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1999-419 V..... =..W _ --- Certificate of • Compliance Town of Queensbury Warren County,New York July 20 99 Date c)q J 0-- 34 0, . 994119 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 • 9 OWEN AVE. Location Owner GLENN, STEPHEN & DEBORAH • TAX MAP NO. 77 . -1-21 By Order Town Board O I OF QUEENS 3).3Ij`�' / G-LA-;.(7--5,..4 .4 . . .-''' c____) Director.of Building&Code Enforcement BUILDING PERMIT VALUE:. $ 0 TOWN OF QUEENSBURY Na 99419 TAX MAP NO. 77 . —1-21 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to GLENN, STEPHEN & DEBORAH. OWNER of property located at 9 OWEN AVE. 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. OWNERS Address is • 9 OWEN AVENUE QUEENSBURY, N.Y. 128.04. .. 2. CONTRACTOR or BUILDERS Name CONDON. SEpTiC: &. DRAIN SERVICE: 3. CONTRACTOR or BUILDERS Address 4. ARCHITECTS Name 5. ARCHITECTS Address 6. TYPE of Construction—(Please indicate by X) SEPTICI . . ( )Wood Frame ( I Masonry ( )Steel ( 1 7. PLANS and Specifications. . SEPTIC: ALTERATION..AS PER PLOT PLAN. SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION $ 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.) 8 .: . .. .: :... July .. 19 1999. Dated at the Town of Queensbury this Day of SIGNED BY ( � Wl for the Town of Queensbury Building and Zoning Inspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury RECEWED Permit No.C) ' ( 9 Dept_ of Community Development Building &Codes Office 742 Bay Road JUL 0 7 1999 Fee Paid oU Queensbury, NY 12804 TOWN OF E r n Location of property for installation: 9 9 419 7 7,. -1=21 ' GLENN, STEPHEN & 'DEBORAH - Property Owner's Name: ..S ; 9 OWEN AVE SEPTIC ALTERATION Property Owner's Mailing Address: C © e€/1'// ,H`E Installer's Name: ^ �'/7/�6Gv S �� �c C����� �'� Phone # 2�(1 --��5/L . Number of bedrooms (if residential): Total daily flow: (residential -compute @ 150 gal./bdrm.) Topography: flat, rolling, steep slope % of slope • • Soil Nature: sand, loam, clay, other I depth: Ground water: at what depth?4 feet / Bedrock or Impervious Material: at what dent feet Percolation test: ( not required, required [rate min. per inch] Domestic water supply: y municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tanlcrl.id gallon (minimum size: 1,000 �I.) �I IV��I Tile field: each trench - feet / Total system Iength: 4 feet Seepage pit(s): number of / size each: . ft.by ft. Size of stone to be used: # / depth or thickness feet I-OLDENTG 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 your protection, please note that pursuant to Section 136-29 of the Ccde of the Town of Qneeasbury, any permit or approval granted which is based upon or is granted in reliance upon airy material misrepresentation or failure to make a material fact or circumstance]mown by or on behalf of an applica-re, 01al1 be void. I have :mod the regulations with respect to this application and ag ee to abide by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Date: '/G� Signature of responsible person ` � IlL, i,--..- .i f TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name CAQ.4,-Q___C:,---k Location oco-eAr\A) -- Date -]-.0_ Permit Per- L'1 C) SOIL TYP : Sand Loam-Clay- Results of rcolation Test- (if applicable) Rate-Minute/ • h TYPE OF SYSTEM: ABSORPTION FIELD: Total enpth � Length of each trench Depth of trenches Size of stone 1� SEEPAGE P ._ N - Size - fr.