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98-484 CERTIFICNrE OF COMPLIANCE TOWN Or QUEENSBURY WARREN COUNTY , NEW YORK Da to A "a s t 6 19 ____q$ r e 98484 This is to a ti y that work requested to be done as shown by Permit No . has been completed . This structure may be used as a SEPTIC ALTERATION Location 14 PINE WOOD HOLLOW RD . Owner CRAVO'T'TA , DANIEL & JUDITH By Order of Town Board TAX MAP NO . 90 . - 5 - 1 3 TOWN OF UEE SOURY Director of Building & Code Enforcement BUILDING PERMIT VALUE IS 0 TOWN OF QUEENSBURY No. 98484— TAX MAP NO . 90 . — 5 - 13 WARREN COUNTY, NEW YQRK PERMISSION is hereby granted to OWNER of property located at 14 Street. Road or Ave. in the Town of Oueensbury, To Construct or place Is 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. t. OtMN " Address Is 14 PINEWOOD HOLLOW RD , QUEENSBURYr NY 12804 2. CONTRACTOR or BUI LQER'S Name I . B . S . SEPTIC S. CONTRACTOR or SUILOER"S Address 2 LOWER WARREN STREET QUEENSBURYr NY 12804 4, ASCHITECT'S Name fi. ARCHITECT'S Acidness 6. TYPE of Construction — (Picas* indicate by X) SEPTIC i ) Wood Frame I I masonry ( ) Steel I I 7. PLANS and Specifications SEPTW ALTERATION AS PER PLOT PLAN SPECIFICATIONS S. Proposed Use SEPTIC ALTERATION 25 August 6 19 2000 S PERMIT FEE PAID — 'PHIS PERMIT EXPIRES (it a "or Period Is required an application for an eetenslon must be made to the Sulldina and Zonng inspector of the town of Gueentbury before the expiration date.l 6 August 1998 Dated at the Town of Oueensbury this bay of t9 III for the Town of +Queensbury SIGNED BY Building end Zoning Inap+eten � 4 - Application for SEPTIC DISPOSAL PERMIT Town of QueenComm bwy Permit No. Dept. of Community Development `--f" Building & Codes Office /! 742 Bay Road Fee Paid $ Queensbury, NY 12804 Location of property for installation: + f` r 't C L 4.,.,d.a- f 0- r. Property owner's Name: A r% `aF- f Ir'f�. \ n I `� Property Owner's Mailing Address: Installer's Name: / 11e /s �7,�7"�r� Phone Number of bedrooms (if residential): Total daily flow: C.e'_d (residential. - compute 0 150 gal.lbdrm.) Topography: flat, rollincr, steep slope % of slope Soil Nature: sand, loam, clay, other / depth: AUG 1 Ground water: at what depth? feet I Bedrock or Impervious. Material: at what depth? ! feet Percolation test: not requir9dw, required [ rate min. per inch j Domestic water supply: ( J municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM Septic tank: & k? gallon (minimum size: 1,000 gal.) Tile field: each trench 5� feet 1 Total system length: 4? d d feet Seepage pit(s): number of I size each: ft. by ft, Size of stone to be used: # I depth or thickness feet y HOLDING TANK SYSTEM: (if required) Number of tanks: Size of each: gallons Akartn system and associated electrical work to be inspected by a wed egeory. For your protection, please note that pursuant to Section 136r29 of the Code of the Town of Queembury, any permid or approval granted wbich is based upon or is granted m reliance upon any material m Akeln or failure to males a material fact or cirewnatance known by or on behalf of an appUcaat, sball be void. I have read the regWAtIOW with respect to this apphc and agree to abide by dwae and a n requirements of the Town of Queensbiuy Sanitary' Sawage Disposal Onlinassce. Signature of responsible person: Date: -" GI TOWN OF QUEENS9URY BUILDING & CODE ENFORCEMENT 742 DAY ROAD QUEENSSURY NY 12804 ( (518) 761-8256 ARRIVE : 1C .� DEPART : 4p:- �. INSP FINAL INSPECTION REPORT — RESIDENT L DATE INSPECTION REQUEST RECEIVED : NAME LOCATION DATE PERMITi TYPE OF STRUCTURE FOOTINGS FOUNDATION ACKFILL F ING ROUGH PLUHBING SEPTIC INSULATION FINAL ELECTRICAL WOODS E OR FIREPLACE A YE NO CHUMEY-HEIGH118 V N EI T PLUMBING ROOFING? SN PS RA ING RELIEF VALVES OT W T OP RATI R T AjjiZ_kBIVACy DOORS W GHT QTHER FjjooORS _SwEEpAB O R CARPET S IR LEA C RA I BOOKE VE I Ns rN xT s '�• F�QUNDATION INAULATION I GAHME FIRE O N CA49SERS FINAL ELECTRICAL SITE pi &tL VAR ANCE LO i EINAL SU VE O AN I K TQ I 9SUS C O R C C rt lFflC�Ti t r�� i_�___ Vic, ��� ►�,�, „ �� i U %o c � TOWN OF QLIEENSWRY PLLDING A CODE ENFORCEMENT 742 Bay Road Queensbury NY 12804 (518) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Location Q date Perini t �� SOIL TYPE : rSan;- Loam-cla Results of lation T st- ( if applicable ) Rate- Min to/ Inch e TYPE OF SYSTEM: ABSORPTION FIELD . Total en Length of each tr nch Depth of trenches Size of stone SEEPAGE PITS : umb - Size - fto x ft . Stone size PIPING; - izype Bldg . to Tank r '� Tank to Dist . Box Dist . Box to Field/ i t Openings Sealed? es No ar ' al LOCATION/SEPARATI Foundation to Tank feet Foundation to Abs rption et Separation o ` Pit feet Conforms as per of P1 an a No LOCATION OF SYS M ON PROPER ( c i rcl Front - ear eft Side - Righ Side Middle i ddl a Rear COMMENTS : SYSTEM USE APPROVED : TIES/ NO Arrived : '- © Dep arte& Building Inspector TOWN OF QUIEEN URY 06 DATE F Aug4 have sm orthieve 1 Derr very at of sit ��� weds, ts�es„ loom oftow -)wn co MrllK t also repre9d *A#1 ■r ,r *wrinces set iaetrf 7 �. ------ 77 FILE COPY VA% viol CWT00" &%W codA Ekt It 5 Ti /\ i l7. � po8 �� C. i a •L l2.. tv 1� v