98-716 1 t1L x .V. COMPLIANCE
CER l7 r
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
1 Date November 16 pg 98
This is to certify that work requested to be done as shown by Permit No . 98716
S716
has been completed ,
This structure may be used as a SEPTIC ALTERATION
Location 13 BUENA VISTA "E . - —
Owner LAZARUS , STEVEN
TAX MAP NO . 80 . . 2 - 5 By Order of Town Board
. - TOWN OFF VE,�,IV SBA II
Director of Building & Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY No. 98716
TAX MAP NO . 80 . - 2 - 5 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to LAZARUS STEVEN
OWNER of property located at 1_3 BUENA VISTA 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.
t. 0WNERs Adams is
13 BUENA VISTA AVE .
QrUEENSBURY , NY 12aO4
2. CONTRACTOR or BUI LDER "S Name
CONDONrS SEPTIC & DRAIN SERe
3. CONTRACTOR or SUILDER'S Address
4. ARCHITECT'S Name
S. ARCHITECT'S Address
6_ TYPE of Construction — IPlease indicate by X)
SEPTIC
I ) Wood Frame { I Masonry I I Steel I I
]. PLANS and Specifications
SEPTI't- ALTERATION AS PER PLOT PLAN SPECIFICATIONS
S. Proposed Use
SEPTIC ALTERATION
$ 25 PERMIT PEE PAID — THIS PERMIT EXPIRES November 16 19 2000
(it 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 16 Day of November 19 1998
SIGNED BY -� � 4 for the Town of Queensbury
Building and ZonirV Inapectpr
Application for SEPTIC DISPOS.AT , PERMIT
Town of Queeasbury
Depr. of Community Development Permit No. �i/
Building & Codes Office
742 Say Road Fee Paid
Queersbury, NY 13344
I ocadon of property for installation: t U g&rA
Property Owner's Name: �U
1998' j 3
Property Owner'shver'S Mailing Address: 13 IJr� F'U /''�".�/4 e5 �y LuL
Installer's Name: ,2liAoy � �- Phone
Number of bedrooms (if residential): Total daily flow: 7 J C
(residential - compute (0 150 gal./bdrtn.)
Topography: —X.flat, rolling, steep slope % of slope
Soil Nature: sand, loaut, clay, other / depth:
Ground water: at what depth? Ofeet / Bedrock or L=lgervious Material: at what depclag feet
Percolation test: of required required. [ rate min. per inch. ]
Domestic water supply: � m�, �i�pa1, well, oilier
If domestic water supply is a WELL, water supply from any septic absorption is feet.
PROPOSED SYSTEM ClS��rAl
Septic tanlc gallon (minimum size: I ,0(]0 gal..)
Tile field: each trench .�O feet / Total system Iength. .2, feet
Seepage pit(s): number of / size each.: ft. by f*
Size of stone to be used: r ' — i dapth or thickness e` feet
HOLDL`JG TANK SYSTEM: (if required)
Nurnber of tanks: Size of each; gallons
Alarm system axd associated electrical vaunt to be: m=p&c;te 3 by a certified ageQ-r.
For your protection, please note that pursuant to Section 136-29 of the Code of tixe Town of
approval gr -.Yt which is based or is Q�abury, y P� or
upon granted in reliasica zxpern azsy matexis.E urisrepreaexdatioq or faulxsr+o to ncaka a
xoAterai fact or circumstance known by or on behalf of art appEc.auk, shall be void.
I have read. the regulations with respect to tbia application and agree to abide by tbase aad all reTzirements of the Town of
Queensbury sanitary Sewage Disposal Ordi ama.
4/'',/
5i¢store of responsible person,r�_ i is� Date, — ,/ `� -- '
fi) 9 w o
. - '~ TOWN OF QUEENSBURY O*r)
BUILDING A CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(519) 7451-9256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name s A v Q Z O R rJ.P
Locationr�C�n
Date 9 Permit #
SOIL TYP,t. S fi-C1ay-
Results of Percolation Test-
( if applicable ) Rate-Minute/ Inch
TYPE OF SYSTEM: }
ABSORPTION FIELD : Total L �gth
Length of each trench _
Depth of enches � - +
Size of sto e
SEEPAGE PI N er-
Size - f x ft .
Stone size
PIPING: Size Type
Bldg . to Tan r
Tank to Dis Sox c t*
Dist . Sox to Field/Pit % %
Openings Sealed ? es p artial
LOCATION/SEPARATI ,
Foundation to Tank �� feet
Foundation to Absorption feet
Separation of Pits t
Conforms as per Plot Plan o
LOCATIONOF SYSTEM ON PROPS
( circle one )
Front - Rear - Left,-Side - Right Side
Middle Front - - Middle Re m�-
COMMENTS-
SYSTEM USE APPROVED : ,.- " ES
Arrived:
Deoa
Buil ing ector
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vio
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