- x ft. Stone size PIPING: - Size ype Bldg. to Tank Tank to Dist. Boa 10 Dist. Box to Fiel. /P' IA IL Openings Sealed? Yes No Partial LOCATION/SEPARATION • Foundation to Tank feet Foundation to Absorption (' feet Separation of Pits feet . Conforms as per Plot PlanIll) No LOCATION OF SYSTEM ON PROPERT (circle Front - Rear 7'/ Left Side - Right Side Middle f- on-C- Middle Rear COMMENTS: L /� 7 C-G A`s- 0lL7 o C\ SYSTEM USE APPROVED: YES NO Arrived: ' /,/ Departed: •55 ' Building Inspector 5 i� ye' �F/11N '°Ilk A c SE? c mac°.�r9/� --Cf4c (it)L ©w�,✓ v - 7p� Y66 Z I sit__ C474-f f rg-oq- - 7 c -SfV L �o FFtisgvr y s�.Y y � Gie�Y Ed& aO-? (k-e/ 99 -- 1 e r1:3 8 "I have seen or observed, or believe I saw evi all of�iQcts such as houses �rells, tre� o Bence of, JUL. 0 1999 sho�Nr s, fer�c s, etc., Iatero ! n this document. I also represent that 6e fC��,�,. �t="'w `r�ufl�� personalty n,� I have asure d the distances set forth on the dig �ram.'� °� SIGNATURE ~` A] tul 7-- DATE z. © - . o OW ...Jo_ ,_ J 2 ) `at7 c .p`G TOWN O DU r?l �i � ,;'_; ` _';=<, 1 i�i�NT ( J � � f7rjs�0 Oil our limit�t;EXaafFiill0t1�:3n, 6 IN C r� compliance ti�rith our corm tints shall 0,0{)1 not be construed as indicating the plans and specifications are ir.fail F compliance with the codie. .3 _J�� ) RECEIVED JUG TOWNOFENSB � �' �9�9 .J � �z cr c:��D9 39BuRy � L °� a j APT. su��®�rv��fvD cn�E REVIEWED f~Y _DATE 2 7 /._5..._ O( I VIIIL TOWN OF QUEENSBURY I 9 BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION NameES -2/\)"--Q- (lae/ ..__Location Ck D1, M � NU Date �N-9Ci Permit # C \CA' ( / I SOIL TYPE: Sand-Loam-Clay- Results I of Percolat' .n Test- (if applicable) Ra e-Mi ute/Inch TYPE OF SYSTEM: ABSORPTION FIELI: Tot. Length Length of 'ch ren Depth of tre . A. Size of stone SEEPAGE PITS: Number- Size - ft. x ft. Stone size PIPING: Size Type Bldg. to Ta _ r7'� �! Tank to Dis . Box Dist. Box to Field/Pit Openings Sealed? Yes No Partial LOCATION/SEPARATIONS: Foundation to Tank feet Foundation to Absorption feet Separation of Pits feet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPERTY: (circle on Front - e v - Left Side - 'ght S' e Middle F ont - Middle Rear _ COMMENTS: 9 — -T-FrAg P -- LGT 6 kF F-6 - 0< SYSTEM USE APPROVED: YES NO Arrived: /- �/ Departed: Building Inspector • -� r �r c�r�runf � c -"? c`c�c y�(r9, O -5 esI c (�/G �����s�vey �_� 1 y Gig,�bj FoAf tV�y 0 r d99r • - , • •.7,9.19 . ' E "I have seen or observed, or believe I saw evidenceobjects eof, [^ JUL 0 7 �ggg such as houses, wells, trees, fences, etc., _ I ��� Fa shover, on this document. I also represent that I have r TOWN O Q� ."�iSBUR1' personally measured the distances set forth on the diagram." G L3tl9�.®it'�tU�£Jf5 CODE e A) tai .�`S 4 ` 6)L• SIGNATURE DATE CIP • 6 a v • . i\y%60 LP° sEr-P . , . conjc rcc-I'l- • Tow,...,.,;3 ,:-.-„.7:. (--,q p7,:,r,:,-..',,,J,:-:2QuRy 104)14 3 �k 13 t. WEY • r ,tu��onour limited examinattcn�oTMENT • ri:mpliance with our comments shall not be construed as indicating the plans and specifications are in full CJrnPlin r.&with the code. 0,�c Roe_ 0U/, �6 �� �