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\CER° IFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date' July 16 19 90
This is to certify that work requested to be done as shown by Permit No. 90-387
has been completed.
This structure may be occupied as a sewage alteration
19 Moorwood Drive
Location
VAUGHN H. FOWLER
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT •
TOWN OF QUEENSBURY
No. 90-387
WARREN COUNTY, NEW YORK �d
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PERMISSION is hereby granted to VAUGHN H. FnwLF:R -�
OWNER of property located at 1 9 PJloorwood Drive Street, Road or Ave. o
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 �J
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same
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2. CONTRACTOR or BUILDER'S Name
Chad Fowler
3. CONTRACTOR or BUILDER'S Address1-4
4. ARCHITECT'S Name cc
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5. ARCHITECT'S Address 0
C1.
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6. TYPE of Construction—(Please indicate by X) ro
( 1 Wood Frame ( ) Masonry ( 1 Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 189 feet tile field with #2 stone as per
plot plan, specifications and application. tryq
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8. Proposed Use �
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Sewage alteration
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 18 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 1 Day of , June 19 90
SIGNED BY /4,0,7 for the Town of Queensbury
Building and Zoni Inspector
TOWN OF QUEENSBURY n
s"# (APPLICATIOII FOR SEPTIC DISPOSAL PERMIT ${ `[0
04)
DATE: June15 /q1O 1(.11 L c o
LOCATION OF PROPERTY FOR INSTALLATION I?Moorwood D►-. AeehsiXirccy,r,AJ/ /P8041
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- Owner' s Name: 1auy4n 79g-64/60
Address: / /1/Dorc000d D,,ve, 9ee/f5ker , /t/p / 1
Installer' s Name:.d4.2 ! /- c)//- . Telephone: /,5/8- 78S-07a6
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per,bedroom) �f.5-D 901.
Topography: Circle one: an. Rolling .Steep Slope % of Slope
Soil Nature: Circle one: 4170 Loam Clay. Other /Depth:
Ground Water: At what depth? - Feet . .
Bedrock or Impervious Material : At what depth? Feet
Percolation test: .Circle one: .0iit required) required jc 01,7 ;� i� 1I �� 41
Rate - Min. Per Inch ,
• JUN 151990
Domestic water supply: Circle one: ,cn_Lrip1D Well Other
If domestic water supply is a, Well : BUILDING &
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank e i5di u gal . (minimum size: 1,000 gal )
=
SEEPAGE PIT(S)' Number of /Size .each feet P
- by <3 feet
- Size of stone to be used #... /Depth or Thickness ,,f��= feet
*****************************
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HOLDING TANK YSTEM IF REQUIRED
NO. of Tanks Size of Each al .
*Ala stem and associated electrical to be inspected by an approved
ncy.
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: 0/X612._ DATE: 0/fr2
1
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 shoving:
1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspuctor. 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;;immediace work stoppage.
D. Shouldunforeseen problems during construction prevent proper installa—
tion, alteration or repair of an approved system, a new proposal must
bu submitted co the Queensbury Building Department before further
construction.
Town of Queensbury .
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
k nn;►rks: :,
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Jown of Queen3tur1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 /Jnjj
Queensbury, New York 12801 /f��/
SEPTIC 4 ISPOSAL SYSTEM , NSPECTION
NAME �I G kJ6GL d/ •
•
LOCATION I _O-V o �./
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DATE 4/ 3/ �D PERMIT NO' 90-3t7
SOIL TYPE - Send - Loam Clay -
Percolation T_st Require ? YES - NO
Percolation r.te - Min/ &Ich
1 r
a
TYPE of SYSTEM\
Absorption fie d, total; length
Length of each \\trench ,
Depth of trench-s " 1
.Size of gravel:_\; —
SEEPAGE {N "' .-r or' )Size- ft. X t.t-
Gravel size , I
PIPING: \ Size Bldg. to tank 1 j pkt •
Tank to dist. bo % P //
Dist. box to fie d/ ' • Ly ,�/-6__„,
Openings sealed?\ YES NO Partial
LOCATION/SEPARATIJNS: el
Foundation to tan,: /L'//ft.
Foundation to absorption `f ft.
Absorption to lot,\ ine u '' ft.
Separation of pit 1, ft:
LOCATIO OFF YSI 1IN P-pPERTY(circle one)
Front Rear - -'ftil sid J - Right side -
COMMENTS: ( , 7.,
e Y t ,c(1 ' 7,
•
11 i( ja—(17 . 76 /
SYSTEM USE A'PROVED /YES' NO
Building nspector
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;: JUN 151990
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