1999-705 CERTIFICATE OF COMPLIANCE
:, TOWN. OF QUEENSBURY
WARREN COUNTY, NEW YORK
November 10 99
Date '19
0799705
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 ads
29 QU EENSBUR1 ATE ---.
Location
1_..e.a"r u r kJ HLvilii L„l,• __
Owner
TAB MAP NO. 11.1 e -af-.q. By,Order. of`Town Board
TOWN OF QUEENSBURY .
` Director of Building 8. Code Enforcement , -
BUILDING PERMIT
Town of Queensbury, 742 Bay Road, Queensbury,NY 12804
County of Warren (518) 761-8256
VALUE $ 0 Building Permit No. 99705
TAX MAP NO. 111 . -4-4
Permission is hereby granted to LETTUS, JAMBS M.
Owner of property located at 29 QUEENSBURY 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 NYS Uniform Building Codes and the Queensbury Zoning Ordinance.
Owner's Address:
29 QUEENSBURY AVE.
QUEENSBURY, NY 12804
Contractor or Builder's Name:
I .B. S . SEPTIC
Contractor or Builder's Address:
2 LOWER WARREN STREET
QUEENSBURY, NY 12804
Electrical Inspection Agency:
Type of Construction:
SEPTIC
Plans and Specifications:
SEPTIC ALTERATION AS PER PLOT PLAN. SPECIFICATIONS
" Proposed Use:
SEPTIC ALTERATION
25 November 10 2001
$ PERMIT FEE PAID—THIS PERMIT EXPIRES
(If alonger 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.)
Dated at the Town of Queensbury this 10 Day of November . 1999
SIGNED BY ,�Q , )&1 . for the Town of Queensbury
• Code Enforcement Officer
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit NO. q - /()
Dept. of Community Development
Building &Codes Office �CO
742 Bay Road Fee Paid
Qt;e sbuy, NY I2804
/ -- _CFIn
Location of property for installation: (X)(}
�j' NOV 0 1999
Property Owner's Name: TO M C C C �(/s TOWN OF
Bl/tL®1iy s.i Er�S�"JRY
Property Owner's Mailing Address: 4-i 6 65 4(.., C_ AlvO COgE
Installer's Name: - 5,- 43, ct 5(i) Phone # 9'
Number of bedrooms (if residential): I Total daily flow:
(residential compute @ 150 gaI./bdrm.)
Tcpo aphy: rX f:at, rolling, steep slope % of slope
• Soil Nature: sand, loam, clay, other /depth:
•
Ground water: at what di, / Bedrock or Impervious Materaf: at what depth? _ feet
Percolation test: not re.red, 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 tarciee 0;a ton (minimum size: I,CCO gal.)
Tile field: each tench 4 t)- feet / Total system length: 1d- - feet
Seepage pit(s): number of / wize each: . ft.by ft.
Size of stone to be used: # / d^h or thickness I feet
I-IOLDL\IG TANK SYSTEM: Cif required)
Number of tanks: Size of each: eons
Alarm system had associated electrical wcr to be inspected by a certified aretcr.
For protection, please note that pursuant to Section 136-29 of the Code of the Town of Qoee-,sl:ury, any permit or
approval .ed r,'sich is based Lxa or is,anted in reiizace a�terial adsrepresectracn or failure to.:aloe a
Inate:ai fart or cr:umstance knocxn by or on behalf of sca appUc., sra1ii be void.
I have read t:a regulations with respect to this application and agree to abide by these and all:e�:searms of the Town of
r.Quee =-..-;r San:t4ry Sewage Disposal Ord^a..
Sig e of responsible person: ('f"� ( t' Date:
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name ,IYArry . j
4-a_<7
Location
Date u" / O L:9 Permit #
SOIL TYPE Sand- oam-Clay-
Results o colation Test-
(if applicable) Ra - inute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: ot.l ength 12-6
Length of each tre c Z t
Depth of trenches
Size of stone
SEEPAG PITS: ,uMeer-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank .0235--
Tank to Dist. Box, H w
Dist. Box to Field Pitt a gc,t) �(%,)
Openings Sealed? Ault No Partial
LOCATION/SEPARATIO /
Foundation to Tank l feet
Foundation to Absorption feet
Separation of Pits Amp -et
Conforms as per Plot Plan fill o
LOCATION OF SYSTEM OTPROPERT .
(circle
Front - Re de - Right Side
Middle -ront - isle Rear
COMMENTS:
SYSTEM USE APPROVED: 1/11i NO
Arrived: �
Departed: T (v
A
Building Inspector
\z_ti) "I have seen or observed, or.believe I saw evidence of,
all objects such as houses, wells, trees, fences, etc.,
T/K. shown on this document. I also represent that I have
person measured the distances set forth on the diagra ."
7—(-1°
. ' I SIGNA DATE
I. l -
I r
NOV 1 0 1999
ry�,i3o� ( s�uoro, r- -'a ,
RY
BU(f_D;NC F'.w•i'U CoUEE
•
20
%,L T�4 yt
s.'P
?- 13)
TO N OF QUEENSBURY
LI
BU WING & CODES DEPT. a
REVIEWED BY .
DATLE
ns ENSB examl�tion,
VOW, on our is shall
r
not 4e wed a tk s a indiCatinntMI
s f� �
r C + 1. �m�l n e kith tat oe•
7� �, r e 4.s4l6 62 6y -4c, c