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98-293 C. ERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY , NEW YORK �] Uate June 4 19 98 This is to certify that work requested to be done as shown by Permit No . 98293 has been completed . This structure may be used as a SEPTIC ALTERATION Location 202 FULLER RD , Owner ST . ANDREWS , CHRISTOPHER By Order of Town Board TAX MAP NO . 1 23 . - 1 - 14 TOWN OF QUEE 5B Y Director of Building & Code Enforcement BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY No. 98293 TAX MAP NO . 123 . - 1 - 14 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to ST * ANDREWS , CHRISTOPHER OWNER of property located at 202 FULLER RD . 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 tiled and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. f' l O 2 BO233 FULLER RD . QUEENSSURY , NY 12804 2. CONTRACTOR or SUI LDEWS Name SANITARY SEWEpR�R Addross 3,yDntTla a.rRTL1L B_IJIL F(7'BOX 224 kG]�L►lE1NLSlltEFiALiL.(LSS NY 12801 -4. ARCiil i LAM.. !`dam! 5. ARCHITECTS Address 6. TYPE of Construction — 4pi"se indicate by X) SEPTIC I I Woad Framr f 1 Masonry l l Steer t i 7. PLANS and Specificatiaro SEPTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS Na. n w.w.c..+ tlsa SEPTIC ALTERATION 25 June 2 2000 S PERMIT FEE PAID - THIS PERMIT 'EXPIRES . 19 of a Ioryer perm is required an application for an extension must be rnadt to the Building and Zoning ina"Ictor of the town of Ck4wmsbury before the txpifatian date.) 2 June /''� �► Dated at the Town of Queensbury this Da 19� SIGNED BY for the Town of Queensbury BuildingzsndZo i rwpaEtor _ ,, Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Dept. of Community Development Permit NO. Building & Codes office 742 .say Read Fee Paid $ �� Queembury, NY 12804 �° Location of property for installation: �'�` A ►;7�� t Property Owner's Name: S~ c� 7- _ ,4,jz>,,FFwfT JUN (J � l� Property Owner' Mailing Address: oe)` Installer's Name: Phone # 7/ 9 d- 7 a S a7 Number of bedrooms (if residential): --- Total daily flaw: D a ,/� (residential - compute 0 150 gal.lbdrm.) Topography: L flat, roiling, steep slope YO of slope Soil Nature: said, loam, clay, othA= depth: Ground water: at what depth? feet I Bedrock or Impervious Material: at what depth? feet Percolation test: y,' not required', required j rate min. per inch ] - - - Domestic water supply: Y municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank ` gallon (minimum size: 1,000 gal.) Tile field: each trench ` feet / Total system length.: ' � � `� feet Seepage pit(s): number of I I size each: ft. by fL Size of stone to be used: # / dearth or thickness , feet --HOLDING TANK SYSTEM: (if required) Number of tames: Size of eaciL-. ,galloAs Alarm system mul associated electrical work to be wapected by a cac� agaoicy. For your pry. Ply note that pummont to Section 136-29 of tbo Code of the Town of Queensbury, my Pew or approval Wanted toed wJ=h is bared upon or is granted is reliupone upon any material or &aam* to rnaloe a ,material fact or circuinxtance known by or on behalf of an applicznt; shall be void. I bave read the regulations with respect to and agree+ to abide by dune and all sequ ram ate of the Town of Qaaeenabury Sanitary Savage 17er7Pcra1 �I !/ Q ��yy Signature of responsible person: el_ �_ Date` � d- I e e TOWN OF QLfEENSSURY BUILDING A CODE ENFORCEMENT 742 Say Road Queensbury NY 12804 -Z�� tsisl 761-8256 s SEPTIC DISPOSAL SYSTEM INSPECTION i Location Date ermit # " SOIL TYPE • S - lay" Results of P rcol ati nneest- ( if applica e ) Rate-Minute/ Inch TYPE OF SYS ABSORPTION ELD : Total Length Length of ea h trench Depth of tren hes • Size of stone SEEPAGE PITS : umber- Size - to x f Stone size PIPING: Size ype Bldg . to Tank Tank. to Dist . Box Dist . Box to Field/ t re 1 Openings Sealed ? s o ar a LOCATION/SEPARATIONS : Foundation to Tank feet Foundation to Absorpti o AWD feet Separation of Pits Conforms as per Plot P an o LOCATION OF SYSTEM ON ROP ( circle one ) Front - Rear - Left id - R ht Side Middle Front 1 e Ke COMMENTS : I 3 i i S3 I i SYSTEM USE PPROYED : C O Arrived Departed : y � lding n actor L C —------------- TOWN OF Pw 4 d I I y B U I I.D A' P c (13 DATE JUN 0 1 FILE COPY I d I qU*MWJMM1AE11'1 or WEVOMW "d good ca Ow all Dug owreeel"Vmh the be CmdPAW ns so k, tull OWS .. apcftajo Vift the cede. "I have seen or observed, or believe I saw evidence at all objects such as houses, wells, trees, fiances, etc., shown an thi's document I also represent that I have rp M ally measu dista set forth on the diagram.T ;7 FK SIGMA RE DATE