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1999-632
CERTIFICATE OF : COMPLIANCE TO WN Of ,.., gUEENSBURY : . WARREN COUNTY,:'NEW.YORK Date September 29 ig 99` '99632 This is to certify ghat work requested to, be done as shown by Permit No; has been completed. ; SEPTIC ;ALTERATION ° :This structure may be „used as a '. Location 95 CHESTNUT RIDGE RD Owner LOWE G NELSON & ELEDA TAX NAP NO - 54 2-1 4 By Order of Town,Board;° Director of Buil ding, & Code Enforcement; • i BUILDING PERMIT Town of Queensbury, 742 Bay Road, Queensbury,NY 12804 County of Warren (518) 761-8256 VALUE $ 0 99632 Building Permit No. TAX MAP NO. 54. -2-14 LOWE, G. NELSON & ELEDA Permission is hereby granted to 95 CHESTNUT RIDGE RD. Owner of property located at SEPTIC ALTERATION in the Town of Queensbury,to construct or place a at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the NYS Uniform Building Codes and the Queensbuty Zoning Ordinance. Owner's Address: 95 CHESTNUT RIDGE RD. QUEENSBURY, NY 12804 Contractor or Builder's Name: IBS SEPTIC Contractor or Builder's Address: IVAN BELL 2 LOWER WARREN STREET QUEENSBURY, NEW YORK 12804 Electrical Inspection Agency: • Type of Construction: SEPTIC Plans and Specifications: SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATION • Proposed Use: SEPTIC ALTERATION 25 September 29 2001 PERMIT..BE PAID—THIS PERMIT EXPIRES (If a longer period is required,an application for an extension must be made to the Code Enforcement Officer of the Town of Queensbury before the expiration date.) 29 September 1999 Dated at the Town of Queensbury this Day of SIGNED Bl� x,t✓�Q_ �1�+�,I,t,� for the Town of Queensbury Code Enforcement Officer Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept.. of Community Development Permit No., �(t) Building &Codes Office - 1 742 Bay Road Fee Paid $' Queensbury, NY 12804 J Location of property for installation: y 5---c 4 r S/ ni c, r / G, cc r J Property Owner's Name: X/c, ( co C A tiz.- e - Property Owner's Mailing Address: 95- C 4 C 5.j,z,ci% ;4 c , -/ Installer's Name: .� ��, i, .>gyp/ ! 6- Phone # 72Jri9v - Number of bedrooms (if residential): Total daily flow: (Q® .,9 (-- (residential -compute @ 150 gal./bdrm.) Topography: /Klat, rolling, steep slope % of slope - Soil Nature: sand, Ioam, clay, other I depth: . . Ground water: at what depti 'feet / Bedrock or Impervious Material: at what depth? feet Percolation test: NAot required,red, required [rate min. per itch] Domestic water supply: municipal, well, other) B. a, E I D If domestic water supply is a WELL, water supply from any septic absorption Ep 2 9 feet1999. TOWN OF 0UEEi_-.f`�v�IJR ' PROPOSED SYSTEM , ^ , f3UiLDiI�L,RNLI GCZD� Si/, S „NN Septic tank/600 gallon (minimum size: 1,aoo -) Tile field: each trench Jo feet / Total I (` systemens > 0 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: ;lens C41arm system and associated electrical work to be inspected by a certified agary.J For your protection, please rote that pursuant to Section 136-29 of the Code of the Town of Qeeersb¢ry, any permit or approval granted which is based upon or is ranted in reliance upon any material misrepreae a in or failure to make a material fact or circumstance known by or on behalf of an applicarct, shall be void. I have read the regulations with respect to this applica ' and agree to abide by these and all rxeremeats of the Town of Queensbury Sanitary Sewage Disposal Ordinance. Signature of responsible person: - Date: 99jf TOWN OF QUEENSBURY BUILDING & CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name w(' 31A Location RS C14 r6.c I;Zd C0 Date Grill/ Permit #a_q____Q--( 3). SOIL TYPE: San -Loa Clay- Results of Pe> colation Test- (if applicable.) Rate-Minute/Inch TYPE OF SYSTEM: ABSORPTION FIELD: Total Length cag Length of each trench 6-6 _ Depth of trenches Size of stone I „z SEEPAGE PITS: Number Size - _ ft. .x __,,,LA ft. Stone size _ ' PIPING: Size Type Bldg. -to Tank • �y Tank to Dist: Bou• y' ,�, ' Dist, Box to Field/Pi S/ Openings Sealed? No Partial LOCATION/SEPARATION . Foundation to Tank A feet Foundation to Absorption 90 feet Separation of Pits ,u eet Conforms as per Plot Plan - No LOCATION OF SYSTEM ON PROPERT' . (circle o Front - Re. Left Side - Right Side Middle Front - Middle Rear COMMENTS: ?Gd' 24• ai 3;SYSTEM USE APPROVED: NO Arrived: 7, ?a Departed: Buil di rector 9 P . . 1 : , 1 , ; ; ; , , , . i. ; ; , • \1. '2 ! Vint) iSj' i -.-1. . ! 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