97-252 C I��I'IFIC T C OF COMPLIANCE
TOWN OF QUEENSBURY . •
WARREN. COUNTY, NEW' YORK
Date t; 2 .- 19 97
•
97252
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 8 BRAYDON AVE.
Owner
`CAFT, JERRRi & ELIZABETH
•
By Order of Town Board
TAX HAP NO. 89 . -3-6 . TOWN OF QUEENSBURY . "
•
• Director of Building & Code Enforcement •
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 97252
TAX MAP NO. 89 . -3-6 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to TAFT, JERRY & ELIZABETH
OWNER of property located at 8 BRAYDON 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 Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
8 BRAYDON AVE.
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
SANITARY SEWER
3. CONTRACTOR or BUILDER'S Address
DAN DRELLOS PO BOX 224
GLENS FALLS NY 12801
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( 1 Wood Frame ( )Masonry ( )Steel ( 1
7. PLANS and Specifications
SERaTIC ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
25 May 22 1g 99
$ PERMIT FEE PAID —THIS PERMIT EXPIRES
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
town of Queensbury before the expiration date.)
22
Dated at the Town of Queensbury this Day of May 9 7
19
SIGNED BY , 1}� ? } for the Town of Queensbury
Building and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
Town of Queensbury Permit No. (` '7. 5
Dept. of Community Development
Building&Codes Office
742 Bay Road Fee Paid $
Queensbury, NY 12804
Location of property for installation: . 2rAeitic1(IX/
�Property Owner's Name: IC J •
Property Owner's Mailing Address: ( / -cE
Installer's Name: A, ny-7 Phone # 7 g )-`s-7
'. Number of bedrooms (if residential): 3 Total daily flow:
(residential -compute 2 150 gal./bdrm.)
Topography: i2L flat, rolling, steep slope % of slope
• Soil Nature: sand, loam, clay, other /depth:
Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet
Percolation test: A not required, required [rate min. per inch]
Domestic water supply: O' municipal, well, other `• r/
If domestic water supply is a WELL, water supply from any septic absorptio' is MAYr
` �t199T
•
PROPOSED SYSTEM TOVri� U �=�'iaJURY
i.JLrr .NG AND CODE
Septic tank I'J gallon (minimum.size: 1,000 gal.)
Tile field: each trench ge feet / Total system length: / 9 0. feet •
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: # 2— / depth or thickness ( feet
HOLDING TANK SYSTEM:. (if required)
Number of tanks: Size of each: gallons
(Aiann system and associated electrical work to be inspected by a certified agency.)
For your protection, please note that pursuant to Section 136-29 of the Code of the Town of Queensbury, any permit or
approval granted which is based upon or is granted in reliance upon any material misrepresentation or failure to make a
material fact or circumstance lmown by or on behalf of an applicant;shall be void.
I have read the regulations with respec ' tuna and agree to abide by these and all requirements of the Town of
Queensbury Sanitary Sewage Dispo O
Signature of responsible person: QAt-4)2 /J� Dater 2L -?
TORN OF QUEENSBURY
BUILDING S, CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name _ L a=
Location 9 P)RPAnC)0VIE
Date 1. 0 Permit # CN�;L2 37
SOIL TYPE tSand- oam-Clay- ' /
Results oft Percolation Test-
/
(if applicable) .Rate-Minute/I;nch
TYPE OF SY TEM:
ABSORPTI�t°8 FIELD: Total Len nit
Length of ea\h trench
Depth of trenches et
Size of stoned 1
SEEPAGE PITS: \Number-
Size - tft. x E ft.
