1990-671 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 'October 5 19 90
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This is to certify that work requested to be done as shown by. Permit No. 90-671
has. been completed. '
This structure may be occupied as a septic system
4 Sycamore Drive
Location '
James Patnode
Owner
By ,Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 90-671
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to James Patnode
OWNER of property located at 4 Sycamore Drive Street, Road or Ave.
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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
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2. CONTRACTOR or BUILDER'S Name —I
Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction— (Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel ( ) ,
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7. PLANS and Specifications
No• Sewage alteration to include two seepage pits 6'x8' with #3 stone at
2 ft. depth.
8. Proposed Use
Septic system
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25.00 October 1 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.)
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Dated at the Town of Queensbury this 1st Day of October 19 90 r•*
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SIGNED BY 4/,4-s/,/ iyf��, for the Town of Queensbury
Build g,6rrf;Zconir1lnspector
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��► TOWN OF QUEENSBURY 90_ ?—
` 1 APPLICATION FOR SEPTIC DISPOSAL PERMIT
DATE: 9C:2 6- 9? J r ,r. �. , � tr
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LOCATION OF PROPERTY FOR INSTALLATION 4-A04-C
Owner' s Name:n�/?2eS frC 0(i.Q_
Address: 1As,/c%� ,
Installer' s Name: , ./v /7--.49 y Ci `ems Telephone: /7'92-- 7as"'t
Number of bedrooms (residential only) 2
Total daily flow (compute @ 150 gal per bedroom) -'6 V
Topography: Circle one: dger Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand . Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: 6-,---equi:!55 required
Rate - Min. Per Inch
Domestic water supply: Circle one: unicipa Well Other
If domestic water supply is a. well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /6 O gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPA PIT(S): Number of /Size each feet
by feet °
Size of stone to be used #. .3 /Depth or Thickness 2— feet
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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.
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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: cD--))— 5 c
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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 co the Building Department at least 24 hours before start
of construction and shall include a plot plan showing:
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1.) 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 and dimensions of. all tanks, distribution boxes.
cile fields and/or drywalls
B. Nu system shall be covered. before inspection and approval by the •
uuilding 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 say
result in an immediate work stoppage.
- D. Should unforeseen problems during construction prevent proper installs-
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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ltianiarks: •
o'.'iun of Queenibury
f 42 BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 94/Y)11_4-1 777-4/ C
LOCATION // 41 7J 7J1e� /4
DATE /o// / 96 PERMIT NO. 90-„ & 7
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SOIL TYPE - Sand -' Loam-' Loam - Clay
Percolation Test squired? YES - NO
Percolation rate - +Min/Inch ,I�
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TYPE of SYSTEM: •
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Absorption field, total len" th
Length of each trench ' ;8'�
Depth of trenches y� ;��
Size of gravel 1 ,kq
SEEPAGE PITS{Numb din ;
Size- ft. X f . /
Gravel size _ ; , ,
PIPING: iize Type
Bldg. to tank 'i
Tank to dist. box ,' "`
Dist. box to field/pit ' .` .
Openings sealed? YES t; NO Partial
LOCATION/SEPARATIONS: keA
Foundation to tank ft.
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' Foundation to absorption 'ift.
. Absorption to lot line J'1 ft.
Separation of pits' -ft.
LOCATION OF SY ROPERTY(circle one)
Front ' t side eight side -
COMMENTS:
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7, . N,
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/ \SYSTEM USE ?APPROVED ES NO
Bui ing In p or
01/86 and vl
'SEP 2 8 1990
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