1990-272 •
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date � /r- 19�
30i
This is to certify that wor req ested to be done as shown by Permit No.Q f1-?7 9
has been completed.
This structure may be occupied as a cpwArrp A1tpr,tinn
Location6 Sugar Pine
James Wright
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-272
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to JAMES WRIGHT o0
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OWNER of property located at 6 Sugar Pine 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
same
2. CONTRACTOR or BUILDER'S Name
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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 ( I Masonry ( )Steel ( 1 .
7. PLANS and Specifications
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No. Sewage alteration includes tile field total system 200 feet with #2 stone
at one-foot depth. as per plot plan, specifications and application.
8. Proposed Use
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Sewage alteration
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES ' May 10 19 92
(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 Oth Day of May 19 g()
SIGNED BY for the Town of Queensbury
Buil ing and Z ni g Inspector
TOWN OF QUE•ENSBLURY 9P()/
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APP TION FOR
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SEPTIC . DISPOSAL PERMIT / / 2.�02/
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DATE c -7- 9-‘)
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LOCATION OF PROPERTY FOR INSTALLATION (:/ /
Owner's Name:D(-1 S € k1f2 ( /� Telephone:- 7 9 44 -/C( 2-
Address: (® cJ ✓ j f' w�
Installer's Name: X-n N irivkid iA Telephone: 7 90z
Number of bedrooms (residential only) ,3
Total daily flow (compute Ca. 150 gal per bedroom) '9.'-0
Topography: Circle one:a Rolling Steep Slope % of Slope
Soil Nature: Circle one: an Loam Clay Other. /Depth: Feet
Ground Water: At what depth? *— Feet
Bedrock or Impervious Material: At what depth? — Feet
Percolation test: Circle one t req no uire required rate min. inch.
Domestic water supply: circle one: .Municipal Well Other
If domestic water supply is a well: -
Separation: Water supply from septic absorption - feet
PROPOSED SYSTEM: Septic Tank/ ( OL) gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length 2 oi7 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # 2-- /Depth or Thickness f 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 Qu s Sanitary f1dA
isposal Ordinance..
SIGNATURE OF RESPONSIBLE PERSON:
DATE: �- YC)
OVER
Septic System Inspections:
• A. Al]. -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—
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 Haviland Roads •
Queensbury, New York 12804 .
Remarks :
_town o/ Queensburc� 'Id
BUILDING and ZONING DEPARTMENT /�/
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME h.V /rn.1a iVi hii
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LOCATION 6 ,4,,e,
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DATE 5;/,//,)/ PERMIT NO. 07 M,
SOIL TYPE - Sand ,I- Loam - Clay -
Percolation Test Required?/ YES - NO
Percolation rate''- Min/Inch
TYPE of SYSTEM: i
Absorption field tota1 ,length �
Length of each trench ;'.,
Depth of trenches '
Size of gravel 1 j f/
SEEPAGE PITS4Number of)
Size- ft. X ft.
Gravel size 9� c;
PIPING: i ' Siwe Type
Bldg. to tank j
Tank to dist. boxya/ "1,, erk
Dist. box to field% ' j
Openings sealed? } Y S NO Partial
•
LOCATION/SEPARATf
Foundation to tankli ,,y AS.ft.
Foundation to absorption '' ft.
Absorption to lot line .4- ft.
Separation of p .ts T . - ft.
LOCATION 0 - STEM ON PROPERTY(circle one)
Front - ear -;Left'tside - Right side -
COMMENT ( ) �J
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SYSTEM USE' APPROVED YES NO
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Bu'a ing inspector
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