98-119 certificate of comphance
Town of Queensbury
Warren County, New York
Late July 7 98
9 8119
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
72 HOMESTEAD VILLAGE
Location
Owner HOMESTEAD VILLAGE L . P .
TAX MAP NO . 9 3 . - 2 - 1 1 . 1 By order Town Board
TO j'QUEENSBURY
Director of Building Code Enforcement
W _
BUILDING PERMIT
VALUE $ TOWN OF QUEENSBURY No 98119
TAX MAP NO , 93 . — 2 - 11 . 1WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to HOMESTEAD VILLAGE L ' P
OWNER of property located at 72 HOMESTEAD VILLAGE Street. Road or Ave.
in the Town of f]ueensbury,
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 sod Zoning Ordinance.
i. OwNER'S Address is
4294 ROUTE 5
CALEDONIAr NY 14423
2. CONTRACTOR or BUILDER'S Name
I a B . S . SEPTIC
S
s. CON2 LG)FfE' bt BI �Ei d 8T1tEET
QUEENSBURY , NY 12804
4. ARCH;TBCT'S Name
5, ARCHITECT'S Address
6. TYPE of Construction — !Please indicate by XI SEPTIC
( 1 wood Frame ( I Mesorwy ( I Steel i f
7. PLANS end Specifiastions
SIWTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
B. Proposed Use
SEPTIC ALTERATION
25 April $ 2000
PERMIT FEE PAID — "THIS PERMIT EXPIRES 19
III a longer period is required an application for an extension mum be made to the Building and Zoning inspector of she
town of Oueensbury before ttw expiration dove.! 8 Apr i 1 19
Gated at the Town of C1ue+Ensbury this Day of 19--�;
SIGNED By �,�� +1 for the Town of Oueensbury
-- " 8uitding a Zoning lnspe+etw
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury
Dept. of Community Development Permit No.
Building & Codes Office
`742 Bay Road cJ(�
Queensbury, NY 12804 Fee Paid a
Location of property for Installation:
Property Owner's ].'Name: /" r
r s .t
Property Owner's Mailing Address: 11>'
Installer's Nance: . s e-VWIN L Phone # _ er ? ¢'...
RY
Number of bedrooms (if residential): Total daily flow:
(residential - compute Q 150 gal.fbdrm.)
Topography: flat,, rolling, steep slope % of slope
Soil. Nature: sand, loam, clay, other / depth:
Ground water: at what depth? eet / 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
Septic tank/QdC) gallon (minimum size: 1 ,000 gal.)
Tile field: each trench feet / Total system length: f et
Seepage pit(s) : number of / size each: ..4 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
Alarm system and associated electrical work to be inspected by a certiFed agency.
For your protectton, 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 m 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 applirphon. and agree to abide by these and all regturPments of the Town of
Queensbury Sanitary Sewage Disposal
ocoole
Signature of responsible person: it Date: 114C" �
i
TOWN OF QUEENSBURY A!
BUILDING N CODE ENFORCEMENT
742 BaY Road
Queensbury NY 12804
c5187 jai-sash
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location ,;;,
Date Permit #�
SOIL TYPE: San Loam- Clay
Results of Percol tion est-
( if applicable ) Ra - Mi ute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tot Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS : Dumb r-
Size - ft , ft .
Stone size
PIPING : Siz ype
Bldg . to Tank
Tank to Dist . Box
Dist . Box to Fief / Pit
Openings Sealed ? Yes No a rti a
LOCATION/SEPARAT S :
Foundation to Ta k
Foundation to Ab orp ti on eet
Separation of Pi s et
� t
Conforms as per 1 of Plan -`
LOCATION OF SYS ON PROPERTY. o
( circle one)
Front - Rear - L ft Side - Right Side
Middle Front - ' ddle Rear
COMMENTS :
SYSTEM USE APPROVED : Y 0
Arrived:
Departed :
ny n e or
Y
`Toe
Qq � �
asw
=6
TOWN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name
Location
Date Permit #_.qLY� j I_C
SOIL TYPE: Sand- Loam-Ciay-
Results of Percolation Test-
( if applicable ) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD : Total eng h
Length of each trenc
Depth of tree s '
Size of stone _
SEEPAGE P- N ber-
Size t . x ft .
Stone size
PIPING; ES Size ype
Bldg . to T
Tank to D ' t . Box
Dist . B to Field it kitOpenings Sealed ? es No Martia
LOCATION/SEPARATIONS :
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits 171--feet
Conforms as per Plot Plan es
LOCATION OF SYSTEM ON PROPERTY:
( circle one )
Front - Rear - ft Si 3 Right Side
Middle Front - Alt--ter
COMMENTS :
7L
SYSTEM USE APPROVED: YES `'�
Arrived : e
Depa nerd :
r
i ding nspefcl` r
f
APR 07 1998
TOWN OF RY
DATE
1
"I have seen or observed, or believe I saw evidence of,
all objects such as houses, wells, trees, fences, etc.,
shown this document I also represent that I have
perso lk measured a distances set forth on the dia ram "
it
SIGNATURE DATE