1989-815 CERTIFICATE +
C3F` (J►MF'LIAl�TC
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Llate_ Api 31 2fi -- 19
89-815
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
a?q ?) Aviation Road
Location
OwnerRobert Shearer
By C7rder Town Board
PI of QUEENSBURY
Director of Bldg. & C ' e Enforcement
r _ BUILDING PERMIT
TOWN OF QUEENSBURY No. 89�915
WARREN COUNTY, NEW YORK
ry
PERMISSION is hereby granted to ROBERT SHEARER o
OWNER of property located at 171 AVi ati on Road Street, Road or Ave.
V
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_ 'F'
1 _ OWNER'S Address is
SAME
0
cc�v
2. CONTRACTOR or BUI LDER'S Name �
A . J . Catalfamo , Inc , to
rre
3. CONTRACTOR or BUILDER'S Address A
m
4. ARCHITECT'S Name
r •
5. ARCHITECT'S Address
C
J,
C
Cf
6. TYPE of Construction — (Please indicate by X)
l ) Wood Frame ( ) Masonry ( 1 Steel ( ? C
N
f�
7. PLANS and Specifications `
No. Existing 1000 gal tank , 2 8 ' x 6 ' seepage pits
as per application and plot plan . '
8_ Proposed Use 4
Sewage Application .
$ . 25 , 00 PERMIT FEE PAID — THIS PERMIT EXPIRES October 19 19 L CD
(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 axpiration date.) O
Dated at the Town of Queensbury this Day of _ October 19 89
r+
SIGNED BY � for the Town of Queensbury
Building and Zoning 1 nspector
TOWN OF QUEENSBURY r'
ct
APPLICAInON FOR.SEPTIC DISPOSAL PERMIT
4j _- V OF QUEENSBURN
APR 2 6 1990
DATE (�, G►
BLDG. & CODE DEPT,
LOCATION OF PROPERTY FOR INSTALLATION / 'ri7 / 4 iovno 1 J a et �]
Owner's .Name: CSIOR � ,, en .Q4r- 'z� Telephone: _ _ 293 y •7 ��r
Address: 7 Z
Installer's Name: Telephone: S/ 7 " S!�L
Number of bedrooms (residential only) 3
Total daily flow (compute (d 150 gal per bedroom ) �✓` CD
Topography: Circle one Flat Rolling Steep Slope of Slope
Soil .Nature: Circle one Sand Loam Clay Lather /Depth.: /° � Feet
Ground Water: At what depth? _ YL G A-. 4Z� Feet
Bedrock or Impervious Material: At what depth ? Feet
Percolation test: Circle one: not required required rate4L/44 min. inch.
Domestic water supply: circle one: unicipal Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM. Septic Tank ,/boo gal. ( minimum size: 1 , 000 gal.)
TILE FIELD : Each Trench feet/Total system length feet
r3� W— v 15-7 1 O^ d
SEEPAGE PIT(S): Number of ;2 / Size each�fe; by / 0 feet ^v4sw
Size of stone to be used # 2 /Depth or Thickness 13 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 Disp Ordinance
SIGNATURE OF RESPONSIBLE PERSON:
DATE:� .�
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 ,
the fields and / or drywells
B6 No :system shall be covered before inspection and approval by the
!Building lnspt� ctor . Failure to comply with this requirement may
result in the uncovering of the system by the installer and a fine
ut up to $ ? 50 . 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
TOWN or QUEE- NSBURY cz;;,
APPLICATIQN FOR
r",�
=w ,SEPTIC DISPOSAL PERMIT ( ;i ,,r 0 i r c
? r - :
DATE /�f!�/ SLOG, COD DEPT.
LOCATION OF PROPERTY FOR INSTALLATION r1 ;V Z�Z�2m,) e!U .
Owner's Name: jeo Telephone: o2 ,22 -
Address: &,
�Lj ° .t&:i, '6ae9 ' IL 1 ' / 2 90 ?
T
Installer's Name: Telephone:�t/
r
Number of bedrooms (residential only) y
Total daily flow (compute (d 150 gal per bedroom} A 5C7
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? Feet
Bedrock or Impervious Material: At what depth ? Feet
Percolation test: Circle one: not required required rate min. inch.
Domestic water supply: circle one: <@junicipa Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM : Septic Tank fe") gal. ( minimum size: 1 • 00n gal. )
TILE FIELD: Each Trench feet /Total system length feet
SEEPAGE PIT(S): Number of c _/ Size each feet by feet -
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:
f /
DATE:
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 ,
the 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 . 000
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 .
L� . Should unforeseen problems during construction prevent proper installa—
tion , alteration or repair of an approved system , a new proposal must
be submitted to the Queunsbury Building Department before further
construction .
Town of Queensbury
BUILDING and. CODES DEPARTMENT
Bay and Haviland Roads
Queensbury , New York 12804
li�marks : ,
Q"erIsLury► �
N/wc �o wn Of
s me R.D. Box
and Hart and Fload128g1
Bay a 98
aueensburY, thew York
SEPTIC DISPOSAL SYSTEM INSPECTION
rr ■ i r ri ..R r ■
LOCATION Y
D , g0 w cam. PERMIT NO.r-- - -
SC>IL TYPE Sar►c3 Loath - clay
'Percolation est 'Required? YES
Percolation race - Min/Inch
TYPE of SYSTEM:
Absox'ption f i +
total le
Length
aCh tren
t
De of rencnche
rze of gra
SEEPAGE PITsokN lb )
er r f of)
Size^ S it. Js.�-
Gravel sire 2' Size Type
PIPI14G :
Bldg . to tank. —
Tank to d.ist . box
Dist. box to field NG Partial
openings sealed? YE
Z OCP+T3:m/SEPP RATI0t3 S :
Foundation to tax' _ft.
Foundation to absorptionp ft.
p,,bsorPti.on to lot. line t.
Separation. of pits gOPERTY (Circle One)
T,piCATICUTiSYST Right side -
Front - ea
eft sid
COTS ' T�
Ll
SYSTEM USE AP
PEED LIQ NO
Qt- ' ` D
l� Building InSp ctor
Ol/8F� and vl
�au,n a� �ueerrs6ure�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 98
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME -7' 'P
LQCAT ION
DATE ? � S~ PEfiM IT NO.
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - No
Percolation rate - Min/Inch
TYPE of SYSTEM ;
Absorption field , total length
Length of each trench
Depth of trenches
Size of gravel
SEEPAGE PITS4number of)
Size- ft. X ft_
Gravel, size
PIPING : Size Type
Bldg , to tank
Tank to dirt , box
Dist . box to field/pit
Openings sealed? YES No Partial
LOCATION/SEPARATIONS :
Foundation to tank ft.
Foundation to absorption ft ,
Absorption to lot line ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY (circle one )
Front - Rear - Left side - Right side -
COMMENTS :
Aj
SYSTEM USE APPROVED YES
Buil ` n71pecetor��
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