98-346 Certificate of Compliance
Town of Queensbury
Warren County, New York
.Tune 19 98
Date
2k 1 98346
This is to certify that work requested to be done as shown by Permit Na.
has been completed.
SEPTIC ALTERATION
This structure may be used as a
4 MOORWOOD DR .
Location
Owner - CARR , - B RUC E & JUDITH —_. . . _.
TAX 'MAP NO , a 1 . - 2 -- 4 . 2 By Order Town Board
� l -
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY 20346
No
TAX MAP NO . 81 . - 2 - 4 . 2 WARREN COUNTY, NEW YORK
PERMISSION is hereby granter! to CARRo BRUCE & JU121TH
OWNER of property located at 4 MOORWOOD DR Street, Road or Ave.
in the Town of Oueensbury, To Construct or place a
raBETIC 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 Queensbury Building and Zoning Ordinance.
1, OWNER'S Address is
4 MOORWOOD DR .
QUEENSBURYr NY 12804
2. CONTRACTOR or BUILOER45 None
SANITARY SEWER
3. CONTRACTOR or BUILDER'S Address
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
4, ARCHITECT'S Name
fi. ARCHITECT'S Address
fi. TYPE or Construction — (Please indicate by X) SEPTIC
I I Mood Frame I l Masonry l l Steel f l
7. PLANS and Specifications
SEP;WC ALTERATION AS PER PLOT PLAN SPECIFCATIONS
a. Proposed Use
SEPTIC ALTERATION
25 June 17 2000
$ PERMIT FEE PAID - THIS PERMIT EXPIRES 19
(If a lonow period is required an application for an eatendon must be made to the Building and Zoning inspector of the
town or Oueensbury before the expiration date.)
17 June 1998
Dated at the Town of Queensbury this Day of 19
t
SIGNED BY for the Town of Queensbury
Buidir6and Zonirg Indpreator
Application for SEPTIC DISPOSA.L PERMIT
Towa of Queesnsbury
Dept. of Community Developmamt Permit No.
Building &. Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12SO4 `16 N 17
Location of property for installation: `"f ! ` 012 C� 0 c2 0 G L`C? . r
Property Owner's Name: +ES cz k..p GF, J UN .17 1M
Property Owner's Mailing Address: � l� � +�-%D r t, c,> a 7
Installer's Name: _ � i L t. d c•z v. Phone # 9 Z - 7 ;XS�07
Number of bedrooms (if residential): Total daily flow:
(residential - compute 0 150 gal./bdrrn.)
Topography: flat, rolling, steep slope % of slope
Soil Nature: sand, loam, clay, other / depth:
Ground water: at what depth? feet I Bedrock or Impervious Material.: at what depth? _ feet
Percolation test: PC not required, required [ rate min, per inch ]
Domestic water supply: municipal, well, ocher
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM
Septic Wda I ZS gallon (minimum Size: 1,000 gal.)
Tile field: each W=h 2, feet / Total system length: ' feet
Seepage pit(s): number of / size each: & by ft.
Size of stone to be used: # depth or thickness � feet
HOLDING TANK SYSTF.11,f.: (if required)
Number of tanks: Size of each: gallons
AW= system and associated electrical vmq* to be inspected by a ceatificd agency.
For your inn* please note that pwrsaaat to Sactkm 13&29 of the Cods of tie Town of ( ueeOslauy, auy pernik or
approval granted which is based upon or is granted zu rabiance upon any matexu or failm+e to nialm a
mataAal fact or civournstance knows by or on behalf of an applicant," shall be void.
I have real the regulations with respect to this mWieatim and agree to abide by there and aII ragoiam eats of the Town of
Queembury Savamy Serwago Disposal - ,r e
Signature of responsible person: Date:
TOWN OF QUEEMSBURY
BUILDING & CODE ENFORCEMENT
742 Say Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name cARR
Location
Date Permit
SOIL TYPE oam-Clay-
Results of Percolation Test-
( if appli able ) Rate-Minuteflnch
TYPE OF S TEM: J
ABSORPTION EL Total ength G
Length of eac =-
Depth of tren hes
Size of stv .. �-
SEEPAGE Number-
Size - PI fto x t .
Stone size
PIPING: ize ype
Bldg . to Tank ���'_`V + � -
Tank to Dist . Box
Dist . Box to Field/Pi `k
Openings Sealed? c�� L Fio arts a
LOCATION/SEPARATIONS : feet
Foundation to Tank
Foundation to Absorption feet
Separation of Pits fapt
Conforms as per Plot Plan
LOCATION OF SYSTEM ON PROPERTY:
( circle one) _ _ Right Side
Front - Rear Le .. ` ' g
Middle Front Middle Rear
COMMENTS :
SYSTEM USE APPROVED: YES
i
Arrived:
Departed : "
ing e r
3`-
¢ '9 have seen a observed, or believe I saw evidence o f
all objects such as houses, wells, trees, fenM
` shown on this document, I also represent IM t have
p net me9s
e di ad foitll OR the diagram,"
SIG TURF
DATE
Stgr+c TA,,.f�.
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