90-480 CERIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date fiet-44.L►cl t g 19 9-1
This is to certify that work requested to be done as shown by Permit No. 90-480
has been completed.
This structure may be occupied as a sewage alteration
Box 1383, Uppet Bay Road
Location
KENNETH FUCHSLOCHER
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No. 90-480
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to KENNETH FUCHSLOCHER
OWNER of property located at Box 1383 Bay Road Street,Road or Ave.
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
RR1 Box 1383
Lake George Ny 12845
2. CONTRACTOR or BUILDER'S Name
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) te
( )Wood Frame ( ) Masonry ( 1 Steel ( )
C
7. PLANS and Specifications
No. Sewage alteration to include 200 feet of tile field and D-Box as per plot plan,
specifications and application and in compliance with Sewage Variance
8. Proposed Use granted.
C
Sewage alteration
a
vc
25.00
$ PERMIT FEE PAID—THIS PERMIT EXPIRES July 23 19 92 a
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the >s
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this d Q y of. July 19 90
SIGNED BY f''.7
for the Town of Queensbury
Building and Zoning nspector
UEtVED
`� pl,a�� , TOWN OF QUEENSBUP j_
�i,T113 0 1990 3 APPLICATIOrl FOR SEPTIC DISPOSAL PERMIT ;001ir
BLDG. &DOME DE 90
LOCATION OF P OPERTY FO INSTAL�A.TION ��s r 9 P, 9 /� t s e a-.s
4howr 1 Kai . ) cEl scc4 rid /�e. �i4e I k / 1t lI
Owner's Name: I ew.14 e t� cat.tts lvclCC.- J
Address: l ! Oa It1. Sf3 �� ire v� r l i,
f
Installer' s Name: .z.t Telephone: 793 9li96.
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) 9,)7 j
Topography: Circle one: Flat Rolling Et-e-ep §lope of Slope 12
Soil Nature: Circle one: Sand Loam Clay Other /Depth: .3 /
1
Ground Water: At what depth? ; 7 Feet
Bedrock or Impervious Material : At what depth? ', Feet
Percolation test: Circle one: not required requir- :
Rate - Min. Per Inch tom= 143,11
Domestic water supply: Circle one: Municipal Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption j k( feet.
Vat �o �� a tC
JP OPOSED SYSTEM: Septic Tank �5a gal . (minimum size: 1,000 gal )
_id' ILE FIELD: Each Trench ,54-0 feet/Total system length 2.-0 feet
1D SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #: /Depth or Thickness feet
**************************r**
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
I have read the regulation on the reverse side of this sheet and agree to abide
by these and all requirements of the Town of Que squry Sanitary Sewage Disposal
Ordinance. /
SIGNATURE OF RESPONSIBLE PERSON: DATE:--4)727 —'
1
Septic System Inspections:
A. All applications for septic system installation. alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted to the Building Department at least 24 hours before start
of construction and 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 co any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywalls
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 co produce said plot plan at time of inspection say
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
k.ata r k s:
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBURY, NEW YORK 1280k
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOR INSPECTION RECEIVED
NAME.`,
LOCATION 406.1%.6,7_4c. //,
DATE %�--� / PERMIT # QQ- 01V
APPROVED
YES NO
FOOTING/PIERS
MONOLITHIC POUR FORMS
FOUNDATION/DAMP-PROOFING
BACKFILL APPROVAL
ROUGH PLUMBING
FRAMING
ELECTRICAL ROUGH-IN
INSULATION:
FOUNDATION
FLOORS
WALLS
CEILING
FINAL INSPECTION:
CHIMNEY HEIGHT
ROOFING
SIDING
EXTERNAL PORCHES/STEPS
STAIRS-CLEARANCE & RAILS
PLUMBING FIXTURES/RELIEF VALVE
INTERIOR TRIM/PRIVACY DOORS
FINISHED FLOORS
GARAGE FIREPROOFING
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION �k
OK TO ISSUE C/O OR C/C
1
A SIGNED CERTIFICATE OF OCCUPANCY Mm BE
OBTAINED FROM THE BUILDING DEPARTMEN BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS:
,4„-d
„„.„4/12, .064
ARRIVE
_
DEPART 5c4z*441(A1/
c7 OILJno/ ?ueenJ
ur y
BUILDI : and ZONING DE"ARTMENT
Bay and aviland Road, D. 1 Box 98
Due:nsbury, New Y3 k 12801
t
.`) 1 )�L fit ; ; _ �.- 66,t(__IL(C--1- p"k_
SE TIC DI.POSAL SYST INSPECTION Att
NAME ± t _ j ,tCJte1=L iC_
.�..IL-.1L E�
LOCAT I• •. Li,/ la
DATE rl ;�J qc PERMIT NO. 7�-4 O
SOIL TYPE - San. - Lo. - Clay -
Percolation Tes Requ red? YES - NO
Percolation rat: - Mi /Inch
TYPE of SYSTEM:
Absorption field to al lengthaj -`- --
Length of each t,en.h So -J--
Depth of trenche- ' - , Pr.,
Size of gravel Ar
SEEPAGE PITS4Numb: .
Size- • - 1 ft.
el size
PIPING: Slge
Type
Bldg. to tank ir67-74./4'
Tank to dist. box — Sccb PVC,
Dist. box to fief•/ c,, /'iL
Openings sealed? (i) NO Partial
LOCATION/SEPARATISNS
Foundation to to k '-(Uft.-f --
Foundation to ab orpt;on _ aft _
Absorption to to lin: '-i ft,
Separation of pi s —r=-
LO •TION OF SYSTN "OPERTY(circle one)
rout - Rear ql-ft side - Right side -
/•,,•� NTS:
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SYSTEM USE APPROVED 0
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uilding In-.o tor
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