94-572 CERTIFICATE OF COMPLIANCE
TOWN Or UUEENSBURY - = •
WARREN COUNTY;" NEW: YORK
-
Date
October31
This is to certify that work requested to be done as shown by Permit No. 94572<
has been completed.
This structure may be used. as a SEPTIC PERMIT
Location HILLMAN RD.
Owner MASON. _ RICHARD
By Order of Town Board
TAX MAP NO. 11.-1-1. 12 - TOWN OF QUEENSBURY
Director of Building. & Code Enforcement •
I
BUILDING PERMIT
TOWN OF QUEENSBURY /�''ll
No. % '1 J,5)
WARREN COUNTY, NEW YOR.K
4
PERMISSION is hereby granted to UKQ
OWNER of property located at k1 _k.u_n( l.D?TQCI-2-AJ Street, Road or Ave.
in the Town of Queensbury,To Construct or place a _ l f =
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
15-8 ' flO1 O -Chc) Mhrshc.la £ , c ? 9.eifteau
2. CONTRACTOR or BUILDERS Name
g. a,Lo k, - .5st A n Ilea
3. CONTRACTOR or BUILDER'S Address
D. 2 c 2Go Uuverldsz. 1`�� /a Sao
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
No.
8. Proposed Use
$ pZr7 , QD PERMIT FEE PAID—THIS PERMIT EXPIRES I0 19 q5
(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 o Queensbury this 3 Day of 19 %4/
SIGNED BY Cv��. for the Town of Queensbury
wilding and Zoning Inspector
/�
� 12
ifi �titt
e' TOWNJF QUEENSBURY
APPLICATI'j;FOR 1I C DISPOSAL PERMIT Permit # 9' -57.-
N �eCe�o� J Fee Paid 7015,0
•
10001
oe°'
Date: 9/30/6/4 Reviewed By
LOCATION OF PROPERTY FOR INSTALL'TfON=:-' Takundewide Cottages, Cleverdale
Owner's Name: Mr. Richard Mason
Owner's Mailing Address: 15-8 Ikenoue-Cho, Kagoshima City, 892 Japan
Installer's.Name: Sunsoval, Inc. Phone #: 656-9956
Number of bedrooms (if residential ): 2
Total daily flow (residentia)-compute @ 150 gal . per bedroom): 300 gal.
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other ' /Depth:
Ground Water-At What Depth? over 4 Feet
Bedrock or Impervious Material-At What Depth? ''over 4 ' Feet
Percolation Test-Circle One: Not :Required ,: Required/Rate 8 Min. Per Inch
Domestic Water Supply-Circle One:: Municipal Well Other Lake '
If domestic water supply is a well -
Separation: Water supply from any septic absorption +120 feet
PROPOSED SYSTEM: ' Septic Tank ` 1000 gal . (Minimum size: ' 1,000 gal . )
Tile Field: Each Trench 60 feet//Total"System 'Length 180 feet
Seepage Pit(s): Number of h ft. x ' .
Size of Stone to be use • / Depth or ess feet
**************
HOLDING 'TAN IF QUIREp
No. of Tanks AznAof Each
Alarm system and ass • ed electrical a ins e — 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: C DATE: 9/29/94
0/6
•
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'"lotlines
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 f
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:
•
r_
- ' A
TOM OF QUEENSBURY 1<��
BUILDING 3 CODE ENFORCEMENT ,��(A l
531 Bay Road �`'
Queeesbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
J�yv.y.,e5//
Name ha-l� t,..4
Location
Date hA/ y Permit # %%e/-S 7'Z
SOIL TYPE• and-Loa -Clay-
Resul s of Percolation Test-
(if . •plicable) Rate-Minute/Inch
TYPE 'I F SYSTEM:
ABSOR'TION FIELD: Total Length
Length of each trench
Depth o trenches
Size of .tone
SEEPAGE "ITS: umber-
Size - t. x ft.
