98-156 •
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Certificate of - Compliance
Town Of Queensbury
Warren County,New York
February 28
Date .
•
98156
This is to certify that work requested to be done as shown by Perrnii
has been completed.
This structure may be used as a SEPTIC ALTERATION
552 ROUTE 9L
Location
Owner FREIHOFER, CHARLES III &
TAX MAP NO. 2 . -1-3
By Order Town Board
AA710F
Director of Building & Code Enforcement
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Application for SEPTIC DISPOSAL PERMIT
- (
Town of Queensbury Permit No. /
Dept- of Community Development
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Building &Codes Office
742 Bay Road Fee Paid diti NY 12804
Location of property for installation: /'v/v - 9 f /,�;o�e ;mod 7 (:ft.<
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Property Owner's Name: G�.e., 777t—
Property Owner's Mailing Addddress: .�.o �e.f_
e �✓-
Installer's Name: %1/,0,f.- e%C ei Phone # -G,? -3
Number of bedrooms (if residential): 'V Total daily flow: o
(residendai - compute CerV ; .—411" r
Topography: flat, rolling, steep slope o Of slope• APR �.7
/sand,
1998Soil Nature: loam, clay, ohm/depth: I TOWN OF
i1�L[31N0;�ND OODE
Ground water: at what depth? feet / Bedrock or Imper::cls Material: at what depth? feet
Percolation test: not required, recured -[raze min. per inch]
Domestic water supply: municipal, �wel, c=.er
If domestic water supply is a WFT T., ware supply from any sic absor_rdon is/*o r feet.
PROPOSED SYSTEM * / 27.
Sepdc tank:/—.id a gallon (minimum size:' 1,CCO gal.) /"
Tile field: each trend feet / Tot<i system lens h: feet
Seepage pit(s): number of --3 / size each: ft. by •
ft
Size of stone to be used: # / depth or t c-r- feet
HOLDNG TANK SYSTEM: (if required)
Number of rant: Size or each gallons
Alarm system and associated electrical cork to be icspeeci by a certified agency.
For your protection, please note that pursuant to Section 136-29 of the Code of Town of Qaeensbury, any permit or
approval granted which is based upon or is granted in reliance upon any meteai misrepresentation or failure to make a
material fact or circumstance known by or on behalf of an applicas r. serail be
I lave read the regulations with respect to.this application and agree to abide b►-;use and all rviuirementa of the Town of
Q,wnsbury.Sanitary Sewage Disposal Ordinance.
S is a re of responsible person.; ! Date: "`,/C A"?
TOWN OF QUEENSBURY
• BUILDING & CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
(518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name k-14:
Location tr5,57 R0' _ CIL
Date '1-725s-ta Permit #
SOIL TYPE: Sand-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Length
Length of each trench
Depth of trenches
Size of stone
SEEPAGE PITS: Number-
Size - ft. x ft.
Stone size
PIPING: Size Type
Bldg. to Tank
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 Plan Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
SYSTEM USE APPROVED:
Arrived:
Departed:
Building Inspector
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TOWN OF 01.IEENSBURY
BUN DING AND car*
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NAME: • DATE: IN OUT
JOB NAME&LOCATION: •
TRUCK JOB DESCRIPTION: •
450 DOZER
850 DOZER
BACKHOE • •
TRACKHOE
PAYLOADER
FORD TRACTOR
YORK RAKE . •.!
MATERIALS:
GRADER •
CHIPPER
LABOR - -
TOTAL - ;
JOB NAME& LOCATION:
TRUCK JOB DESCRIPTION:
450 DOZER -
850 DOZER
BACKHOE _• •
TRACKHOE
PAYLOADER
FORD-TRACTOR:- -- ) . •
- - _ _
YORK RAKE
GRADER MATERIALS: - •
CHIPPER
LABOR
TOTAL „
_
JOB NAME& LOCATION: •
TRUCK JOB DESCRIPTION:
450 DOZER
850 DOZER
BACKHOE
TRACKHOE
- PAYLOADER -
FORD TRACTOR-
YORK RAKE MATERIALS:
GRADER
CHIPPER •
LABOR
TOTAL
CRANDALL EXCAVATING, INC
TOTAL HRS.
__
TOWN OF QUEENSBURY
BUILDING .& CODE ENFORCEMENT
742 Bay Road
Queensbury NY 12804
• (518) 761-8256
SEPTIC DISPOSAL SYSTEM INSPECTION
Name l-k oFF2
Location (ESL. RM E.. 9 L
)Date c--Z1-9(2) Permit # 9c6--1,5 -1
G1 SOIL TYPE: Sand-Loam-Clay-
IOResults of Percolation Test-
(D(if applicable) Rate-Minute/Inch
CCTYPE OF SYSTEM:
?ABSORPTION FIELD: Total Length
Length of each trench
IVILIJDepth of trenches
T.: Size of stone
SEEPAGE PITS: Numb: -
Size - 1-1 ft. .> ft.,,,z} �► o�J�
Stone size - 9 G-"skim,
PIPING: Size Type
Bldg. to Tank
Tank to Dist._ Box
- Dist. Box
Openings Sealed? es No Partial
LOCATION/SEPARATIONS ..
Foundation to Tank ' feet
Foundation to Absorvion _ feet
Separation of Pits ti _ feet
Conforms as per. Plot "Ian Yes No
LOCATION OF SYSTEM ON PROPERTY:
(circle one)
Front - Rear - Left Side - Right Side
Middle Front - Middle Rear
COMMENTS:
mod
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SYSTEM USE APPROVED: YES
Arrived: .
Depar
uil in actor
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