91-383 41
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 25, 19 91
This is to certify that work requested to be done as shown by Permit No. 91 '3
has been completed.
This structure may be occupied as a Septic Al terati n
Brayton Lane, Assembly Point
Location
Owner Phil E. Hosegood
By Order Town Board
TOWN OF QUEENSBURY
Director of B1dg. & Code Enforcement
4
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-383
WARREN COUNTY, NEW YORK
Cit
PERMISSION is hereby granted to Phil E. Hosegood ro
OWNER of property located at Brayton Lane, Assembly Point 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 C
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. m
ce
0
1. OWNER'S Address is 0
1433 Clifton Park Rd
Schnectady, NY 12309
2. CONTRACTOR or BUILDER'S Name
Condon's Septic & Drain Service
r+
0
3. CONTRACTOR or BUILDER'S Address
I—
a
0
0
4. ARCHITECT'S Name
CD
5. ARCHITECT'S Address
fD
6. TYPE of Construction—(Please indicate by X)
( 1 Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Septic alteration to include: 2 holding tanks each 2000 Gal .
8. Proposed Use
Septic ALteration
$ 25_00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 5, 19 93
(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 5th Day of , June 19 91
SIGNED BY }� , / for the Town of Queensbury
Building and Zoning In ctor
TOWN OF QUEffilit!t9F cw7-7Nssuily APPLICATION FOR SEPTIC DISPOSAL PERt41 1 '1f) Permit # ql/ J
3
Fee Paid
JUN 31991
Date: 6 / BAD Reviewed By
®J
E PT
LOCATION OF PROPERTY FOR INSTALLATION: Q� //(�J�� 64,1 p r Agio2g(i, pef417'
Owner' s Name: /4lel 8 PJ��SF O - (c6- Q9 J 377•-5O%3 �R�rF
V 141';°3 6`41F%o`tJ j
Owner' s Mailing Address: '� �� piii drub 4,S1q )�' C`t'i' stifEY -P7
Installer' s Name: (r)rvJ1,v S Li v /)OL9 CA Phone #: Fq6-90120-
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom) : 301
Topography-Circle One: lat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? 4/ Feet.
Bedrock or Impervious Material-At What Depth? 4i4 Feet
Percolation Test-Circle One: Q1c-.)7tRec---1Dired, Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
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 ', Size of Each _VO11 Gal .
Alarm system and a` sociated electrical work to be inspected by a certified
agency.
****************
I have read the regula ion on the reverse side of this sheet and agree to abide
by these and all requir ments of the Town of Queensbury Sanitary Sewage Disposal
TOW tra19 QUEENS
S IGNATURE 9 a RE '` T C'C ( 41 elf DATE:
REVIEW/
P �_ATE • �`
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 an 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:
•
1• c� // J
- . . _Down of Queeniur,
BUILDING and ZONING DEPARTMENT
. Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME aL,,eGil V"-ii
leeh'74-__ ;
LOCATION 4,z>c... /-4 'IX,
DATE Iz'q/ PERMIT NO. 9/303
SOIL TYPE -'Sand - Loami- Clay -
PercolationYTest Required? YES - NO
Percolation irate Min/Inc
2,1/4_ .24y7f,'9 e// 1„i 1 .
TYPE of SYSTEM � �'�� 4/
Absorption field, total length
Length of each trench
Depth of trenches
Size of gravel \ r _
SEEPAGE PITS{Nuinbe`r of)
Size- ft. X V ft.
Grabel size ;F .
PIPING: I \ Size Type
Bldg. to tank ,i`
Tank to dist. $box
1/4
Dist. box -to field/p;it
Openings sealed? YES NO Partial- .
I •
LOCATION/SEPARATIONS: \
Foundation �o tank S V :ft.
Foundation Ito absorption ' 1-7ft.
. Absorptioi to lot line g � )ft.
Separation 'of pits l; ft.
LOCATION + - YSTEM ON PR0PE} TY(circle one)
Front ear - Left side 1:- Right side -
COMMENTS/ \
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C07?),w , j>i," i c:17-7,/4179. ril ,II' ,,. (?1 • )
SYSTEM USE APPRO ED YES 0 .
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' /r;v,K-77-
Building;'Inspector
01/86 and vl
T CORP 700 SO.CLAREMONT ST.- SAN MATEO,CA.94402
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