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98-771 CERTIFICATE FICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY . NEW YORK €?ate December 27 ig 98 98771 This is to certify that work requested to be done as shown by Permit No . _ has been completed . SEPTIC ALTERATI0I3 This structure may be used as a Location 10 FQXHURST DR . S I DEBOTHA14 , JEAN Am Owner TAX MAP NOC 90 0 - 6 - 5 By Order of Town Board Director of Building & Code Enforcement BUILDING PERMIT VALUE $ e TOWN OF QUEENSBURY No. TAX MAP NO . 90 . - 6 - 5 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to SIDEBOTHAN J RAW OWNER of property located at 10 FOX14URST DR , Street. Road or Ave. in the Torun of Queensbury. To Construct or place a SE PTIC 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 I i C1XHURS T DR IN QUEENSBURYr NY 12804 2. CONTRACTOR or BUILOER'S Name SANITARY SEWER - BWR& ©�S tL POD Address BOX 224 GLENS FALLS NY 12801 4. ARCHITECT'S Name S. ARCHITECTS Address 5. TYPE of construction — (please indicate by X) SEPTIC l ) wood (Frame l 1 Masonry ( ? Steel f 1 y. PLANS and SpecificatiOns SEPTIIQ, ALTERAA'TION AS PER PLOT PLAN SPECIFICATIONS =SEPTICALTEPJATION 25 December 15 t92000 $ PERMIT FEE PAID - THIS PERMIT EXPIRES (It a longer period is required an application for an extension must be made to the Building and Zoning inspector of the town of Oueensbury before the axpiration date.( 15 December i9 1998 Dated at the Town of QueenspLury this Day of for the Town of Queensbury SIGNED BY Building III Zoning Inspector Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Permit No. DePL of Counnunity Development Bull ing & Codes Office QueenSbury, NY 12804 Location of property for installation: Io X rkJl 4�.ri Property Owner's Name: 46 C � C7,7"°�j l� M C r +, j � 1998 Property own 's Mailing Address: + V Installer's Name* I Phone # �/ / ,Z Number of bedrooms (if residential): Total daily flow: (residential - compute @ 150 gal.lbdrm.) Topography: dat, rolling, steep slope % of slope Soil Nature: sand: k:am, clay, other C depth: Ground water: at what depth? feet / Bedrock or Impervious Material: at what depth? _ feet Percolation test: not required, required [ rate Hain.. per inch ] Domestic water supply: .)I. municipal, well, other If domestic water supply is a WELL, water supply from any septic absorption is feet. PROPOSED SYSTEM �XldiiN � Septic tank: )00-0 gallon (minim vim , Size: 1 ,000 gal.) Tile field: each trench IV l�j' feet / Total system length: feet Seepage pit(s): number of Z f size eachm. t ' h. by — ft. Size of stone to be used: # I depth or thickness feet HOLDING TANK SYSTEM: (if required) Number of tnn : Size of each: gallons Alarm eyatran and associated electrical work to be h=pected by a certified agency For your protea4on, pl+esso note that Puts to Section. 136-29 of the Code of the Tovm of Qaesuabnry, nay pexnut or approval granted which is based upam or is ,granted in reli+aa>+ce wpm any malamd or Stiilure to mAm a njaunwd fact or circusnatencs known by or on behalf of arm applicant; shall be void. I have react the � with �a to abides by these and all r � of the Town of Que nsbury Sanitary Sewage ' e Signature of responsible person: -�`—�' f Tow OF QUEENSBURY BUILDING i CODE ENFORCEMEIff 531 Bay Road Queensbury NY 12804 518445- 4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name Locations _ f Date 4 Permi t #�� ` ' - ! SOIL Sand- am-Clay_ Results of Percolation Test- ( if appli ble ) Rate-Minute/ Inch TYPE OF SY T E14 M ABSORPTION IELO : Tot Lengt Length of ea h tre Depth of tren e 11 Size of stone SEEPAGE PI Num�+er- ft______---.._ _ Size - � x ='---- Stone s Type PIPING: i ,rj 1J� Bldg . to Tank -- Tank to Dist . Box Dist . Box to Field / Pi � Openings Sealed '. a No 'arti al LOCATIONISEPARATI r,% feet Foundation to Tank Absorption feet Foundation to Absorp ett Separation ox� Pits Ye eNo Conforms as per Plot Plan R LOCATION OF SYSTEM ( circle one ) i ht Side Front - Rear - eft Side - g Middle Front M1 ear COWENTSww SYSTEM USE APPRO ED : YE5 ' NO Arrived: Departed: Building nsp{ector ----� TOWN OF Q U E f ASBURY 71 BUILDING I5u) CO a, EPT. REVIEWED EY •_�' DATE 1008 I s � u r � r s 3 M rim � A— Wieve 58;h �rf "! , trees, i l k M > erese,zt gram:' s1a�► ,� fiances s DATE lVp�UR'E