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CERTIFICATE• OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY; NEW YORK
Date Li Q B ,996
3�C14*( & � � No. 90-343
This is to certifythat work rc uested to be d a as shown by Permit
has been completed.
This structure may be occupied as a SewRP'e Rlterration
Location �� � )j lI{ol'& Road
Owner STANLEY SEASIAN
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enfockement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-343
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to STANLEY SEAMAN
OWNER of property located at 80 Dixon Road Street,Road or Ave. 4?
t'3
in the Town of Queensbury,To Construct or place a Sewage 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
same
2. CONTRACTOR or BUI LDER'S Name
Sanitary Sewer CD
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) O
( )Wood Frame ( ) Masonry ( )Steel ( ) - p
7. PLANS and Specifications
No. Septic alteration to include 200 ft Tile fields with #2 stone at 1 ft depth,
as per plot plan and application.
8. Proposed Use U
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Sewage alteration
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$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES June 4 19 92 /22
(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 4th Day of June 1990
SIGNED BY Uia for the Town of Queensbury
Buildi g and Zoning' Spector
TOWN OF QUEENSBURY
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. ...,% . APPLICATION';; FOR, , i
--v › SEPTIC DISPOSAL PERMIT'41111110
//41- 2-74 111.13,,
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DATE - -- -22 - T BUILDING & CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION SID /y42,‘, Ave
Owner's Name: �7-AkfC e 6 f1 f,9-i'44s Telephone: 7 9, C'7 41,?
Address: gO e X 0,Lf -
Installer's Name: XiAir77lici JII . Telephone: 7 92'7 '7
Number of bedrooms (residential only) `3
Total daily flow (compute (. 150 gal per bedroom) 4/16V
Topography: Circle one: er ` Rolling Steep Slope % of Slope
Soil Nature: Circle ones Loam clay Other /Depth: Feet
Ground Water: At what depth? — Feet
Bedrock or Impervious Material: At what depth? - Feet
Percolation test: Circle one• not required required rate min. inch.
Domestic water supply: circle one: lunicipa Well Other
If domestic water supply is a wel :
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank I CUD £'gal. (min mum size: 1,000 gal.)
TILE FIELD: Each Trench n41-0 feet/Total system length 0 0 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # y /Depth or Thickness / feet
*************************
I have read the regulation on the reverse s de of is sheet and ag abide by these
and all requirements of the Town of Glue nsbur S nitary Sewag i o al Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: / 4//1"-
DATE: . —2. ' 93
OVER
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t'" ' Septic System. Inspections: -
,"5 r"•.ref• -..:.
A. All applications•'for septic system installation, alteration or repair,
a's-•f:requfired. by,. the ,Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of .constructionand shall include a plot plan showing:
1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywells__ _ - _ .— _
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B. No system shall be covered before inspection and approval by the •
Building Inspector. Failure to comply with this requirement may
result in the uncovering of the system by the installer and a fine
of up to $250.00.
C. An approved copy of the plot plan shall be available on the construction
site. Failure to produce said plot plan at time of inspection may
result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further •
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
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Remarks : '
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Leqcc�� // x(ei
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_loran o/ Queeni6ury
BUILDING and ZONING DEPARTMENT
Bay and Ha iland Road, R.D. 1 Bo •8
Queens*ury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPTCTION
NAME //i ,!g/ ,/LIB /
LOCATIO ?) argar/
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DAT f /fd "ERMIT NO. q'o ' 3 -3
SO TYPE - Sand' - Loam - Cl -
Percolation Test Required? ES - NO
Percolation ratel- Min/Inch
TYPE of SYSTEM:
Absorption field, total le th. 2 )
Length of each t I:ench , , ,Depth of trenches
Size of gravel i 'r r
SEEPAGE PITS{Numbs of) j
Size- ft. X - ft.
Gravel size
PIPING: i S`ze- Type
Bldg. to tank i ' ,(/f f`�� c'
Tank to dist. box G( ' �l G
Dist. box to fiel _ ;' pc
Openings sealed? , ES NO Partial
LOCATION/SEPARATION;::
Foundation to tank i •
eft.
' Foundation to abso3ip ion TV-it.
Absorption to lot/.i e —ft.
Separation of pits I ft.
LOCATION 0 STEM ON PROPERTY.�c reie one)
Front - Rear - Lift s de -� igh side
COMMENTS°• '
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SYSTEM ' SE APPROVED E ,Ne/' _---
Building In•pector
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JUN -41990
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