OF QUEENSBURY :
Director of Building & Code Enforcement •
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BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 99328
TAX MAP NO. 64 .-1-4 • WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to SPERRY, TIMOTHY & ANN
OWNER of property located at 70 SWEET RD. Street,Road or Ave.
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 Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
70 SWEET RD.
QUEENSBURY, NY. 12804
2. CONTRACTOR or BUILDER'S Name .
CONDON SEPTIC & DRAIN SERVICE
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( )Masonry ( I Steel I )
a .
7. PLANS and Specifications.
SEPTie ALTERATION. AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION.
June 9 2001
$ 25 PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
9- June _ 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY `"'^'� for the Town of Queensbury
• Building and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
D-T)2-\
Dept_ of Community Development •Permit NO. �
Building &Codes Office UD
742 Bay Road Fee Paid $ c:96
Que`nsbury, NY 12804
Location of property for installation: l; SZ. ee -i R.D
Property Owner's Name: Sp - 7?,1— r 7,7- - . QV E
D
Property Owner's Mailing Address: 7 3 Sw E e f A7) J U N 0 8 1999
_-- < TOWN OF CtE.)teENSBURY
Installer's Name: S «.,gc ,i11 Phone # GOI1=
. Number of bedrooms (if residential . Total daily flow: /-, 6
(residential -compute @ 150 gal./bdrm.)
Topography: y flat, rolling, steep slope 90 of slope
Soil Nature: }<<sand, loam, clay, other /depth:
Ground water: .at what depth?A-feet / Bedrock or Impervious Material: at what depth? . feet
Percolation test: x not required, recuired [rate min. per inch]
Domestic water supply:,
Y municipal, well, other
If domestic water supply is a WFT T, water supply from any septic absorption is feet.
PROPOSED SYSTEM
&(Shill? Vo Cc E
Septic tanlc(( AD gallon (minimum size: 1,000 al.)
Tile field: each trench 5-6 feet / Total system length: )-0 0 feet
Seepage pit(s): number of / size each: - ft.by ft.
Size of stone to be used: # 2. / depth or thickness feet .
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HOLDING TANK SYSTEM: (if required)
Number of tanks: : Size of each: gallons
Alarm system and associated electrical work to be inspected by a certified agency.
For yoi protection, please note that pursuant to Section 136-29 of the Code of the Town of Qaeensbury, any permit or
approval grs1-•P 1 which is based upon or is granted in reliance upon any material misrepresentarnn or failure to make a
material fact or circumstance known by or on behhlf of an applicant, chid"(be void.
I have :.,ad the regulations with respect to this application and a...,.-ee to abide by these and all requirements of the Town of
Queens icy SanitAry Sewage Disposal Ordinance. 6
Signature of responsible person: ac-,71 _ Date: ^e`` r
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT.
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name \ YY� 42
Locatio7 12/^
Date tp 401 CI Permit #(- - a.?
SOIL TYP Sand-Loa Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Len
Length o each trench, C
Depth of enches
Size of ston
SEEPAGE PITS: Numb -
Size - f x ft.
Stone size
PIPING: Size
Bldg. to Ta C->C • b 0
Tank to D. t. Box 50o��0
Dist. Bo.. to Field/P ice,
Openings Sealed? 4111, No Partial
LOCATION/SEPARATIONS:
Foundation to Tank /feet
Foundation to Absorption feet
Separation of Pits _ , feet
Conforms as per Plot Plan No
LOCATION . STEM ON PROPER
(circle ne
,,. Front - Re'ar - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
s i 5 i�T e n) -mac
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SYSTEM USE APPROVED: YES NO
Arrived:
Departed:
Building Inspector
I//7, stew A ` .` LQ -- 1736 �011lCfotU S' .5ft rC P14/91/1J S(c%Q1/I!
.73 Sweef ii'D (1_y (R,.V 'AVE , 79f4s- y i
• ,_: ufteNs Su r y 'lL ? - I...O y G/ ,i,g J s/ 11).7 1 )- CrC t
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/ 6, JUN 0 8 1999 mo
TOWN OF Q E NSBURY
BUILDIN AND ODE �Sf. 4
N�'w � G.
JUN 10 1999 I U
TOWN OF QUEEN SBURY 0 C�7NCr4- S r rill
d
BUILDING AND CODE
ugu .7'€X�s tr�if
4
"I have seen or observed, or believe I saw evidence of, R _ .r- k-- .�
all objects such as houses, wells,trees fences,etc., �.
shown on this document I also represent that I have BUILDING 2 ,�- 1.-�;. a
i personally measured the distances set forth on the diagram." 3 .,x o,PT
REVIEWEn B
6' L )—Fig ®ATE -:
SIGNATURE DATE ,==___„,« __