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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY'
WARREN COUNTY NEW YORK
Date J&IY 13 19 90
ARb\\ 90-452
This is to certify that work request
ed to be done as shown by Permit No.
has been completed.
This structure may be occupied as a sewage alteration
1,) Tee Hill.Road
Location
FORREST AND JOAN FISHER
Owner
By Order Town Board
TOWN OF QUEENSBURY
e
Director of.Bldg."& Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-452
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to FORREST & JOAN FISHER
OWNER of property located at Tee Hill Road Street, Road or Ave. 00
in the Town of Queensbury,To Construct or place a Sewng-. A1tPration
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.
1.71
1. OWNER'S Address is
same
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2. CONTRACTOR or BUILDER'S Name 0
Steven Sanders
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3. CONTRACTOR or BUILDER'S Address R"
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel ( ) s2
7. PLANS and Specifications
No.Sewage alteration to include 200 feet of tile field with #2 stone at 1 ft depth.
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8. Proposed Use
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Sewawge alteration
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 11 19 92 0
(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 llth Day of July 19 90
SIGNED BY . � for the Town of Queensbury
Building and Zoning Inspector
' 8 TOWN OF QUEENSBURYPet/
N FOR SEPTIC APPLICATION DISPOSAL PERMIT S
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DATE: �J /U 96 �. D _ Iai Lam.
LOCATION, OF PROPERTY FOR INSTALLATION / Ii-lI Rd. JUL 10 1990
Owner's Name: 7/51 er r rorpeS74 -'Ut°DING CODE DEFT.
Address: /;e4•%/ i',/r/f C�v c rsk),-/'/
Installer' s Name: c� 'ven cSPha���� / Telephone:
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) -,5-C) Gc?-/Circle one: 10 Rolling. Steep Slope % of Slope
Soil Nature: Circle one: 4411h 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: Municipal 40 Other
If domestic water supply is a- well :
Separation: Water supply from any septic absorption //O feet.
PROPOSED SYSTEM: Septic Tank /e7c70 gal . (minimum size: 1,000 gal )
XIs'/` h� i
TILE FIELD: Each Trench 5 C7 feet/Total system length d d feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #-. c9., /Depth or Thickness ,/ ' 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 •F RESPONSIBLE PERSON: .iaJ-- DATE:
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 co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields anal/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 time of inspection nay.
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
kv.niarks: :. •
•
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Town of QueeniLur y •� �E1
BUILDING and ZONING DEPARTMENT 10
Bay and Haviland Road, R.D. 1 Box 98
• Queens wry, New York 12801
SEPTIC DISPISAL SYSTEM INSPECTION
NAME \� ?j/' , Li(.l 4J '
LOCATION _ '� / i j.1
DATE 22//. / '°ERMIT NO. ,'G ' � a
i
1
SOIL TYPE - Sand - Loam - Cla -
Percolation Test :-equired? Y; S - NO
Percolation rate - Min/Inch r
TYPE of SYSTEM: /
Absorption field, total lens h . t----
Length of each trench t
Depth of trenches 17
Size of gravel I
SEEPAGE PITS{Numbe of) i
Size- ft. X ft. /
Gravel size , ;
PIPING: Si = ' Type
'Bldg. to tank �1• ,k
Tank to dist. box r . �;{%i✓
Dist. box to field/.iit ,
Openings sealed? 'Y S / NO t'artial •
LOCATION/SEPARATIONS I Ly ,1
Foundation to tank I ,1.S ft.
Foundation to absorpti . 71,Tit.
Absorption to lot lint " ft.
Separati its ® ft.
. LOCATI OF SY EM ON i°ROPERTY(circle one)
Front ear eft s'�ae - Right side -
COMMEN
(____) ) 7 0 0
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SYSTEM USE APPRO ED. YES N
Builain n ector
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