Stone size
PIPING: Size Ty e
Bldg. to Ta _ �``
Tank to Dist. tox
Dist. Box to '"ield/Pit
Openings Seal -,? 440w No Partial
LOCATION/'SEP ' IO .
Foundation to Ta'k feet
Foundation t Absorption mg feet
Separation . . Pit / feet
Conforms as per Plot Plan No
LOCATION OF SYSTEM A PROPER' .
(circle one)
Front - Re, r - Left Side - Right Side
Middle Fro t - Middle 'ear
COMMENTS:
Z ///
p)
SYSTEM USE APPROVED: gill NO
Arrived: PA
Departed: / y(
Building Inspector
to--1
tiro
TWA OF QUEENSBURY
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name s`�. � ria5cfl
101aK- ;"ae j "_ �o+IaC(-q3
Location
el
Date I O ,Fj N Permit # '-c�' 6���
SOIL TYPE: San+'-Loam-Clay-
Results of Percolation Test-
(if applicable) 'ate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Tota Length lee
Length of each tre ch ‘0
Depth of trenches 2-'
Size of stone 1 1,-
SEEPAGE PITS: Numbe L
Size - ft. x '[ t.
Stone size
PIPING: Size Type
Bldg. to Tank
Tank to Dist. Box _
Dist. Box to Field/'i 1' PUL
Openings Sealed? ' No Partial
LOCATION/SEPARATIO'
Foundation to Tank feet
Foundation to Abs.rption feet
Separation of Pit. feet
Conforms as per Piot Plan W. No
LOCATION OF SYST t 2 ON PROPE' : ` :
(circle one)
Front - Rear - eft Side - Right Side
Middle Front - iddle Rear
COMMENTS:
de? (;),./.
•
I47 G
SYSTEM USE A"PROVED: YES 4~
Arrived: e-,g
Departed: r,2,31
Building Inspector
• i 1 , -�_a�
47 '''' . ,
DRAINFIELD
LAKE
GEORGE Beach Lands of. CROSS SECTION OF LATERALS
Area Takundewide Homeowners` •
Association, Inc. y
)l ...E .! ../. .✓ „f ,.✓ ti' ' '.f '.J
y 6" topsoi
murafi ',�'Z;}:9 >•
y paper :' it• ti
��• i,JQ. 2'011 _gip..•
4" PVC '.,.; t '+
Dock ng ~ #2 stone 21011
lity ����� ` I �l i;- •
I 6'0" I 6'O"
+120'2) . to lake /, 7,
•
�I /�
�� '///'
/,� /�,�/ 3 -,60'0" long laterals
TOTAL: 180 if
/�/ i/ i drainfield
/' I/ �1% -(see blowup)
7 ,/: ;/ •
10'0" r. I,
Lands of / //
/ setback I
/ •
Sacklow / / i '�1I/
#3 / / ,� distribution box
4" PVC solid
•� / / ands of
Richard Maso j 1000 gallon concrete septic tank
\ / / #10 / ,
/ \� L\ / • TOWN OF UEEI'SBUF
/� \ ,�.. / BUILDING CODES T9�
ands of \ f location of `�.� J`' •
REVIEWED B
/ Stephen Mason / existing system,
< #2 t be removed C / ,, DATE 0 4
N
j I� / f \ NOTE:
1 \\ f� ` / / Lands of DOMESTIC WATER SUPPLY IS FROM LAKE.
A / / r_James Mason
\
f /
/ Parking Area /
N.
MR. AND MRS. RICHARD MASON
ands f
W — / TAX MAP #11-1-1.12 TOWN OF QUEENSBU',
JAM Inve mentt
APPROVED BY DRAWN BY
Company • ti/ SCALE 1"=25'0" P'
#1 / `/ DATE 9/29/94 REVISED
a / // i SEPTIC SYSTEM
i • DRAWING NU
PROPOSED
o �
STOOCORAFTING FORM HO.101.61