Stone size \, I
PIPING: Size Type
Bldg. to Tank \,
Tank to' Dist. Box\ /
Dist. Box to Field+/Pjt
Openings Sealed? \ aYes No Partial
LOCATION/SEPARATION
Foundation to Tanki feet
Foundation to Abso'p ion feet
Separation of Pit ; feet
Conforms as per Prot ,l an Yes No
LOCATION OF SYSTE ON ,ROPERTY:
(circle one) 1
Front - Rear - L�'eft Side - Right Side
Middle Front - Addle Re r •
COMMENTS:
t _
-2 tJ�h C1--O
1 o \�16
SYSTEM USE /S)()OL._
OVED: YES i,N
Arrived: '`L,,,
IIrAirA lir f
/Building In:a::ctor
C; ;1' )-0:17-2.-->
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
01(\
Queensbury NY 12804 n;
(518) 761-8256 �
SEPTIC DISPOSAL SYSTEM INSPECTION
I/
Name P ', U ( A 4"
Location
Date -A�- Permit CA /-- .,5 ,
SOIL YE: Sand-loam-Clay- if
.
Results of Percolation Te t-
(if applicable) .te-Minute/Inch`
TYPE OF SYSTEM: '
ABSORPTION FIELD: TotaljLength
Length of each tr-nch "r \2
Depth of trenches ° '., �`
Size of stone /*-
SEEPAGE PITS: Numb"
Size - ft. : t.
Stone size
PIPING: I S ze�,Type ,111
Bldg. to Tank F
Tank to Dist. Bo 4 9` b()P—fite
Dist. Box to Fi e1'd/Pi\ fl�' �e_�,G-V
Openings Sealed? Ye: No Partial
LOCATION/SEPARATIONS: '
Foundation to Wank , ---) feet
Foundation to Absorptioq70 feet
Separation of/ Pits feet
Conforms as per Plot P1 a ` '.e_ ► o
LOCATION OF/SYSTEM ON PRO'ER ° .
(circle one)
Front - Rea`r - Left S..- - Right Side
Middle Front -.wall.. e Re.
CO ENTS:
//
______\ \
f Z1
SYSTEM USE APPROVED: . YES--- :12 0
Arrived: ..
/64)Depaea: / (.: //,24,( /
Bui'1ding sp-ctor
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name r gA1:0 a —14F
Location / 62 '4,)
Date tyi-6jj7 Permit # / /6
SOIL TYPE: Sand-Loam-Clay- 7---a5c;),
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size ft. x ft.
Stone size
PIPING: .. Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Field/Pit
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption _ feet
Separation of Pits feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear .- Left Side - Right Side
Middle Front - Middle Rear
COMMENTS: .
tre (Aker i rt}`G''&) . - vSY ivy
•
•
SYSTEM USE APPROVED: YES NO
Arrived: C/C___
Departed: �)
Building Inspector .
7‘ ,4)
TOWN OF QUEENSBURY
BUILDING A CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name %' Q
44
Location /✓4) iZ /
Date �/j Permit # eAv J/16
SOIL TYPE: Sand-Loam-Clay= 1Ta-512.„
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF YSTEM:
ABSORPTII . FIELD: To ,a1 Length
Length of ea. h tren' h
Depth of trenc •es
Size of stone
SEEPAGE PITS: Nu'.er-
Size - f ft.
Stone size
PIPING: -'Size Type
Bldg. to Tank
Tank to Dist. Box
Dist. Box to Fi •ld/Pit
Openings Sealed! Yes No Partial
LOCATION/SEPA' , IONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits _ feet
Conforms as per Plot Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YES O
Arrived: 9 67)
Departed:
•
Building Inspector
F, "2 '''''75 ' Jff �.
,,.a .
TOWN OF r9m
Y BUILDING OEP1MENT
limited commentsshall '
compliance with 1`D
not be construed as indicating the
plans and specifications are in lull D 12 —
compliance with the code. �6L
f1
,..) i 7?
_____\
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FILE COPY `
p- 4' SA�Y 2� ,997
TOWN
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HI have seen or observed,et believe t sire fence of, 1
all objects such as housesam r , ► eta
shown oo this daEwn .i AO t t{ieue
i • ,® }Ity A
, �. 011 the diagram:" T® '>w`.� — --
4 .4_,..ft44/ ,
MI
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