1990-602 • _ j , E ..4• • .:. / 4
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date q ha_ 19,
3 01 f
This is to certify that work requested to be done as shown by Permit No.90-602
has been completed. •
This structure may be occupied as a septic system
Location
9\30 ect Lot 16 Homestead Village
HOMESTEAD VILLAGE MOBILE HOME ]PARK
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enfo .ement
y
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 9n-602
O
WARREN COUNTY, NEW YORK
to
PERMISSION is hereby granted to HOMESTEAD VILLAGE MOBIL EHOME PARK
OWNER of property located at Lot 16 Homestead Village Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Septic System
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 Road
O
trj
2. CONTRACTOR or BUI LDER'S Name y
ti7
Morningstar Septic Service
3. CONTRACTOR or BUILDER'S Address t"
4. ARCHITECT'S Name 0
td
r
tit
5. ARCHITECT'S Address O
4
t=?
6. TYPE of Construction—(Please indicate by X) PZi
( )Wood Frame ( ) Masonry ( )Steel ( ) o
7. PLANS and Specifications rn
No. Septic system to include 1000 gallon tank with 125 feet of tile field with #2
stone at 1 foot thickness.
8. Proposed Use
Septic system
cn
V
25.00 September 11 92 41.
$ 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 D y of September 19 90
SIGNED BY 1 for the Town of Queensbury
Building and ning Inspector
411141,
TOWN OF QUEENSB URY
;O j A 1;4 APPLICATIOtN FOR SEPTIC DISPOSAL PERMI
DATE: K AN I OF QUEFEN •SI.JRy
LOCATION OF PROPERTY FOR INSTALLATI N ,,l 7144 RECEIVED
Owner' s Name: ,.✓e SEP 1 0 1990
Address: ,/� BLDG. A renDP DEPT.
Installer' s Name: (7t1 -. Telephone: 299 ---- v
Number of bedrooms (residential only) Z_
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: ;t Rolling Steep Slope % of Slope
Soil Nature: Circle one: . P - Loam Clay Other /Depth:
Ground Water: At what depth? C) Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Municipa Well Other
If domestic water supply is a, we •
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /coda gal . (minimum size: 1,000 gal )
4o- 4a
TILE FIELD: Each Trench feet/Total system length f a j 110 feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. 2_ /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 OF RESPONSIBLE PERSO N.N ��z� /a —9a
�� AL DATE:
•
Septic Syste■ 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,
cild fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspector. Failure to comply with this requirement may
result in the uncovering of chd 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'musc
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
Rwmarks:
Jocun o/ Queenitury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME" , .(>iS7
LOCAT 101 /�
DATE .9/// /v PERMIT NO 670 —4,0o2.
SOIL TYPE - and - Loam - Clay -
Percolation est Required. YES - NO
Percolation =te - Min/In h
)E of SYSTEM
Absorption fiel., total l ngth /25
Length of each : ench L(O_ L10 - 4
Depth of trenche. ' "3/-7
Size of graveili .
SEE GE P TS{Numb:. of)
S' .e- ft. X ft.
avel //////size
PIPING: S ze Type
Bldg. to tank .f "(TL
Tank to dist. box tf p rc_
Dist. box to field/•it /VC--
Openings sealed? E' NO Partial
LOCATION/SEPARATIONS.
Foundation to tank 1 f
Foundation to absor•tion ft.
Absorption to lot 1 ne ft. �Jr
Separation of pits . It
LOCATION OF SYSTEM ON PROPERTY ircle one)
Front - Rear - Lef side - Right side -
COMMENTS:
SYSTEM USE APP RoVED Y NO
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B ilding In ector
01/86 and vl
1s
Lev- 6)
O). i 2 s SU l it la
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4i) /6
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47