1999-603 • _ .
•
Certificate of • Compliance
Town of Queensbtu-y
Warren County,New York
Date September 23 99
99603
This is to certify that work requeste to be done as shown by Permit No.
has been completed.
This structure may be used as a SEPTIC ALTERATION
/3 CROWNWOOD LANE
Location
•
Owner PEPER,._ CHRISTIAN
•
TAX MAP NO. 82 . -6-6 By Order Town Board
TOWN: QUEENSB Y
Director of Building & Code Enforcement
•
BUILDING PERMIT
VALUE $ 0 TOWN OF . QUEENSBURY No 99603
TAX MAP NO. 82 . -6-6 WARREN COUNTY, NEW YORK
PEPER, CHRISTIAN
PERMISSION is hereby granted to
13 CROWNWOOD LANE Street, Road or Ave.
OWNER of property located at
in the Town of Gueensbury,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.
t.DINNED LANE
QUEENSBURY,. NY 12804
2. CONTRACTOR or BUILDERS Name
SANITARY SEWER
3DANTORICOILOSulLM1811V522 2 4
GLENS FALLS NY 12801
4. ARCHITECT'S Name
6. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) SEPTIC.•,
( I Wood Frame ( )Masonry ( I Steel I 1
7. PLANS and Specifications
SEPTIC ALTERATION AS PER PLOT PLAN- SPECIFICATIONS
No.
B Pro sed Use
SEPTIC. ALTERATION
25 September 21 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 Queensbury before the expiration date.)
2.1 September- 1999
Dated at the Town of Queensbury this Day of 19
SIGNED BY -
tak-N,j' for the Town of Gueensbury
Building and Zoning Inspector
•
Application for SEPTIC DISPOSAL PERMIT
•
r- 99603 82 . -6-6
Town of l': • . .PEPER, CHRI STIAN 0 _
V)3
Dept.'of(:.,..,...:1.3 .-CROWNWOOD LANE Permit No.
BnMing -SEPTIC ALTERATION ) $ O�
• 742 Bay R Fee Paid
QiiePnsbury, NY 12804
' J
Location of property for installation: 13 Cro 6Q,,! o f> ('ter_
Property Owner's Name: CA it(.l � �'�- /se f t? ea
Property Owner's Mailing Address: I—3 Cro(..rev( -o 0
Installer's Name: df.1.44-im d, if c/,rt se— .12"-cer.ct Phone # 7 4 L-7 24.7
' Number of bedrooms (if residential): Total daily flow: ' 0
(residential -compute @ 150 gal./bdrm.)
Topography: 2 flat, rolling, steep slope % of slope
• • Soil Nature: sand, loam, clay, other /depth:
•
• •
Ground water: at what depth? feet / 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
(.gxw AJ6)
.Septic tank )'OD-D gallon•(minimum•size: 1,000 gal.)
Tile field:''each trench 0feet / Total system length: ' feet
Seepage pit(s): number of I / size each: /0 ft. by _ ' ft. • •
•
Size of stone to be used: # 3 / depth or thickness . feet •
•
•
•
•• HOLDING TANK SYSTEM:. (if required)
Number of tanks: Size of each: •gallons
&limn system and associated electrical work to be inspected by a certified agency.) •
s1.30 y For=youcprotect on. please note that pursuant to Section 136-29 of the Code of the Town of Queacsbary, any permit or
`;,"'.<<;:,.s' ap0gval:granted which is based on or is granted in reliance upon any material misrepresentation or failure to make a
,•*;::msite 'Sid.or circumstance lmown by or on behalf of an applicant;shall be void.
have read the regulations with reaped A application and Air abide by aid all mgiuremears of the Town of
Q �y` y Sewage Diapoaal \ i,� , ��
/ 17/99Signature of responsible person: Date:
i WV?TOM OF QUEENSBURY
BUILDING & CODE ENFORCEMENT v2S.
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name N4-- lairk-e_
RVl.Location ��(
Data- � Permit # (3-6 O3
Y
SOIL TYPE: and Loam-Clay-
Results of Percola 'on Test-
(if applicable) R. e- inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Lengthof each tr:nch
Depth of\'enches
Size of sto" -
SEEPAGE PUS: Nimber- /
Size - ft. x /0 ft.
Stone size -', -5
PIPING: Ucce Type
Bldg. to Tank C oliiy/JC9
Tank to Dist Box "
4
Dist. Box t. Field/P ' g j/2 35'
Openings Se,.led? No Partial
LOCATION/SEPARATIO
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits eet
Conforms as per Plot Plan e No
Lii .ION OF SYSTEM ON PROPERT .
,circa - one)
ront ' Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES NO
Arrived:
Departed: 147613— vz
it
Building Inspector ector
D0(7,OW
m
`o ° TOWN OF QUEENSBURy BUILDING DEPARTMENT "I have seen or observed, or believe I saw evidence of,
Based on our limited examination
{� 0 , all objects such as houses, wells,trees,fences, etc.,
W W compliance with our comments shall , non this do t. 1 also rep :.ent that I have
°- o o not be construed asdndicatin
LL v, Z = plans and specifications are Ent t p rso Ily mess d t distanc.A et forth on t e dia ram."
O compliance with the code.
` od 9 9
` �� S A --9
DA E--
TOWN OF .UE 4) qKU
on SBURY
� N i`- BUILDING Pr<< ;y S :IP
REVIEWED BY -'
0 DATE Iff ...._
1
soxe. ! lki r
Y6' 1 \,\ RCP
p.
39
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