98-120 Certificate of Compliance
Town of Queonsbury
Warren County, New York
July 7 98
Date
98120
This is to certify that work requested to be done as shown by Permit No*
has been completed.
This structure may be used as a SEPTIC ALTERATION
_ __
59 HOMESTEAD VILLAGE
LOCStki7YY
Owner HOMESTEAD VILLAGE L . P .
TAX MAP NO , 93 . - Z - II , f
By Order Town Board
TO k N O2 UEE B
1141.
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE s 0 TOWN OF Q►UEENSBURY No. 98120
TAX HAP NO . 93 a - 2 - 11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HOMESTEAD VILLAGE L . P .
OWNER of property located at 59 HOMESTEAD VILLAGE 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.
t. OWN@ R'S Address is
4294 ROUTE 5
CALEDONIAr NY 14423
2. CONTRACTOR or BUILDERS Name
I . B . S . SEPTIC
a 2° nW I REN SET
QUEENSBURYr NY 12804
4. ARCHITECT'S Name
S. ARCHITECT'S Address
6, TYPE of Construction — JPleaso indicate by 7[I SEPTIC
I I Wood Frame I I Masonry [ ! Steel [ f
7. PLANS and Specifications
SEPT7p ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 April 8 2000
$ PERMIT FEE PAID — THIS PERMIT EXPIRES 19
[If a "at period is required an application for an extension must be made to the Building and Zoning inspector of the
town of C}ueoasbury before the expiration date.)
8 April 19
Dated at the Town of Oueensbury this DaY of t$
SIGNED SY fii !?GCX 1P �I n Ior the Town of Queensbury
Building and Zoning Inepecspr
Application for SEPTIC DISPOSAL, PERMIT
Town of Queensbury
Dept_ of Community Development Permit No,
Building c4c Codes Office
742 Bay Road. Fee Paid $
Qaeensbury, NY 12804 '
Location of property for installation: i 6 ,� � � ,7
,�''�"�"' .a �r'C-CC.Gam" t'r�.� .c
Property Owner's Name: er
Property Owner's Mailing Address: /� c.�
Installer's Name: . I � �/' � / Phone # — i
Number of bedrooms (if residential) : Total daily flow:
(residential - compute @ l50 /APR
l ni $
Topography: flat, rolling, steep slope % of slope u `
Soil Nature: sand, foam, clay,
�BIf+ C1;''1 >� ' •,, _;ul�E�,
y, other / depth,:
Ground water: at what depth feet / Bedrock or Impervious Material: at what depth? feet
Percolation test: ALqnot required, required ( rate min. per inch ]
Domestic water supply: r' + municipal, welt, other
If domestic water supply is a WELL, water supply from any septic absorption is feet,
PROPOSED SYSTEM
Septic tank: / 66 Q gaUon (muini,mum size: 1 ,000 gal..)
Tile field: each trench feet / Total system Iength: feet
Seepage pit(s) : number of r / 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
Ala= 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 Code of the Town of Queensbury, any permit or
approval 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 on behalf of an applicant, shall be void.
I have read the regulations with respect to this appli and agree to abide by these and all requirements of the Town of
Queensbury Sari Se pond requirements Wage 17ia (3ndrn
Signature of responsible person: �s
s
TOM OF QUEENSBURY
BUILDING !i CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(sts) 761-9256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name p ,
i
Location
Date Fe it #-� �
SOIL TYPE: Sand Loa Clay-
Results of Perco at on Test-
( if applicable ) -Minute/ Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : otal Length
Length of each tr h
Depth of trenches
Size of stone
SEEPAGE PITS : N be
Size - f x f t .
Stone size
PIPING : Size ype
Bldg . to Tank
Tank to Dist . B
Dist . Box to Fi ld/Pit
Openings Sealed Yes No NaFtMaT
LOCATION/SEPARA IONS :
Foundation to T nk feet
Foundation to sorption feet
Separation of its feet
Conforms as pe Plot Plan No
LOCATION OF SY ON PROP R
( circle one )
Front - Rear - eft Side - ight Side
Middle Front - ' ddle Rear
COMMENTS :
f
SYSTEM USE APPROVED : C" ~ Y no
Arrived:
Departed :
' C
ui ing r
f
l
I t odd, Or bOW" 1 SW O'dOW444
d do*W as hoses, wells, trees, Wok �
shorn on this document. I also represent the ! bm
personally sured the distances it lam en 00dow
7
SIGNATURE
"
WMN
dqN
c
G
L1 �
c�
f
' TOWN OF QUEEgSBURY -
BurLDING a CODE
ENFORCEMENT
742 Bay Road
+Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date
Permit #
SOIL. TYP�.--��a�n,�r..zoam-clay_
Results of Percolation Test.
( if applicable ) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPT FIELD: Total Length
Length of e h trench
Depth of t1^enc
Size of stone
SEEPAGE PITS : Number ---�
Size Stone sizeze ft . ft;
PIPING;
Bldg , ank ize ype,,
Tank-to Dist . Sox � k
Dist . Box to Fiel �—
Openings Sealed?
LaCATI0IYlSEPARATI s ' N° a rti a
Foundation to Tank
Foundation to Absorption �- -- feet
Separation of Pits - - feet
Conforms as per Plot Pi an '� f��
LOCATION OF SYSTE]�d am PROPERTY: N
( circle one )
Front - Rear - Left Side de
Middle Front - Middle Rearht. Side
COMMENTS
SYSTEM USE APP a YES
Arrived=
Depa rted
i
u ding ns
for
i
'I y+ hm nmor�r or 1 Sm eU�nt Of,
all o 1�` s Aousesr welts trees #ereaeS, etc"
shown on 1hk dommment. I also present that I have
Ir
person I the distanc set forth on the diagram,
.2
DATE
La
4
%PR 0 7 19M
Tay^ N :7i F3v
4�
D'
TOW OF
BUILD
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