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1990-603 1k, • .t • CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date September 12 19 '10 30C tq - 1 - • This is to certify that work requested to be done as shown by Permit No. flO-ROR has been completed. septic system This structure may be occupied as a ci Dixon Road -^r Location RICHARD SMITH • Owner By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement BUILDING PERMIT ' . TOWN OF QUEENSBURY No. 90-603 WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to RTCHART) SMITH • rn OWNER of property located at 1 R nixr)n Street,Road or Ave.Road F-` 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 2. CONTRACTOR or BUILDER'S Name n Sanitary Sewer 0, 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name co 5. ARCHITECT'S Address DC 0 0 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 one 8tx10' Seepage Pit with #3 stone at 2 foot depth. CD 8. Proposed Use Septic System ro ro 25.00 September 11 92 $ 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 11th Day of September 19 90 SIGNED BY ( L for the Town of Queensbury ilding and Zonir: I n dor y ' a / "9.& _ /_. T - TOWN OF QUEENSBURY s, �—! f APPLICATION FOR SEPTIC DISPOSAL PERMI DATE: 9— /0 — 90 LOCATION OF PROPERTY FOR INSTALLATION /(P5 6/r ,ge-7,1. w: as ENE MR . �" RECEIVED Owner's Name: IA / C /4 /2J) /12. 11• Address: 1 k 6 /1,2;iJ;- ::; = •)) SEP 1 ® 1990' Installer' s Name: %/v /1—",, tiCr: Tel ephori.:D.ideoPigt dtpt Number of bedrooms (residential only) Total daily flow (compute @ 150 gal per bedroom) 2 Q a Topography: Circle one: 0 Rolling Steep Slope % of Slope Soil Nature: Circle one: eLoam Clay Other /Depth: Ground Water: At what depth? Feet - Bedrock or Impervious Material: At what depth? Feet • Percolation test: Circle one: (ot require required Rate - Min. Per Inch Domestic water supply: Circle one: Municipa Well . Other If domestic water supply is a. well.: Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank /V 0 0 gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench feet/Total system length ((feet SEEP PIT(S): Number of / /Si.ze eaItP feet by eet Sick 1?LL - YLA►f Size of stone to be used #. ' /Depth or Thickness 2-- feet ***************************** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks Size of Each Gal . *Alain 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 PERSON: DATE: 9"- /O 90 • • 0-- • 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: - I.) 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 and1dimensions of all tanks; distribution boxes,- tile fields and/or drywalls Z. No system shall be covered before inspection and approval by the iuilding Inspuctor. Failure to comply with this requirement may result in the uncovering of the system by the installer and a fins __Jul 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 • kLm rks: ,:S • • • • • • • hicI . _/own of Queenibur y . BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 ; SEPTIC DI POSAL SYSTEM' INSPECTION 1 NAME__ V,CN r---czb &M.k (4- - K i� LOCATION / -5• 0 1 Xo ' pr DATE t ( (,( /� PERMIT NO. J---(p 03` - _ 6 SOIL TYPE - :add Loam - Clay - Percolation - E Required? YES -OF) Percolation rate - Midi/Inch _ . b ^C TYPE of SYSTEM: Absorption field, total h Length of each e Depth of ncheI I - S' of gravel I SEEPAGE PITS4Nuinbier of) Size- ' ft. X y1 yC� ft. Gravel size PIPING: i Size Type Bldg. to tank � q Pu Tank -to dist.- boxjtri- Dist. .box to fiel1dl pit 1(f� Openings sealed? } YES NO Partial LOCATION/SEPARATIO S: Foundation to tack . ;' • ft. Foundation to absoption ft Absorption to loft Dtine f t ©jL" Separation of pits f LOCATION OF SYSTEM eN PROPERTY(circle one) Front - Rear - Leftide - Right side -. COMMENTS: ,1 f5 att-62- TA A I I L X tO i PLr� s O !L . SYSTEM USE A PROVED YE N Building Ins ctor 01/86 and vl ,----- Of/ -,_ 'veo tiFty CO`"CC"-PUCCI-4-11 /91 Q Petl- ct 5 V) chi) v A fc cptA 1:31.1)°' & CoDE 0 51° e b Epr. -f oct // / 0 /Goo 5.A.#0,0 14-00 if ic.- Il . CI t% \-Z11 i • • ‘\ 4" ----- (4-4 , . , • 1) /.1/ ),\-) 4046f-p . .