1990-453 • CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY°
WARREN COUNTY, NEW YORK
Date July 16 19 9°
This is to certify that work requested to be done as shown by Permit No. 90-453
has been completed.
This structure may be occupied as a sewage alteration
( 00 Lt7-ev I 'ts 69 &-•70
HOMESTEAD VILLAGE
Owner
By.Order Town Board
TOWN OF QUEENSBURY
'Director of Bldg. .&Code:Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY No. 90-453
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to HOMESTEAD VILLAGE w
OWNER of property located at Lots 69 & 70 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. OWNER'S Address is
Luzerne Rd
Queensbury NY 12804
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2. CONTRACTOR or BUILDER'S Name
til
1-3
Morning Star Excavating Inc.
3. CONTRACTOR or BUILDER'S Address
r
128 Kobor Rd r"
Gansevoort Ny 12831
4. ARCHITECT'S Name
5. ARCHITECT'S Address
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to
6. TYPE of Construction—(Please indicate by X) R,
( 1 Wood Frame ( I Masonry ( I Steel ( I - -
7. PLANS and Specifications
Sewage alteration to include 3 seepage pits 8'x9' as per plot plan, specifications
anapplication.
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8. Proposed Use
Sewage alteration
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 11 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 llth Day o Jul 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning nspector
TOWN OF QUEE•NSBURY �s
APPLICATION FOR
> SEPTIC DISPOSAL PERMIT
Mir I( QUELI
DATE // JUL/�'t, 11 1990
RUILDI G -
�� CODS. DEPT.
LOCATION OF PROPERTY FOR INSTALLATION � 4� P / ,,, /&4 -
Owner's Name: 1Y"1 j'!; - 70 Telephone: 7 cf 2 2 zjOO
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Address: 1'J
Installer's Name: l s' v � Telephone: 3-2.299 o
Number of bedrooms (residential only) S—
Total daily flow (compute ( . 150 gal per bedroom)
Topography: Circle one: ElAt Rolling Steep Slope % of Slope
Soil Nature: Circle one: ansl. Loam Clay-Other /Depth: Feet '
Ground Water: At what depth?. -- - Feet
Bedrock or Impervious Material: At what depth? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one. Municipa- Well Other
If domestic water supply is a we 1
Separation: Water supply from septic orption feet
PROPOSED SYSTEM: Septic Tank /609 gal. (minimum size: 1,000 gal.)
TILE FIELD: Each Trench feet/Total system length - feet
SEEPAGE PIT(S): Number of 3 • / Size each feet by C/ feet
Size of stone to be used # `, /Depth or Thickness feet
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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:. ' Lh
DATE: Q1Z A •sGU ✓
OVER •
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Septic Systeni; 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 codstr.uction 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,
tile 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 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—
Lion, 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
Remarks : •
awn
t
_Down o1 Queenibury
BUILDING arid ZONING DEPARTMENT
Bay and Hay land Road, R.D. 1 Box 98
Queens .ury, New York 12801
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SEPTIC DISPOPAL SYSTEM INSPECTION
NAME 4-79,v,,,4z, !r
1.
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LOCATION fi s, Cif f- 7
DATE f 1 19� P RMIT N . �U '
SOIL TYPE - Sand Loam-- Clay -
Percolation Test quir,-d? YES - NO
• Percolation rate -IMin :Inch
TYPE of SYSTEM: I
Absorption field, otl length
Lengthof each trek
Depth of trenches ;
Size of gravel 'I
SEEPAGE PITS{Nuinber .f) s ,-
Size- 5( ft. X :ft. �l( / '. _j akg--'
Gravel size i
- PIPING: Size Type
Bldg. to tank fV4 .
Tank to dist. box Wive:-
Dist. box to field , 1'
Openings sealed? �Y S NO P rtial
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LOCATION/SEPARATI!►NS:
Foundation to to ' / •ft.
Foundation to ab-orpt on p r ft.
Absorption to to lin: " ft.
Separation of p'ts IV ft.
LOCATION OF SYS. EM aN i• PE Ylci one)
Front - Rear - eft sio- - Right sid -
COMMENTS: }
1 • \ /
\ . .
SYSTEM USE APPROVED YES No
Buildi,gI. spector
01/86 and vl
JUL 111990 r
UILDING & COOL. LJ
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