98-224 CLIP TI FICNrE 01 COMPLIANCE
TOWN or QUEENSOURY
WARREN COWITY . NEW YORK
Da to may 6 19 98
98224
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
Location 12 COUNTRY COLONY DR *
Owner CANTERf ROBERT & 14ARIANNE
By Order of Town Board
TAX MAP NO . 4 7 . - 3 - 6 __ TQWN OF QU "EN . 'BURY
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 98224
TAX MAP NO . 47 . - 3 - 6 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to iGANTER ROBERT -- & MARIANNE
OWNER of property located at 12 COUNTRY COLONY DR * Street. Road or Ave.
in the Town of Oueensbury. 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 Oueensbury Building and Zoning Ordinance_
1. OWNER'S Address is
12 COUNTRY COLONY DR .
QUEENSBURY , NY 12804
2. CONTRACTOR or BUlLOER'S Name
SANITARY SEWER.
3, CONTRACTOR or BUILDERS Address
DM DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCHITECT'S Narne .
S. ARCHITECT'S Address
6. TYPE of Construction — (Please indicate by X) SEPTIC
I I Wood Frame I I Masonry 11 Steel I I
7. PLANS and Specifications
SER,TIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
S. Proposed Use
SEPTIC ALTERATION
25 May 6 2000
$ 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
Iowa of Oueensbury before the expiration date.)
6 May 19
Dated at the Town of Gueensbury this Day of 19
SIGNED BY i o.= Afor the Town of Oueensbury
Building and Zoning lrtepanW
Application for SEPTIC DISPOSAL PERMIT
Town of Queencommubury
nity
Perm!& a.
Dept of Cornoorunily Development ""`�
Building & Codes Office
A 11
742 Bay Road d .Paid $
Queensbury. PAY 12804 F , '
Location of property for installation;
Property owner's Name 1 �-eA
Property Owner' Mailing g Address: 1 �- t c�mil` i r
Installer's Name: N Phone # 2! & -
Number of bedrooms (if residential): Total daily flow:
(residential. - compute (W 150 gal.rbdrm.)
Topography: flax, mom, steep slope of slope
Soil Nature: 1/�.ssarld, kx=p clay, other r depth:
Ground water: at what depth? feet ! Bedrock or Impervious Material; at what depth? . feet
Percolation test: 'rot required, required [ rate min, per inch )
Domestic water supply: .municipal, well, od2er
If domestic water supply is a WELL, water supply from any septic absorption is feet_
PROPOSED SYSTEjgMy�� Lc,
Septic tank: / �-+�- b gallon (minimum size: 1 ,000 gal.)
Tile field: each trench feet r Total system Lmgth: feet
Seepage pit(s): number of / size each: & by fr.
Size of stone to be used: # ! depth or thickness feet
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
Alaorm syslesn and aseodated electrical vuoxic to be iaspmted by a cxrtiSed egeocy.
For your protectiam, Ply now Cho pumoant to Soctia7n 13&29 of tie Code of the Town of Qoee ebory. any partmt or
approval granted which a based upon or is granted in rebame upon any maten-ed nnm I or fnhzm to rn a
material Ox t or eireo®smacs known by oron behalf of An appicaxit: rhall be void.
1 have seed the regulations with bo this wood to abide by tb se and all requirements of d2a Town of
Cftwousbary SmAtary Sowase DimpoedO e.
Signature of responsible person: Date: s4 '` .-
Office No. (518) 761-8256
Building & Code Enforcment Arrive: Zira Lnsp:
Dept. of Community Dcvelopment
Town of Queensbury Date inspection Request Received:
742 Bay Road
Qseensbury, NY 12804 �y
NAME A&YJ PERMIT NO. 3!'
LOCAT10 S , r..• LV DATE 7 .2z , G
TYPE OF STRUCTURE
Chimney Height/"B" Vent/Direct Vent Location
Fresh Air Intake
Plumb Vent Through Roof
Roof Complete
Exterior Finish Complete
Interior/Exterior Railings 30" to 36"
Exterior Handrails, Balconies, Landing 18 in. or more
Interior Handrails Stairs Both Sides 3 or More Risers '
Grade 2% Away From Foundation
8" Clearance To Sill Plate
Gas Valve Shut-Off ExposedlRegulator 18" ve Grade
Gas Furnace Shut-Off within 34 Feet within 0 of Site
Oil Furnace Shut-Off at Entrance urnace Area
Furnace/Hot Water Hea Cape g
Relief Valve(s) Installed
Headroom 6 ft. 6 injinS..f
Basement Stairs 6 f .
Handrail Exterior S Sides More Than 3 Risers
Interior Privacy/TriMain Entrance 36" es.
Floor Finish
Bathroom/Kitchen WaWrtight
Interior Handrails Balconies/Landing 18 in. or more
Railing Across Window in Stairwells
Smoke Detectors:
every level
every bedroom
outside every bedroom
inter connected
Bathroom Fans
Plumbing Fixtures
Foundation Insulation
3/4 Hour Fire Door/Door Closer
Garage Fireproofing
Garage Penetrations Sealed
Furnace In Separate Room Protected (In Garage)
Light Ventilation Per Room
Safety Glazing 18" or Less From Floor
Final Electrical
Site Ptan/Variance Required
Final Survey Plot Plan
As Built Septic System Layout Req.
Okay to Issue Temp C/O
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL 'SYSTEM INSPECTION
Name Ancpz-
LocatDatePerm
i � 0
0)0
SOILnd- Loam- Clay-
Resul is of Percolation Test-
( if applicable ) Rate- Minute/ Inch
TYPE OF SYSTEMS
ABSORPTION FIEL Total Length
Length of each reach
Depth of trenche --
Size of stone
SEEPAGE PITS : N r" f t .
Size - ft .
Stone size ize ype
PIPING:
Bldg . to Tank �D¢-� " �' '�`q°�
Tank to Dist . Box
Dist . Box to Field/Pit
openings Sealed? Yes^^� art� a
LOCATIONJSEPARATIONS : feet
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits e eo
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPER
( circle one )
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS :
SYSTEM USE APPROVED : OYESft
.•!.-�
Arrived :
Depa - 4din
u� ctor
"f haws seen or obrserve k 0 believe 1 saw evil�e A
all objects such as haMeM. Wgfte trees, fences,
sh4 on this doCue MW' t that i have �..
a measured tAe M [do '
a As aIMMA31i
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