98-753 CERTIFICATE, 01P COMPLIANCE
TOWN OF QUEENSBURY
r
' WARREN COUNTY. NEW YORK
Date December 30 19 98
98753
This is to certify that work requested to be done as shown by Permit No .
has been completed .
SEPTIC ALTERATION
, This structure may be used as a _
Location
LOT 73 HOMESTEAD VILLAGE r I-00 Uklcy ".q� {J ,,,,a
F-�,/a HOMESTEAD VILLAGE -
Owner
TAX MAP NO 93 . - 2 - 11 . 1 By Order of Town Board
TOWN OF QUEENSBURY
Director of Building A Code Enforcement
BUILDING PERMIT
VALUE $ 0 TOWN OF QUEENSBURY
TAX MAP NO . 93 . - 2 - 11 . 1 WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to
Street. Road or Ave.
OWNER of property located at LOT 7
AD UTTA
in the Town of Queensbury, To Construct or place a
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. OWNER'S Address is
LOT 72 HOMESTEAD VILLAGE 72 ALPINE AVENUE
QUEENSBURYr NY 12804
2. CONTRACTOR or SUILt]ER'S Name
I . B . S . SEPTIC
3. CONTRACTOR or SUILDER"S Address
2 LOWER WARREN STREET
QQUEENSBURYr NY 12804
4. ARCHITECT'S Name
5. ARCHITECT`S Address
f1. TYPE of Construction - iPleate indicate by x1 ,SEPTIC
l 1 wood Frame f I Masonry t )Steel I I - --
7. PLANS and Specifications
SEPTT49 ALTERATION AS PER PLOT FLAN SPECIFICATIONS
B. Proposed use
SEPTIC ALTERATION
25 December 7 '$ 2000
S PERMIT FEE PAID - THIS PERMIT" EXPIRES
Sit longer
periodCkpaer is required an
bato ns ap n date l
plic sion jor on ex
Iow
tension swat be made to the Swilling AndZoning impactor of the
7 day of December 1998
Dated at the Townof Queensburif this
t9
for the Town of Oueensbury
SIGNED BY 8ulld and Zoni t
Application for SEPTIC DISPOSAL, PERMIT
Tow-a of Queensbury
Permit No9
Dept_ of Community Development
D
Building & Codes Office �� ( � - ]
'742 Bay Road Fee Paid `
Chueeasbury, h"Y 12804
Location of property for installation:
Property Owner's Name: / 7C3/ti l` ✓C�- !� G' �L t• 4 - T � .. $
>
Property Owner's Mailing Address: n f c.�
Installer's Name: Phone to s
Number of bedrooms (if residential.): � Total daily flow:
�^ (residential - compute 0 150 gal.lbdrm.)
Topography: ( flat, rollna, steep slope % of slope
Soil Nature: sand, 1o2xn, clay, Debar I depth:
Ground water: at what depth feet I Bedrock or Ira-pervious Material: at what depth? _ fee:
Percolation test:/6ffnot required, regtaired [ rests min. per inch ]
Domestic water supply: rns�,icipal y we:I, other
If domestic water supply is a W'=, water supply E om any septic absorption is feet.
PROPOSED SYSTEM
Septic taak: � agallon (m:nirnurn 512M.: I ,000 `?'al')
Tile field: each trench — feet I Total system length: feet
Seepage pit(s): number of } I Size each: . ft.. by &
Size of stone to be used: # / depth or thickness � _ feet
HOLDING TANK SYSTEM: (if rewired)
Number of ranks: Size of each.; moons
Alarm system and associated electrical vfxar 3 to be imsnec'a3 by a ccru$ed agmop.
For yct= protection. please note that pursuant to Section 136-29 Of tbo Code of the Town of Queembacty, any permit or
apvroval which is based tq= or is granted in reliance t poo any material Asa rsej;ta6v or faz7ure to tnak8 a
ra.ater2l fact or circtanstazce 3moaa by or an behalf of as applic mt, shall be void.
I have rid the regulations with respect to this applicabi and agxele to a by these mod all requirements of tba Town of
s" ,—y sanitary "sewage Disposal CgXi±+itocer /�
Si.na. .r e of responsible person: Date: I t
TOWN OF QUEENSBURY
WILDING � CODy R FORCE NT
oad
pueensbury NY 12804
(518) 761-9256
SEPTIC OISPOSAL SYSTEM INSPECTION
Name
Location �7 Date Perm! t #_ $-
SOIL TYPE` Sand- oam-Clay-
( i f p of Percolation
Rate-Minute/ l nch,�
( i f applicable )
TYPE OF SYSTEM:
ABSORPTIoONeachLDA Total Length r_
Leng
nch
Depth of trenches
Size of stone SEEPAGE PITS :
PITS = f?elo
ft .
Sizestone sizee�PIPING:Bldg . to TanTank to DistDist . Box toNo artiaOpen ; ngs SeaLOCATIONISEPfeet
Foundation feet
Foundation feet
SeparationConforms aspNOER s o
LOCATION 'CIF SYSTEM ON
( circle Rear . Left Side - Right Side
Front Middle Front - Middle Rear
CAS: _•- l r� S 7&tw*�
K
sYSI M USE APPROVED -
NO
Arrived:
Departed=
Building Inspector
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