1990-474 CERTIFICATE OF COMPLIANCE
TOWN:'OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date July 24 19 90
This is to certify that work requested to be done as shown by Permit No.
90-474
has been completed.
This structure may be occupied as a sewage alteration
{Location A Dives-inn R tea t� .
Owner GERALD MONRIAN JR.
By Order Town Board
TOWN OF QUEENSBURY •
•
Director of Bldg. do Code Enforcement
BUILDING PERMIT y
TOWN OF QUEENSBURY No. 90-474
WARREN COUNTY, NEW YORK
G
PERMISSION is hereby granted to GERALD MONRIAN JR. -�
426 Division Rd
OWNER of property located at Street, Road or Ave.
e alteration
in the Town of Queensbury,To Construct or place a Sewage
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 0
2. CONTRACTOR or BUILDER'S Name
Condon's Septic & Drain Service rD
3. CONTRACTOR or BUILDER'S Address
-a
4. ARCHITECT'S Name
5. ARCHITECT'S Address
rn
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
"'Sewage alteration to include 1000 gallon septic tank as per plot plan, specifications
and applicaiton.
8. Proposed Use V]
CI)
Sewage alteration
$25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 20 19 92 fD,
a,
(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.) z
Dated at the Town of Queensbury this 20th Day of July 19 90
i
SIGNED BY ` � �' L/ for the Town of Queensbury
Building and Zoning Inspector
.. .. . v. y`ut:[:�vJul'1C r
APPLICATION FOR
t%a SEPTIC DISPOSAL PERMIT
[i 11;
�} q JUL 191990
DATE 9 - / ( `— / d
�►U DING & CODE DE:
LOCATION OF PROPERTY FOR INSTALLATION 5/.).(p fiedAzita •a'
Owner's Name: ii)(),11 IQ 1)9n,- ,%9 vr Y . Telephone:713 3 2.-V
Address: jn !l/!.S/On) Fivseoisy
Installer's Name:a`1 w S ,c -6 ? i i ,i,1� ccF/Q Telephone: e D V)
Number of bedrooms (residential only) 3
Total daily flow (compute O. 150 gal per bedroom) ZIO
Topography: Circle one:gl, Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: • Feet
Ground Water: At what depth? 41/4 Feet
Bedrock or Impervious Material: At what depth? Jy/ Feet
Percolation test: Circle one: not require2required rate min. inch.
Domestic water supply: circle one: 1�Zunicipaj Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
t1VVw
PROPOSED SYSTEM: Septic Tank/000 gal. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of / Size each feet by feet a ti
Size of stone to be used # /Depth or Thickness feet
*************************
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: Vc� (I/ 00-yLd_dv\_,
DATE: 7-19- f:
OVER
•
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 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—
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
•
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