1990-449 ffi — Y z` � ! f `�•
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY,-NEW PORK-
Date July 13 19 90
13 11'0 —I.__
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This is. to certify that work requested o be done as shown by Permit No. 90-449
has been completed.
This structure may be occupied as a 'ewaP'e R1termtion
89IMain Street •
Location
NORMAN BENACK
Owner
By Order Town Board
TOWN OF QUEENSBURY
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'Director of Bldg. ac Code.Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY No 90-449
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to NORMAN BENACK
OWNER of property located at 89 Main Street Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Sewage alteration
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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
Sanitary Sewer n
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3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 125 feet of tile field with #2 stone at 1 ft
depth per plot plan, specificaitons and application.
8. Proposed Use Cfq
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Sewage alteration
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2 5.0 0 July 10 9 2
$ PERMIT FEE PAID —THIS PERMIT EXPIRES 19
(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 th Day of July 19 90
SIGNED BY C .CC1?n, / - for the Town of Queensbury
Building and Zoning n ctor
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/ � ,v�, TOWN OF QUEENSBURY
*I APPLICATIOI FOR SEPTIC DISPOSAL PERMIT 19
DATE:
LOCATION OF PROPERTY FOR INSTALLATIONf ^t f 8
��l� ��Q fi';r' '-BUF�Y
Owner' s Name: ,0 0 k 8,e,U4ck .
JUL 101990
Address: /f4 ,I J T re ei
BLDG. QQDE T.
Installer' s Name: &N 1 '7—,}-n, Telephone: �E�
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) J o 0
Topography: Circle one: _ .Rolling Steep Slope % of Slope
Soil Nature: Circle one: OW Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: (—not require required •
Rate - Min. Per Inch
Domestic water supply: Circle one: unicipa Well Other
If domestic water supply is a• well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ` 0 O 0 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length J feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. A /Depth or Thickness /1 • feet
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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 o everse side of this sheet and agree to abide
by these and all requirement of th Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: / 9e)
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Septic System Inspections:
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A. All applications for septic system installation, alteration or repair,
as required by the Town of .Queensbury Sanitary Sewage Ordinance, shall
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be submitted ;o the. Building Department at least. 24- hOurs before start
of conittOCtiOn 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,
and/or drywalls - -
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 tins 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
bu submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bey and Haviland Roads
. - Queensbury, New York 12804
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_lown of Queenilurry ''''---"--
BUILDING and ZONING D PARTMENT
Bay and Haviland Road, r.D. 1 Box 98
•ueensbury, New Yirk 12801
SEPT. DIS OSAL SYS ' INSPECTIO -
NAME /r" �f — l,( lam, C
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LOCAT I ON , .I ��/
DATE ,7 42/ ''° PERMIT NO. 7 — C 7 y ,
SOIL TYPE - •`,and - Lo.' - Clay -
Percolation T-st Required? YES - NO
Percolation r.,te - M' /Inch
TYPE of SYSTEM.
Absorption fiel. , to al length b
Length of each r.ren. i`�!t�
Depth of trenche',. '
Size of gravel_
SEEPAGE PITS{Nuinb. r of)
Size- ft. X _ ft.
Gravel size
PIPING: Size , i Type
Bldg. to tank _ __
Tank to dist. box V
Dist. box to fiel./. VC.
Openings sealed? E . NO Partial
LOCATION/SEPARATIANS: '
Foundation to to LeX f S!f t.
Foundation to ab-.rptioi 5 6,ft.
Absorption to lot line 4 ft.
Separation e pi.s
LOCATION z`0 YST.I ON PRIvERTY(circle one)
Front -. . - -ft side Right side -
COMMENT l
11 y ,t , /tl f
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SYSTEM USE 'PPROVED `YES NO
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Building Inspec or
01/86 and vl
5 - RY
JUL 1u 1990
Js BLDG. & CODE DEPT.
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