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1990-245 `10 . , CERTIFICATE OF COMPLIANCE . TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date May 7 1961_43 (01\ This is to certify that work requested to be done as shown by Permit No. 90-?"?. _ has been completed. septic alteration This structure may be occupied as a Location 96 Wectland A V Owner Charles Nock By Order Town Board TOWN OF QUEENSBURY 2 Director of Bldg. & Code Enforcement •4 BUILDING PERMIT TOWN OF QUEENSBURY No. 90-245 -o WARREN COUNTY, NEW YORK 00 - o PERMISSION is hereby granted to CHARLES NOVAK OWNER of property located at 26 Westland Av Street, Road or Ave. in the Town of Queensbury,To Construct or place a sewage 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. 1. OWNER'S Address is ZO same a 2. CONTRACTOR or BUILDER'S Name Queensbury Septic Tank Service 3. CONTRACTOR or BUILDER'S Address t•3 cn 4. ARCHITECT'S Name En r' !v _ a - 5. ARCHITECT'S Address 6. TYPE of Construction— (Please indicate by X) • ( )Wood Frame ( ) Masonry ( )Steel ( ) CD 7. PLANS and Specifications Qr3 No. sewage alteration to include seepage pits (2) 8'x81 with #3 stone at 2' depth, CI) as per plot plan, specifications and application. $ Et; 8. Proposed Use sv Sewage alteration o $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 3 19 90 (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 3rd Day of May 19 90 SIGNED BY for the Town of Queensbury Building and Zoni g Inspector • va ).,; rJUL'It APPLICATION FOR SEPTIC DISPOSAL PERMIT OF ?UEENsF! 'RECEIVED `l fv - I MAY ® 1 1990 7'1 DATE Jo /61 w 0 E DEFT, LOCATION OF PROPERTY FOR INSTALLATION - dv J-�_ L c Owner's Name: C-'� �V�� /? " Telephone: 7 g Address: c LJ-epG,-(1 / Installer's Name: QU-0-0-16 ,,,,,,_44c 71/74, `/ :'H,Telephone: / gja7—.-3-6 411- .r Number of bedrooms (residential only) Total daily flow (compute Cd 150 gal per bedroom) zS () Topography: Circle one:..Rolling Steep Slope % of Slope Soil Nature: Circle one Sand Loam Clay Other /Depth: Feet Ground Water: At what depth? Feet Bedrock or Impervious Material: At what depth? Feet Percolation test: Circle one: not required required rate. 'min. inch. Domestic water supply: circle one: b'IunicipalJ Well Other If domestic water supply 1 is a we Separation: Water supply from septic absorption feet PROPOSED SYSTEM: Septic Tank 's(1/;? gal. (minimum size: 1.000 gal.) TILE FIELD: Each Trench- feet/Total system length • feet SEEPAGE PIT(S): Number of 1-- / Size each feet by g. feet Size of stone to be used # /Depth or Thickness i "47 - feet ************************* 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: ` Cj--64eA- CL) , ,(� U`-4. DATE: ' (, I g q d OVER • • • 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 installa- Lion, 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 and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 • h�ni:trks: — — • loom o f Q3i , BUILDING and ZONING DEPARTMENT \ Bay and Haviland Road, R.D. 1 Box 98 514J Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 0 LOCATION 2G 11f DATE ,5/_ /q,(D PERMIT NO. V—241 SOIL TYPE - Sand �' Loam - Clay - Percolation Test Required?. YES - NO Percolation rate - Min/Inch • TYPE of SYSTEM: Absorption field, total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS{Nuinber of) Size- J' ft. X _ (ft. Gravel size PIPING: Size Type Bldg. to tank e)(,s4 Tank to dist. box- y Dist. box to field/ t 7i Openings sealed;? YES, _ NO Partial LOCATION/SEPARATIONS: Foundation to% tank C.> '�-/ ft. Foundation to absorption Absorption to lot line �fl ft. Separation of pits 7,9.... ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front Ream Left side Right side - CQMMEN'T'� _ 1 {ti s � .11 „ ;� t, SYSTEM USE APPROVED YES it 'rig 'Inspector 01/86 and vl ,A A\pe_.. SEIURY MAY 0 190 BL , ;ODE IIEPT. Is' 1 2S- pa.r. etr. 0 — fir 7° ' FILE COPY TOWN OF QUEE N URY BUILDING & CODESD EPT, REVIEWED B, DATE