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98-774 CERTIFICATE 01t COM1JLJ IIANCE TOWN OF QUEEN58URY WARREN COUNTY, NEW YORK Da to December 21 19 9 9877 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 55 HELEN DR . Owner RAGER , SC©TT & KAREN TAX MAP NO . 90 . - 4 - 76 By Order of Town Board { TO OF qUEE46BUOY Director of Building & Code Enforcement BUILDING PERMIT VALUE s 0 TOWN OF QUEENSBURY No. 98774 TAX HAP NO . 90 . 1111111141111111176 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to RAGER r SCOTT & KAREN OWNER of property located at 55 HELEN DR . Street . Road or Ave. In the Town of (]ueertsbuty, 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. OWNERS Address is 55 HELEN DR . QUir SBURYr NY 12804 2. CONTRACTOR or 13U1 LQERS Name I . H . S . SEPTIC 3. CONTRACTOR or 13UNLDE=R'E. Address 2 LOWER WARREN STREET QUEEN.SBURYr NY 12804 4. ARCHITECT'S Name 5, ,ARCHITECT'S Address 6. TYPE of Construction — tPlease indicate by X) ,SEPTIC t I Wood Frame I I Masonry { I Steel i ! 7. PLANS and 'Specifitetions SEPTA', ALTERATION AS PER PLOT PLAN SPECIFICATIONS 8. Proposed Use SEPTIC ALTERATION 25 December 18 lg 2000 $ PERMIT FEE PAID — THIS PERMIT EXPIRES tit a longer period is required an application for an extension must be made to the auifding and Zoning inspector or the town of Queensbury before the expiration date.) 18 December 1998 Gated at the Town of flu nsbury this Day of 15 for the Town of Queensbury SIGNED By Building a Zonirq tnapectar Application for SEPTIC DISPOSAL PERMIT Town of Queensbury Permit No. 99 � 7 Dept. of Community Development Building & Codes office 742 Bay Road Fee Paid x -> Queensbury, NTY 12804 Location of property for installation: Ire r t dr. Property Owner's Name: [ d I r' u to e / C '"C 1998 Property Owner's Mailing Address: C Cc ex �� ✓` Installer's Name: WL , �r SC',4/ r' Phone # Number of bedrooms (if residential): Total daily flow: 70 (residential - compute a 150 gal./bdrm.) Topography: t, rollina, steep slope of slope Soli Nature: sand, �l/oam, clay, other I depth: Ground water: at what depth?./u'lq feet / Bedrock or Impervious Material: at what depth? _____ feet Percolation test: /7 not required, required j rate min. per inch � Domestic water supply: Xrnunicipal, well, other If domestic water supply is a VVELL, water supply from any septic absorption is feet. PROPOSED SYSTEM IsySit `�' ny Septic tank 00 gallon (minimurn size: 1 ,000 gal.) Tile field: each trench feet I Total system Iength: feet Seepage pit(s). number of 0 _ I size each: , fL by ft. Size of stone to be used: # I depth or thickness - feet I-TOLDLNG TANK SYSTEM: (if required) Number of tanks: Size of each: Gallons Alarm syetem and associated electrical work to be h,"cted by a cexti.6ai 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 m reliance upc+u any tnatexua misreepreseutation or failure to roska a material fact or circa= stance known by or on behalf of an applicsont, shall be void. I have react the regulations with respect to this app ' stion and agree to abide by these azd an requirements of the Town of Queensbury Sanitary Sewage Disposal Signature of responsible person: ._. ...- Date: / �/G3 TOWN OF QUEENSBURY BUILDING �,2C DE BayENFORCEMENT ad QueensburY NY 12804 (s18) 761-8256 SEPTIC DISPOSAL SYSTEM INSPECTION Name Locate�qercolation -�DatePermId it # /"SOIL oam- Cl ay- Resin Test- es( if a able ) Rate-Minutellnch. � TYPE OF S STEM= Total Length �� ASSORPTI FIELD : Length of a ch trench ----- Depth of tre ches Size of stone umbe SEEPAGE P f t • f t . Size - -- Stone siz _ size yPe PIPING. Bl dg . to Tank Tank to Dist • 4�ox P Dist . Sox to Fiel o artia Openings Sealed? e LOCATION/SEPARATION feet Foundation to Tank ti feet Foundation to Absorpon feet Separation of Pits Not P Conforms as per Plo paROPER LOCATION OF SYSTEM[ ON ( circle - Left Side Ri9h Side Front - Re - Middle Rear Middle Front COMETS SYSTEM USE APPROVED = Y NO Arrived: 1� � Departed: Building nspector PI/I TOWK F QUEENSBURY BUILDING i CODE ENFORCEMENT 531 Say Road Queensbury MY 12804 518-745-4447 SEPTIC DISPOSAL SYSTEM INSPECTION Name cation '�W �-I/ Date Permit # SOIL TYP San Loam- Clay- Results of ercol ati on est- ( if applicab e ) Rate- inute/ ch TYPE OF SYS ABSORPTION FIEL T al Leng h _ Length of each tr h _ Depth of trenches Size of stone SEEPAGE P 13 Size - f x TE Stone size PIPING: Smze pe Bldg , to Tank -� 6 T:Tank to Dist , ox d Dist . Sox t ield/P Openings Sealed ? Yes No artial LOCATION/SEPARATION Foundation to Tank feet Foundation to Absorption feet Separation of Pits -3 R__ eet Conforms as per Plot Plan Yes No LOCATION OF SYSTEM ON PROPER { circle Front - ear - Left Side - Righ ide Middle Fr nt Middle Rear COMMENTS SYSTEM USE APPROVED _ YES NO Arrived : Departed : Building Inspector TOYJt'1 Of Q JNZpt WK ORRTMENT � [ kc Based on our limited enarrr`nairr, coViaro YA our oarnrner�snail rrot be wrlstrugd as it N the have see>7 plansandspeabbsare fop 3; : .�, erj , m#mmlwdh the ll r 1 t ail obis Such d, erg! ] as 1'�t: �'S �rEVe � say t;,ShOWh " alts v�ljS tree; off, personall rrrrc���ent t al,o rw rn ! fen�et y I ':�V set north oil ild SIGN _ FILE COPY } (" CrrC. TOWN OF QU ENS UR / BUILDING & I04 F. DATE 1998 i � r Cyr( i