1992-760 r
•
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 42me,m4a, 1992
This is to certify that work requested to be done as shown by Permit No. 9_760
has been completed.
This structure may be used as a e .f-am
Location cq Miviora.t+ D.piwn
Owner Philip ! rt /
•
By Order of Town Board •
TOWN OF QUEENSBURY
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Director of Building St Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY 92-760
No.
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to PHILIP HART •
OWNER of property located at 53 Wincrest Drive 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.
1. OWNER'S Address is
same �I
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2. c $JTiitefi1RSeWel1CDER S Name
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name c31
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5. ARCHITECT'S Address - CCD
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6. TYPE of Construction—(Please indicate by X) N
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
fir_
No. Two 10')(8' Seepage pits for septic alteration as per plot
plan . specifications and application.
8. Proposed Use
Septic system
25.00 December 1 94
$ PERMIT FEE PAID—THIS PERMIT EXPIRES 19
c+
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the (1:0
town of Queensbury before the expiration date.) -5iu
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Dated at the Town of Queensbury this r �� Day of _ -,,,. 19 92
ir-AF
SIGNED BY Iwo for the Town of Queensbury
Building and Zoning In-'or
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�6� TOWN OF QUEENSBURYx .
APPLICATION FOR SEPTIC DISPOSAL 'P R!Yt . n Permit # 92- 160
Fee Paid ,, 5
DEC', 1. 1992
Date: i / / /99? Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: . 1/ "7%1ICcc7
Owner' s Name:
s �' e
Owner' s Mailing Addres � d//,//`'f,' c/ex,e"-
Installer' s Name: , 4-®u /7' 474v.t _ Phone #: 7?2- `72S
Number of bedrooms (if residential ) : '7
Total daily flowl(residential-compute @ 150 gal . per bedroom) : ll D
Topography-Circle One: eo. Rolling Steep Slope % of Slope
Soil Nature-Circle One: , Sand,; Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Require. Required/Rate Min. Per Inch
Domestic Water Supply-Circle One:, Munici.p 11 Well Other
If domestic water supply is a-
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank / ô0 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of 2- / Size each: /0 ft. x P ft.
Size of Stone to be used: # y / Depth or Thickness 2-- feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks 1 Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency.
****************
I have read the regulation on the verse side of this sheet and agree to abide
by these and all1 requirements o th own of Que ury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: 47--- /- S
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BU'i l D N G
REVIEWED BY
•
DATE i", ..ift /91,
•
Jocun of Queniurty
• BUILDING and ZONING DEPARTMENT- alp
' Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME / 7-ti. -9) 9(/
LOCATION
DATE 4/,`2/g,2P PERMIT NO. �,. 7l i
;i SOIL TYPE - Sand - Loam - Clay -
1 Percolation Test Required? YES - NO
Percolation rate - Min/Inch •
TYPE of SYSTEM: 1
[ Absorption field, total length
I Length of each trench
•
.Depth of trenches ' " :
Size of gravel
'SEEPAGE PITS{Number of)
Size- ft. X. ft.
Gravel size ,
PIPING: Size i Type
Bldg. to tank
Tank to dist. box '
Dist. box to field/pit
Openings sealed? YES /NO Partial
LOCATION/SEPARATIONS: {' •
Foundation to tank ft.
Foundation to absorption` ft.
Absorption to lot line ft.
Separation of pits / ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left/side Right side -
COMMENTS: I
/!1,
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SYSTEM USE APPROVED YES NO
Building Inspector
O1/86 and vl
awn, o/ Queeni4ur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98.
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
?L12 th
iLi'
LOCATION /,'I A LeM t
DATE/, /9Z_PERMIT NO. 9 - 7 0
SOIL TYPE - an - Loam - Clay -
Percolation Test Required? YES. - N�
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length
Length of each trench 1
Depth of trenches ' I "
Size of gravel
SEEPAGE P ITS{Nuimbeer of) 1, i a
Size- R" ft. X" P6 ft. 1,:
Gravel size ,,,3
PIPING: Size Type
Bldg. to tank
Tank to dist. box Vii ��-
Dist. box to field/pit $ ��
Openings sealed? 4C9 NO" Partial
LOCATION/SEPARATIONS:
Foundation to tank: ft.
Foundation to absorption 2,5*-ft.
Absorption to lot.' line fp' ft.
Separation of pits *3d' ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - teft side - Right side -
COMMENTS:
of
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1 1
III
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SYSTEM USE APPROVEDOlt$ NO
Building In pector
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