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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
19 •`J
90-40
This is to certify that work requested to be done as shown by Permit No.
has been completed. .�
This structure may be occupied as a sewage alteration
4 Aviation Road
Location
Owner GERALD NEWTON
By Order Town Board
• TOWN OF QUEENSBURY
Director of Bldg. &Code En#orcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-401
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to GERALD NEWTON
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OWNER of property located at 214 Aviation Road Street, Road or Ave.
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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
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2. CONTRACTOR or BUILDER'S Name r?
Sanitary Sewer
�s
3. CONTRACTOR or BUILDER'S Address
POBox224
Glens Falls NY 12801
4. ARCHITECT'S Name
FP
5. ARCHITECT'S Address S�
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6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 1000 gallon tank, and three tile field trenches
of 42 ft each with #2 stone at 1 foot depth.
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8. Proposed Use fD
Sewage alteration SID,
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25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES June 21 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
21st Day of June 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
A TA
TOWN OF QUEENSBURY iii _d
� j 70 APPLICATIOr1 FOR SEPTIC DISPOSAL P`'., T�iw�,
_,_ it 6y ZDDATE: ola - QD i„,,,, OF GU�-EN,, U
/ R EI f�D
LOCATION OF PROPS TY FOR INSTALLATION �/ L( / 7 7 M
Owner's Name: (W A-0 /UQfiJT&".) A 2 01990
Address: //.,( r :( 'J7 >..D : fit: DLIG. & CODE DEPI`.
Installer' s Name: 1 ./.� e' �W /..,¢ Telephone: 9) — 7 -
Number of bedrooms (residential only) )4* 1
Total daily flow (compute @ 150 gal per bedroom) ,,1�' ,�
Topography: Circle one:400 Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious. Material : At what depth? Feet
Percolation test: Circle one: not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Municipal Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
b 0 A SDI /ems /i A-c4 f . cD,A.
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 42— feet/Total system length /25 feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used it, 2 /Depth or Thickness /1 feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm system and associated electrical work to be inspected by an approved
agency.
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: DATE:•4 ,- 0,
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Septic System Inspections; £ \,
A. -All -applications for -septic system installation. alteri,cick or repair,
as required by_ the Town of Queensbury Sanitary: Sewage Ordinance. shall
be submictedje c.he Building Department at—least 24..'hoursj4fore start
Of construction and shall include a plot plan showing: `
1.) the proposed location of the system
2.) locdcion and distance to lot lines
3.) location and distance co structures
4.) location and distance to any water supply
_5.)_size and dimensions of_ all_canks-. distribution boxes.
tile fields anal/or drywalls
B. No 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.
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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
coiistruccion. ' •
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Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
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k.anarks:
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_Down of Queeniitur1
BUILDING and ZONING DEPARTMENT/
Bay and Haviland Road, R.D. 1 Box 98 f
Queensbury, New York 12801 Pfn
SEPTIC DISPO.AL SYSTEM INSPECtION
NAME -r/ O hO 'r] W.0„u- l--
LOCAT I ON i�' .'U...WorU Rd
DATE D&kw q 0 P:1° IT NO. o
SOIL TYPE - Sand -1 Loam - Clay -
Percolation Test •iquired? YrS - NO
Percolation rate -IMin/Inch
TYPE of SYSTEM:
Absorption field, '.tal lens; h / J
Length of each tre ' h 4
Depth of trenches II,
Size of gravel '� _
SEEPAGE PITS*Number?of)
Size- ft. X :_ft.
Gravel size
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PIPING: , S''e Type
Bldg. to tank , Jr/� -
Tank to dist. box Li `
Dist. box to field/chi iil '/j477 ,
Openings sealed? (a>) NO Partial
LOCATION/SEPARATIONS
Foundation to tank l aft.
Foundation to abso••t'v.n J(-f ft.
Absorption to lot ;, ine. 7 / ft.
Separation-of-.Rit% v ,-ft.
LOCATION/F-SYSTn ON d+ROPERTY(circle one)
Front (Rdear - -ft si•,- - Right side -
COMMENTS]
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1 (1
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SYSTEM U'.E APPROVED YES ' 0
BVi1ding Inspector
01/86 and vl
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,i,tive- 0 1000
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'COWN OF QUEENSBURY
RECEIVED
JUN 2 0 1990
BLDG, 8 CODE DEPT,
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