1990-604 . .
•
Iminamor
CERTIFICATE, OF COMPLIANCE
TOWN OF QUEENSBURY .
WARREN COUNTY, NEW YORK
Date October 5 19 90
• 90-640
This is to certify that work requeated to be done as shown by Permit No.
has been completed.
This structure may be occupied as a sep ic system
k\k
Lot 5 of Mobile Home Park, Aviation Road
Location
Owner IVAN BARSIIKOFF
By Order Town Board
TOWN OF QUEENSBURY
7/f7)0/
Director of Bldg. & Code Enforcement
. „
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-640
WARREN COUNTY, NEW YORK
G
PERMISSION is hereby granted to IVAN BARSUKOFF
cc
OWNER of property located at Aviation Rd-I of 5 Mobile Home Park Street, Road or Ave. cn
in the Town of Queensbury,To Construct or place a septic 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
RD#1 Box 139F Rock City Road
Hudson Falls NY 12839
2. CONTRACTOR or BUILDER'S Name
CD
T
3. CONTRACTOR or BUILDER'S Address 'rl
1-1
sv
4. ARCHITECT'S Name
5. ARCHITECT'S Address
0
6. TYPE of Construction—(Please indicate by X)
0
( )Wood Frame ( I Masonry ( I Steel ( )
1 �
7. PLANS and Specifications r"
No Septic alteration in cluding one seepage pit 8'x10' with #2 stone at
3-4 ft depth. 0
$' gti c Ssystem o
Cr
0
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 20 19 92
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the
sv
town of Queensbury before the expiration date.) -5
Dated at the Town of Queensbury this h Day of $ 19 90 cn
m
-o
SIGNED BY for the Town of Queensbury r�
Building and Zoning In or 0
c--t-
(D
0)
c+
0
0
_ TOWN OF QUEENSBURY
a
� r� t 4:015e--/
sat _APPLICATION FOR SEPTIC DISPOSAL PERMIT ,
r1-'1" ij 1Y
DATE: g z O / 9 0 �.
LOCATION OF PROPERTY FOR INSTALLATION 4 ,#��� rtv/a2 qA
� q'
Owner's Name:17/ -n g ; -,? ,((5 ,C-111(0
Address: �
F d� P �
,� no ie i r) tfy k
Installer' s Name: ,s 1 Telephone: i 4/7
Number of bedrooms (residential only) Z—
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one:41, Rolling Steep Slope % of Slope
Soil Nature: Circle one: S d1 Loam Clay Other /Depth:
Ground Water: At what depth? z O Fr: 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: Municipal Well Other
If domestic water supply is a, we :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ,614/ 0: gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of / /Size each ,Crfeet
by , V prfeet
Size of stone to be used #. 2 /Depth or Thickness ,3®"e/ 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 PERSON:AJ/2,A a.,. DATE: Xo„:"
1
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 drywalls
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 co 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
Remarks: •
own io/ Queeniuru
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
�eL / /t
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME �-v y .IiJ/ '
D
LOCATION .�2?-1 ,(6 ' C_,, ,,a
DATE /ie// /GJ/; PERMIT NO. (]7D-'64L
/ b'
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate'~ - Min/Inch/
TYPE of. SYSTEM: �l ;✓
Absorption field, total length
Length of each trench' ;
Depth of trenches i i
Size of gravel ,
SEEPAGE PITS{Numberof) Y
Size- l ft. X _Lft.J
Gravel size . .0771"2— k, ,
PIPING: Size SI `1 Type Y
Bldg. to tank ,t U
Tank to dist. box
Dist. box to field/pit; / Q 1
Openings sealed? Ygi; NO Partial
f -
1
LOCATION/SEPARATIONS:.
Foundation to tank I ! ft.
Foundation to absorption`; ft.
Absorption to lot dine r /d 'ft.
Separation 'of pits v} ft.
LOCATION OF SYST ON PROtERTY(circle one)
Front - Rear - Le±t side =s Right side -
COMMENTS:
.
r
1'
1
SYSTEM USE APPROVED YES/ NO
Bu ding Insp ctor
01/86 and vl
• 1
. .
. ;4•
• 30 �r TOWN . OF UEENSBUkY . .
REVIEWED BY •
� i1 ..
• DATE . ' Sr9e
•
c.
141 066L 6 d3S •
.
7k I i, ;I ! 1
7
•I
--.. - - . ,.... -t-• , .- J .K) . .A _ t • .
. `'4, . tzt„ .
a q
.
•
_ft, , 5 Q-(eo t5 -tctii-tie -
k19 h if u1<Ii_(..q...5
. � )1C- 7t l- �.es �Lfcie e--,
. . -r,2, €19)1 d,.t.2 t ec d Ce �"
yi4� V e,tv . t '1 E - v o g r/ci ? - .