1990-290 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
June 5 90
Date 19 _
Da . - 1- 12;
This iss to certify that work requested to be done as shown by Permit No. 90-290
has been completed.
This structure may be occupied as a sewage alteration
Location 27 Pershing Road
Owner Charles Farrar
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT 1-3
TOWN OF QUEENSBURY No. 90-290
WARREN COUNTY, NEW YORK + O
PERMISSION is hereby granted to CHARLES FARRAR 4=,
OWNER of property located at 27 Pershing Road 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.
1-11
1. OWNER'S Address is
same
2. CONTRACTOR or BUILDER'S Name tea„
Condon's Septic & Drain11)
ul
3. CONTRACTOR or BUILDER'S Address •
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4. ARCHITECT'S Name
Co
5. ARCHITECT'S Address
0
. L7.
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry' ( )Steel ( )
7. PLANS and Specifications
lD
No. Sewage alteration to include new distribution box and 200 ft. Leach field
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as per plot plan and application. ce
8. Proposed Use p�
Sewage alteration (
z
$ 25.00 PERMIT FEE PAID-THIS PERMIT.EXPIRES May 17 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 Da ,of May 19 90
t d� 7
SIGNED BY - 'G*� / for the Town of Queensbury
Building and Zoning Inspector
''s���• APPLICATION FOR
-� SEPTIC DISPOSAL PERMIT
�
9� V up8
DATE J '/ (0
LOCATION OF PROPERTY FOR INSTALLATION 2:7 , Pg5/t(%U9
Owner's Name: °114A LES A. I,4/PA Telephone: 7q3` 6
Address: 7 f7fQSH /t'7 A.1/ Gux,,civs -Ruty
Installer's Name: ODivD b/U S cf/0-71, r C, � % 1 Telephone: 7 g.-- ,Y6--i
Number of bedrooms (residential only)
Total daily flow (compute Cd 150 gal per bedroom)
Topography: Circle one: dia. Rolling Steep Slope % of Slope
Soil Nature: Circle one:6and)Loam Clay Other /Depth: Feet
Ground Water: At what depth? WA Feet
Bedrock or Impervious Material: At what depth? NA Feet
Percolation test: Circle one: not requiredrequired rate min. inch.
Domestic water supply: circle one: Municipal) Well ,Other
If domestic water supply is a well:
Separation: Water supply from septic
�absorption p feet
v
PROPOSED SYSTEM: Se tic Tank/006 4-�, (lC.S m/�ini ufn
p ga ( m size: 1.00n gal.)
TILE FIELD: Each Trench '/ feet/Total system length ,; -00 feet
SEEPAGE PIT(S): Number of / Size each feet by feet
Size of stone to be used # 2i/Depth or Thickness / 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 Sew e Disposal Ordinance.
SIGNATURE F RESPONSIBLE PERSON: 1. L1/M�//✓C � -� —
DATE: /61 ?/
/ OVER
a
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 co 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,
. rile 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 co 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 co the Queensbury Building Department before further
construction.
•
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
kizniarks: •
_town o/ QUCUry
I.
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, fi.D. 1 Box 98,
Queensbury, New York 12801
SEPTIC DISPOSAL SYST INSPECTION
I
NAME N1 t 6,A ,,--10.)4 C J2.- r
LOCATION ;1 J 6:4 (4 Al
DATE O�/?S/�j) PERMIT p 0. ;u,? % -a 9 n
.
SOIL TYPE -�nd - Loaf - C1y -
Percolation Test Required? .?YES - NO
Percolation rate - Min inch
1
TYPE of SYSTEM:
Absorption field, total /length Zoo
Length of each trench" .4 -;!)
Depth of trenches. R'.
Size of gravel 4 ;
SEEPAGE PITS{Number )
Size- ft. X kt.
Gravel size ,4'
PIPING: �? Size Type
Bldg. to tank CwST',--S
Tank to dist. box r ! 4 pc)c�
Dist. box to field . i- ecJL-
Openings sealed?f' 4 NO Partial
(,
LOCATION/SEPAR fiIO S:
Foundation to /tank 8(45'T: ft.
Foundation to absorption 7, ft.
Absorption tolot line /Q ft.
Separation of pitsi ,(p ft.
LOCATION 0- STEM4ON PROPERTY(circle one)
Front - Left side - Right side -
COMMENTS:
,,
n
SYSTI USE APPROVED 01111 NO
0141 -......
Buildir? spector
01/86 and vl
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