94-295 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 9:wnL 2 i 19 q4/
This is to certify that work requested to be done as shown by Permit No. 94-295
has been completed.
This structure may be used as a septic system
Location Crrner Ridge and Cronin Roads
Owner Glens Falls National Bank & Trust Co.
59-4-2 By Order of Town Board
TOWN OF QUEENSBURY
Director of Building & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No. 94-295
WARREN COUNTY, NEW YORK •
o
PERMISSION is hereby granted to GLENS FALLS NATIONAL BANK & TRUST CO. liD
OWNER of property located at Corner Ridge & Cronin Roads 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. ti
tli
1.2%0 EGlenr St
Glens Falls NY 12801
2. CONTRACTOR or BUILDER'S Name
z
Andy Scarpellino
H
O
3. CONTRACTOR or BUILDER'S Address
w
z
4. ARCHITECT'S Name
sr,
H
:d
5. ARCHITECT'S Address
(A
0
6. TYPE of Construction—(Please indicate by X)
n
( 1 Wood Frame ( ) Masonry ( 1 Steel ( ) 1-1
O
7. PLANS and Specifications ,T1
Septic alteration to include 1000 gallon septic tank
No. with one 10 ' x 8 ' seepage pit as per plot plan and
application.
8. Proposed Use
n
Septic system
25 .00 June 14 6
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 199
(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 14th D 19 9 4
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
F-'
(D
ri
ct
F'•
0
111110i
irj TOWN OF QUEENSBURY
. j ,; APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Paid ' 12
Date:
/d6/rtf Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: (if, iii?, ,lic o C f'r/4✓/ ?(''
Owner' s Name: 6-/C I ( 6//s `Z-.4 /%v r" .2 4
Owner' s Mailing Address: C.:- C'/.--� F ! 4 y.
Installer' s Name: / ltri C(. ,` )c r`,,*j c
1 Phone #: 7 - s
Number of bedrooms (if residential ) : c9,
Total daily flow (residential-compute @ 150 gal . per bedroom): :3 00
Topography-Circle One: lat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? (W)r 7615- 1 Feet
Bedrock or Impervious Material-At What Depth? 1tf / 0 di Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank / (O gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of / / Size each: /d ft. x P ft.
Size of Stone to be used: # o / Depth or Thickness / 1j/vffeet
**************
HOLDING TANK SYSTEM IF REQUIRE
No. of Tanks Size\of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
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 Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: .7 )--/ DATE: i `i"j q f--.
7 - /
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 to any water supply
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
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 installation,
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 & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
: , -) .. TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name J a./-f9 r %r l d
Location 6Z . /te`,/
Date 4/,f4,7/<< Permit #
SOIL TYPE: Sand oa lay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total
Length of each
Depth o nches f
Size of stone
SEEPAGE P . Number- _ :�
Size - F • f �J ft
Stone size
PIPING: Si e/ pe
Bldg. to Tank
Terrk—teremintopikyx
Dist. Box to Field/Pit '
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorptio feet
Separation of Pits feet
Conforms as per Plot P an es No
LOCATION OF SYSTEM ONE PROPERTY: `.
(circle one)
Front - Rear - Left Side - fight Side \
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED: YE a NO
Arrived:
Departed: 9
Building I pector
TOWN Ort QUEENSBURY
BUILDING AND CODES DEPARTMENT
BAY & HAVILAND ROADS
QUEENSBUPY, NEW YORK 12804-
TELEPHONE (518) 792-5832
BUILDING INSPECTOR'S REPORT
REQUEST FOUR.INSPECTION RECEIVED �� �y� / `'
NAME 't 1 1 N- . NN C-QA-1�i'i'�L Avd
LOCATION -t. Al:) 1 - + ` J r `7 __
DATE PERMIT # ? j F
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 ,&4LVE
INTERIOR TRIM/PRIVACY DORS`
FINISHED FLOORS
GARAGE FIREPROOFING _
DOOR CLOSER(S)
SMOKE DETECTORS
FINAL ELECTRICAL INSPECTION
FINAL APPROVAL OF CONSTRUCTION
A SIGNED CERTIFICATE OF OCCUPANCY MUST BE
OBTAINED FROM THE BUILDING DEPARTMENT BEFORE
THESE PREMISES ARE OCCUPIED!
REMARKS
(yr * c2,..tj\--(-4 ----
1 - Lc/kit- \ ' 4-
4Ti
j€0 t.L.S it-
•
0 _K ,
,....
•
TV TY-W-07 yi
Ti-0WW 5/11:1 rra 7 1_,--vae7
m of s _v7 try
A--Idd`ns caror-74:9717,9---f -v7y o/1471 77-7-61---Ne)N1 c