93-311 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date Qu.LLf 14 19 Q 3
This is to certify that work requested to be done as shown by Permit No.93-311
has been completed.
This structure may be used as a septic system
Location Harris Road
Owner Myles Miller
11-1-21 By Order of Town Board
TOWN OF QUEENSBURY
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Director of Building & Code Enforcement
BUILDING PERMIT
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TOWN OF QUEENSBURY 0
No. 93-311 ' •
WARREN COUNTY, NEW YORK l
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PERMISSION is hereby granted to MYLES MILLER
Harris Road ~
OWNER of property located at 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. H
1. OWNER'S Address is
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2. CONTRACTOR or BUILDER'S Name t-'
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to
Creative Construction Co
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Addresscn
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
Septic alteration to include two 2000 gallon tanks as per
No.plot plan and application.
8. Proposed Use
Septic System
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25 .00 June 17 95
$ PERMIT FEE PAID—THIS PERMIT EXPIRES 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
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town of Queensbury before the expiration date.)
1
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Dated at the Town of Queensbury this Day o June 1993 rr
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SIGNED BY for the Town of Queensbury
Building and Zoning In ctor
' '1 j TOWN OF QUEENSBURY
1 :4, APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # / - �
Fee "d f^ .1
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Date: (�-J5-- 3 Review By, 4c6$• 7
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N -..'1, ofea, A
LOCATION OF PROPERTY FOR INSTALLATION: -kc.j,Y'Y1 S R� Cc(�2 sk-,b.' 4,
Owner's Name: C`(�,J,�, �& \\p_Y-- 4"q�,eZirrater49''bt'
Owner' s Mailing Address:
Installer' s Name: ( \\ Deck,(.- Crecx'"\- oe_ fcig\- rp Phone #: 7//7-030
Number of bedrooms (if residential ) : • f-\\c-'e i
Total daily flow (residential-compute @ 150 gal . per bedroom) : 5-C
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? 70 " Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other ),(d e -(forpJ
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
a -
PROPOSED SYSTEM: Septic Tank gal . (Minimum size: 1,000 gal . )
' Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks `}-Uj Size\of Each Oco 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: (Al DATE: (```7 q ,
ELECTRICAL INSPECTIONS
93DUPLICATE MUNICIPAL RECORD
Permit No. /� -314// /J
Owner 41 /Yt 1 U 72
Occupant ��/- /�
Location 1'�A'a tei s kfe
04,6=-Li&--/z bfi-tc-7)
Town or Cm
Installation as itemized on reverse side has been visually inspected pursuant to applicable
codes. ,/�^ /���✓
Installed by 7• 4 �A""'""`
P
Date _. - ��"" Inspector
MIDDLE DEPARTMENT INSPECTION AGENCY INC.
FORM NO.18 EL. 900 Haddon Ave.,Collingswood,NJ 08108
ROUGH WIRING OUTLETS H.P.AIR CONDITIONER
OUTLETS WIRING &CONTROLS FOR BURNER
RECEPTACLES • H.P. PUMP
FIXTURES K.W.OVEN
AMP.SERVICE EQUIPMENT H.P.GARBAGE DISPOSAL UNIT
AMP.SERVICE CONDUCTORS K.W. DISHWASHER
K.W. SURFACE UNIT K.W. DRYER
K.W. RANGE AMP. RECEPTACLE
K.W. WATER HEATER FRAC. H.P. VENT FANS
6fi. sus. 6pf/iiG r�4- 610t7
MOTORS N.P. 1/20 1/12 1/10 I/e I/ '% I/3 'h 1% 1 11/ 2 3 5 71/ 10 15 20 25 30 40 50 75 101
MARK NUMBER
DF EACH SIZE
APPARATUS
TOWN OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
•
Name
Location A Al2.a\ fiL
Date 6*-3 Permit # 93-3//
SOIL TYPE: San ea 4Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total l
Length of each trenc
Depth of trenche (—
Size of stop
SEEPAGE P :J04 mber-
Size - r ft. x ft.
St e size
PIPING: Size Type
Bldg. to Tank 3 -
Tank to Dist. Box
Dist. Box to Field/Pit _-
Openings Sealed? Yes No Partial
LOCATION/SEPARATIONS:
Foundation to Tank feet
Foundation to Absorption `—. feet
Separation of Pits — feet
Conforms as per Plot Plane Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Sid Right Side
Middle Front - Middle Rear
COMMENTS:
cf
SYSTEM USE APPROVED: YES NO
Arrived: �` � '
Departed: 5,5
Building' P
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•,- CREATIVE CONSTRUCTION' COMPANY
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CARPENTRY-GENERAL CONTRACTING
18 MAIN STREET HUDSON FALLS, NY 12839
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9,6,5 _ (518) 747-0930
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