1990-473 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
11 {--1 19 "iD
Date
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90-473
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
25 Main Street
Location:'
Owner WILLIAM BARRETT
, By Order Town Board
TOWN OF QUEENSBURY
4\6--5-;:,v
Director of Bldg. & Code EniArcement
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BUILDING PERMIT
TOWN OF QUEENSBURY No 90-473
WARREN COUNTY, NEW YORK •
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PERMISSION is hereby granted to WILLIAM BARRETT
25 Main Street
OWNER of property located at
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
same
1-3
2. CONTRACTOR or BUILDER'S Name G
Condon's Septic & Drain Service 5
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
cn
5. ARCHITECT'S Address
C/)
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CD
CD
6. TYPE of Construction- (Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No.Sewage alteration to include 1000 gallon septic tank and 2 seepage pits 8'x8'
with #3 stone at 1 ft. depth as per plot plan, specificaitons and application.
8. Proposed Use c
g
Sewage alteration crq
sv
25.00 July 20 92 n
$ 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 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 20th Day of ,July 19 90
SIGNED BY for the Town of Queensbury
Building and Zoningiinspector
APPLICATION FOR
SEPTIC DISPOSAL PERMIT
DATE ?� / ?'d
JUL 19 1990
LOCATION OF PROPERTY FOR INSTALLATION , , ��
Owner's Name: ,�r/hen f�Rfi 7c- Telephone: / ?-- gcZ_c
Address: 2 . 6; F) U /vs'
Installer's Name: -04m i /(c.21)1 .//v (c&c' Telephone: 7? g,Srr/3
Y2
Number of bedrooms (residential only)
Total daily flow (compute O. 150 gal per bedroom) /7/60
Topography: Circle one: Rolling Steep Slope % of Slope \,
Soil Nature: Circle one:gSand Loam clay Other /Depth: Feet
Ground Water: At what depth? ! h Feet
Bedrock or Impervious.Material: At what depth? f�i Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one:(Municipal Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
/vC
PROPOSED SYSTEM: Septic Tank /06 6 gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of 7._- / Size each feet by 6 feet
Size of stone to be used # /Depth or Thickness 1 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: c3 f L / e.:(7-y\_0C/1/‘ ,
DATE: 7-1
OVER
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
be submitted to the Building Department at least 24 hours before start
of construction 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. Nu system shall be covered before inspection and approval by the
Building Inspector. Failure to comply with this .r.equirement 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—
tion, alteration or repair of an approved system, a new proposal must
be submitted co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
l:umarks
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1p, fit _ -3 0
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Jocun o� ueen3bur,
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• BUILDING and ZONING DEPART NT
Bay and kiaviland Road, R.D. 1 :lox 98
Quee sbury, New York 12:01
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SEPTIC DI•"SAL SYSTEM I PECTION
NAME /: !.
jG
LOCATION / 7e-V
r�7
DATE_ ''fI 2 / Cr(� '.PERMIT NO. - 1i
SOIL TYPE - San• Loam - • lay -
Percolation Tes Required./' YES - NO
Percolation rate - Min/In h
TYPE of SYSTEM: •
Absorption field ' total ength
Length of each t -nch
Depth of trenches •
Size of gravel i
SEEPAGE PLTS-Nuinb r.of
Size- ft. X f L
Gravel size -�� � I
PIPING: /Siz lype
Bldg. to tank ' J Tank to dist. box f ; /f
Dist. box to field/9 c e.-/ • rit--
Openings sealed? 4 S) rNO Partial
LOCATION/SEPARATION \
Foundation to tank ! ft.
Foundation to abso;pt'on ft.
Absorption to lot ,in: �)ft.
Separation of pit-
LOCATION OF SYST �` ON 'i ROPERTY(circle one)
Front /Rea /- Lei t side - Right side -
COMMENTS. 1 �--
2/20
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SYSTEM USE A'PROVED YES r 1O
Building In`.pector •
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It 11 t ii g is
JUL 191990
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