1999-481 CERTIFICATE RTIFICATE OF COMPLIANCE '
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Uato August 3 19 . 99
30 \ Ci\
99481
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 32 APPLEHOUSE. LANE
Owner BURRALL, PETER & LYNDA —
TAX 'MAP NO. 88 . -1-4 . 2 " By Order of Town Board
TOWN OF SBUR .
Director of Building & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
VALUE $ 0 -. ..,• ;, . No. . . 99481 _ .
TAX. MAP NO 88 .:=1-4..2 WARREN COUNTY,NEW YORK
PERMISSION is hereby granted to BURRALL,. PETER & LYNDA
OWNER of property located at 32 APPLEHOUSE LANE 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 .
32 APPLEHOUSE LANE :
QUEENSBURY,. NY: 12804
2. CONTRACTOR or BUILDERS Name -
CONDON'.S SEPTIC & DRAIN .
3. CONTRACTOR or BUILDERS Address
4. ARCHITECT'S Name
5. ARCHITECTS Address
6: TYPE of Construction—(Please indicate by X)
SEPTIC
(. I Wood Frame 1 1 Masonry? ( )Steel ( l
7. PLANS and Specifications
SEPT4CL:...ALTERATION AS. PER PLOT PLAN SPECIFICATION
B: Propoed.Use
SEPTIC ALTERATION';
25 _ August' 3 2001
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 Oueonsbury before the expiration dated
1999.
_.;� 3 August'
Dated at the Town of Queensbury this Day of
19
SIGNED BY
for the Town of Queensbury
Building and Zoning Ins* or
Application for SEPTIC DISPOSAL PERMIT
•
Town of Queensbury qg
Dept. of Community Development Permit No. L�
Building & Codes Office
•
742 Bay Road Fee Paid S �
Queensbury, NY 12804 C�
L
Location of property for installation: 3 2-- A404/1-k9 0-2 �� (ti �EC i
Property Owner's Name: L t rV7)//j v AA AUG 0 3 1999
/ rovviV op C UB
Property Owner's Mailing Address: 6?Z 79 l E/7d OS 6 .L a _ BUltal�� �0CpU�.'dc$t1Ry
r (� � �
Installer's Name: Ntliv-S'c� �` �—c ` f Phone #
. Number of bedrooms (if residential): _3 Total daily flow: S
(residential - compute @ 150 gal./bdrrn.)
Topography: \ flat, rolling, steep slope 9 of slope
Soil Nature: y sand, loam, clay, other I depth:
Ground water: at what depth? f} feet / Bedrock or Impervious Material: at what depth feet
7
Percolation test: not required, required [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 SYSTEMwhip,
•
Septic rank-P gallon (minimum size: 1,000 al.)
Tile field: each trench fb feet / Total system length: ol--S feet
Seepage pit(s): number of / size each: - ft.by ft.
Size of stone to be used: # / depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Cxm system and associated electrical work to be inspected by a certified agency,
For yot protection, please note that pursuant to Section 136-29 of the Code of the Town of Queens-my, any permit or
aypruval granted which is based upon or is granted in reliance upon any rst2t,-rial misrepresentation cr failure to make a -
material fact or circumstance known by or on behRlf of an applir -re, 01.911 be void.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbuzy Sanitary Sewage Disposal Ordinance.
`
Signature of responsible person: (J� Date: / ( ` �
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ( -alid\;\_c%
Location
Date 3- . 1 Permit #99`1-0
SOIL TYP nCNLoam-Clay-
Results of Percolati.• Test-
(if applicable) Rat:-Mi to/Inch
TYPE OF SYSTEM: I
ABSORPTION FIELD: otal L-ngth)
Length of each tre ch ; Ap Q
Depth of trenches
Size of s '5ne
SEEPAGE PIT' . Nu b-
Size - t x ft.
Stone size
PIPING: Size Type
Bldg. to Tank C Xi 5110C.,
Tank to Dist. Bo
Dist. Box to Fie d/P: t•
Openings Sealed? es No Partial
LOCATION/SEPARA"ONS:
Foundation to Ta k / feet
Foundation to Ab orption S5 feet
Separation of Pits feet
—'Conforms as per Plot Plan Aim No
LOCATION OF SYSTEM ON PROPERT .
(cFr - -irtl
Front e Side - Right Side
Middle Front - Middle Rear
COMMENTS: Q
)46J
•
SYSTEM USE APPROVED: YES NO
Arrived: /
Departed: —75
Building Inspector
'W:0/9 43 cif 1 4°( e._ 1... — �c�Ivaow -�L� — - -
A��1E�io�s� 1.�,�c 743,8�z-� 1a ._ &AM ' i4vE - 7,8.-e14/2,
)uEE,.JsgU/sy /V,y ()_s,0 y efewsla!/s N.r /)-go
BUILDING & ,rS
i
t �P�.
-q61 ��0 REVIEWED BY.. __
.\
%47 C 1 0 DATE • '' ; f
r ,.
�'CIV „ •TOWN 0 QUEEiki i;,.�:-, '' ;:... 'L:�-A TMENT
E"s d on our bite()t:Kamination,
�,ucqo ' *999 \:,,.
a compliance with our comments shall
s' RY �ly / not he construed as indicating the
TONNN Or OUEE 40 iii , �� plans and strued s i n i are in full
BJt � �F_ - compliance with ii':c code.
-. -f.c S0b.pc.
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�ok d �.r. 1 a 1 ,4L
j' \G 130\tf 6e\(- \( ?bori\) 4 ,
r..____...___________: ..
;•; '9 \s-,. EE0 j
rbelieveIsaw evidenceedti
,"Ihaveseen or observed, e etc.,AUG 0 3 1999 wells,trees, fens s,allobjectssuch ashouses resent thatI hav ram:'.- .�,�Y_�•�� Y shownonthisdocument. (stances set forth on the ag
TOWN�o'�.� DATE
personally measured the �`
,,„,���UrtlftsNG A��D CODE _
•
PATE
SIGNATURE
3Z A-e, te house Lanf € oS--f tP5-C m AD.