1990-271 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date June 5 19 90
3 (511 _ 1 ____S
This is to certify that work requested to be done as shown by Permit No. 90-271
has been completed.
This structure may be occupied as a sewac'e alteration
Location Luzerne Road
Owner Todd Potter
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No.90-271
WARREN COUNTY, NEW YORK ' o
'
ND
PERMISSION is hereby granted to TODD POTTER
OWNER of property located at Luzerne Road Street, Road or Ave. es)
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. ,-d
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1-3
1. OWNER'S Address is
same til
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( 1
7. PLANS and Specifications
No. Sewage alteration-for two seepage pits 8'x8' with #3 stone at 2 ft depth CD
as per specifications and application. crq
8. Proposed Use ; cD
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Sewage alteration co
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$ 25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES • May-10 1%
(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 t ' Day of May 19 90
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SIGNED BY 1( for the Town of Queensbury
Building and Zoning In ector
TOWN.OF QULL-NSBUPY ,/0 y
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�_.� APPLICATION FOR
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_� SEPTIC DISPOSAL PERMIT
. r`, -- j� .owN OF QUE-5\-.
. / ii / M 101 L. iu
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DATE ti— 9� . ///
� � MAY -q 1990
LOCATION OF PROPERTY FOR INSTALLATION
(.SN'9 BUI �'.1(�f & COG` Di=r
Owner's Name: 7--u‘/ �`�/7 � Te phone: �.�`
Address: jU - %,"-'_ � t
Installer's Name: oq-N /TA' h\G•14L- Telephone: 79 '7� _
Number of bedrooms (residential only)
Total daily flow (compute Cd. 150 gal per bedroom) '96-0
Topography: Circle one Rolling Steep Slope % of Slope
Soil Nature: Circle one: an .foam clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: not required quired rate min. inch.
Domestic water supply: circle one: -6I:nnicip Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
SST/ArC
PROPOSED SYSTEM: Septic Tank /(- gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • - feet
SEEPAGE PIT(S): Number of 2._ / Size each 8 feet by feet
Size of stone to be used #2 /Depth or Thickness 2-- feet
*************************
I have read the regulation on the reverse s' a of th sheet and agree to abide by these
and all requirements of the Town of Rue nsbu y Sa itary.Sewa•e I isp,sal Or•inance.
SIGNATURE OF RESPONSIBLE PERSON: 0 / / ,
' ( ----
DATE: [- ' -
OVER
•
•
-- . Septic System Inspections:
• A. AllialicaëoñS) for septic system installation, alteration or repair,
--.as required by theft own of -Queensbury Sanitary Sewage Ordinance, shall
be submitted to the'~B'uilding Department at least 24 hours before start
of'.constructi'on and shall include a plot plan showing:
1
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 -inspe•c-lion-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 $250.00. -
C. An approved copy of the plot plan shall be available on the construction •
•
site. Failure to produce said plot plan at time of inspection may •
result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or repair of an approved system, a new proposal must
be submitted to the Queensbury Building Department before further
construction. -
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and _llaviland Roads
Queensbury, New York 12804 •
•
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hcniar4�s: — — — —
Jown o/ Queeniur, hi,a
BUILDING and'ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 DJ7)6)
Queensbiiry, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \A) Gl,di
LOCATION 7/}/yl,Q:, (;f''
1 9
DATE , /�„��' / Q�) PERMIT NO. '-27/
SOIL TYPE - Sand ; Loam - Clay -
Percolation Test }Required? ftES - NO
Percolation rater Min/Inch
TYPE of SYSTEM:
Absorption field,' total l/ngth
Length of each trench
Depth of trenches =-
Size of gravel if
SEEPAGEcPPS{NumbKof,),'7 1r
Size- -r)ft. X t ftQ
Gravel size dA 1
PIPING: . Size � Type
Bldg. to tank `e.
Tank to dist. box ': L/ n fJ4XLI,
Dist. box to field',-'-t L-/ /I/f!_..
Openings sealed? OCES I$O Partial
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LOCATION/SEPARATIONS: 7
Foundation to tank ;' g ks- .f t.
Foundation to absorption j,, ft.
Absorption to lot t line ft.
Separation of pits ; ft.
LOCATION OF SYSTEM ON; PROPERTY(circle one)
rout- Rear - eft s°'de - Right side -
OMMMENTS: 'I F
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SYSTEM USE APPROVED YES,; / N
/ 144-------
Building Inspector
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MAY -
9 1990
BUILDING & CODE