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98-330
+CERTIFI+C,�, rE O +COMPLIANCE i TOWN OF QUEENSBIJRY WARREN couraY , NEW YORK Date June 23 191 98 4 98330 I 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 fLocation 18 PINEWOOD AVE . —T - { Owner RAUNER , ELIZABETH l - I TAX MAP NO , 81 . - 3 - 7 By Order of Town Board TOWN OF UEENSBURY 1 I 1 Director of Building R Code Enforcement if f BUILDING PERMIT VALUE $ 0 TOWN OF QUEENSBURY No, 98330 TAX MAP NO . 81 . - 3 - 7 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to RAUNER ELIZABETH OWNER of property located at IS PINEWOOD AVE . 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 filed and approved and in compliance with the Town of Clueensbury Building and Zoning Ordinance. : III III I 1. o WNE R S Address is 18 PINEWOOD AVE . ¢UEENSBURY , NY 12804 2. CONTRACTOR or BUILt?ER"S Name SANITARY SEWER 3. CONTRACTOR or BUiLDER'S Address DAN DRELLOS PO BOX 224 GLENS FALLS NY 12801 4. ARCHITECT'S Name S. ARCHITECT'S Address S. TYPE of Construction — fPlesse indicate by XI SEPTIC { i Wood Frame I I Masonry f ) State I I 7. PLANS and Specifications SEtoIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS 8, Proposed Use SEPTIC ALTERATION 25 June 17 2000 S PERMIT FEE PAID - THIS PERMIT EXPIRES itf a longer period is required an application for of, extension nxssl be made to this Building and Zoning inspector of the town of Oueensbury bo4ona the expiration date.) 17 Jut'IB 1998 Dated at the Town of Queensbury this Dsty of 19 .--, x " for the Town of Queensbury SIGNED BY Buiidiing and Zoning inapiacsor Application for SEPTIC DISPOSAL PERMIT Town of Qu«:nsbury FIFFee mit NO. �720 Dept. of Community Developzumt Building & Codes Office Paid $ 742 Bay Road Queensbury, NY 12804 Location of property for installation: / .v e G� 41 ' property Owner's Name: 2 /� C3 ra' le property Owner's Mailing Address: fir' �� • -+ e [t r W ,A u F Installer's Name: T rrC 4.j C,4I + Q rt USG phone # 7 9 2Z - a J-2 Total gaily flow: ' Number of bedrooms Cif residential): (residential - compute (& 150 gal./bdrm.) Topography: � flat, Tolling, steep slope % of slope Soil Nature: _ sand, learn, clay, ©then 1 depth: Ground water+. at what depth? feet / Bedrock or impervious Material: at what depth? —.._ feet r not uired, required [ rate min. per inch ] Percolation test: �1 1 municipal, well, other Domestic water Supply,* If domestic water supply is a VM.L, water supply from any septic absorption is feet. PROPOSED SYSTEM �Xt i ~ f•� � Septic tanks gallon, (minimum size: 1,000 VI-) Tile field: each trench _�_ feet ! Total system length: ' �' � feet Seepage pigs . number of ' /�" 1 size each: & by ft )' Size of stone to be used: # _ 1 depth or thickness feet HOLDING TANK SYSTEM: (if required) Number of banks: Size of each: _ - gallons _ A1a� system gad "'aand°d ele0trical woo$ to be inspected by a cartilied agency. or your protection, please, note that pursuant to gem 136-29 of the Cade of the Town of Y0 may P et"l t Or m xel =00 � any or faalure to make r applov � �a is based upon Or ie � material � or � moan by or on behalf of an applicant. I have rand them with respect bO be vokL this aad ogres to abide by these and all rOVA eaneue of the Town of Queensbury Sxok=7 age Diep°a d OxOx�'°cs. POP Date- Signature of responsible person: - ti1 �� To tl=tS TOWN OF QUEENSBURY BUILDING A CODE ENFORCEMENT 742 Say Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Date (ram— '��j79QSPermit #� q - rim SOIL TYP an - am-Clay- Results of Percolation Test- ( if applicable ) Rate-Minute/Inch TYPE OF SYSTEM: t ABSORPTION FIELD : Tota ngth _ Length of eac trenc Depth of tree hes Size of stone SEEPAGE PITS : ber- Size - ft . x ft . Stone size PIPING : Size TypLe Bldg . to Tank Y,�= Yjis `.�____ _ Tank to Dist . Box +� ¢-- Dist . Box to Field/Pit + + Openings Sealed? a artia LOCATION/SEPARATIONS : Foundation to Tank :feet Foundation to Absorption feet Separation of Pits _ feet Conforms as per Plot Plan LOCATION OF SYSTEM ON PROPERTY: ~ ( circle one ) Front - Rear - Lef _S4a�Right Side Middle Front - i ddl a Ream COMMENTS : SYSTEM USE APPROVED : YE 0 Arrived : Departed - zl Tng nsp y � gay ti A t{ 3 x � a9m cr 1 � � � c emb r� TAvK �fkj It TC3VJ URY 11� DATE E i i