97-357 CERTIFICATE OF COMPLIANCE
TOWN Of QUEENSBURY
WARREN COUNTY, NEW YORK
Date ,Tn1 19 07
3oS _ I- 7 •
This is to certify that. work requested to be done as shown by Permit No. . 97357
has been completed.
This structure may be used as a SF I"TTC 'ALTERATION
'Location 24 CR ;ENt A`i NORTH
' Owner VIELE EtiOENN 1 CF T'H RINE
By Order of Town Board
TAX, MAP NO. 72 .6-1 TOWN OF QUEENSBURY
Di 2/f ui .-,".81`-4de Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 97357
TAX MAP NO. 72 . -6-1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to_ VTFT,F , FITaPATF CATHE-RIB
OWNER of property located at - 24 GRFFNWAY NORT..H Street,Road or Ave.
in the Town of Queensbury,To Construct or place a SEPTTC 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
24 GREENWAY NORTH
QUEENSBURY, NY 12804
2. CONTRACTOR or BUILDER'S Name
QUEENSBURY SEWER
3. CONTRACTOR or BUILDER'S Address
JAY SWEET
0
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
SEPTIC
( )Wood Frame ( I Masonry ( I Steel l 1
7. PLANS and Specifications
SEPTIC°ALTERATION AS PER PLOT PLAN SPECIFICATIONS
8. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT FEE PAID -THIS PERMIT EXPIRES June 30 19 99
(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.)
Dated at the Town of Queensbury this 30 Day of June 19 97
SIGNED BY k\-)u,„.
for the Town of Queensbury
Building and Zoning Inspector
Application for SEPTIC DISPOSAL PERMIT
• (
Town of Queensbury
q 7-35-7
Dept. of Community Development Permit No.
Building &Codes Office e->
742 Bay Road Fee Paid $95,
Queensbury, NY 12804
Location of property for installation: e e (A../
Property Owner's Name: -7 Cl ge (//"re Property
-
Property Owner's Mailing Address: re44JLT D-
Installer's Name: 1 c7??(--L4,-- at,, Phone # 7'7 ,ogff
Number of bedrooms (if residential): Z.— Total daily flow:
(residential - compute @ 150 gallbdrm.)
Topography: X' flat, rolling, steep slope % of sloe p51vE.o
Soil Nature: .2c.' sand, loam, clay, ,.other /depth: JUN .3 0 1997
• Ground water: at what depth? feet / Bedrock or Impervious Material:TakePtIit
Percolation test: ?( not required, required [rate min. per inch]
Domestic water supply: X municipal, well, other
If domestic water supply is a WELL, water supply from any septic absorption is feet.
• PROPOSED SYSTEM
Septic tnk gallon (minimum,size: 1,000 gal.)
' Tile field: each trench 7 5 feet / Total system length: /3L-r- feet
Seepage pit(s): number of / size each: ft. by ft.
Size of stone to be used: / depth or thickness feet
•
•
HOLDING TANK SYSTEM: (if required)
Number of tanks: Size of each: gallons
------- -
Alarm 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 known by or on behalf of an applicant;shall be void.
I have read the regulations with respect to this application and agree to abide by these and all requirements of the Town of
Queensbury Simitary Sewage Disposal • ‘.
6
Signature of responsible person: • Date: -11 •
•
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TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 6//fg5
Location 6 .t/e0,} f'
Date 7 __ 9 Permit # 17 367
SOIL TYPE San. Loam-Clay-
Results o Percol 1 n Test-
(if applica e) ate Minute/Inch
TYPE OF SYST
ABSORPTION FI : T al Len th ) j 35
Length of e h tre ch / 76--
Depth of t nches '2
Size of one -
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size .�
PIPING: l�e Type
Bldg. to Tank yz7, .,'
Tank to Dist. Box a u 9-0
Dist. Box to Field/P ' ii 11 A
Openings Sealed? ' No P ial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption feet
Separation of Pits
Conforms as per Plot Plani;f5eet
No
LOCATION OF SYSTEM ON PROP
(circle
Front - earl- Left Side - Right Side
Middle • - Middle Rear
COMMENTS:
•
SYSTEM USE APPROVED: YES NO
Arrived: 7: 7-5
Departed: `` /�
Building Inspector
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REVIEWED BY
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JUN .2 7 1997
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