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1990-672 r f . • ,-r"•- r---,t. ..ii.}r' .4;✓^.,.,.- fir•,_._.. . \ f. i 7 �. ryt r r ( �o ".7.--... .. a .w.r... 4•:'�' , t:'= CERTIFICATE OF COMPLIANCE - TOWN OF QUEENSBURY - WARREN COUNTY, NEW YORK , • Date October'5 19 96' b� \IA ._,\ `...•-?.?, '' This is to certify that work. requested to be done as shown by Permit No. 90-672 has been completed. This structure may be occupied as a canti r cyctram 'i, Location 1 W X Di xon Road JEFFREY OLSON Owner By Order Town Board TOWN OF QUEENSBURY - -: mil✓ �,� Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY r No. 90-672 WARREN COUNTY, NEW YORK t z - o PERMISSION is hereby granted to ,]FFFRFY OLSON '—' OWNER of property located at 62 Dixon Rd Street, Road or Ave. -P N 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 co approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is same 2. CONTRACTOR or BUI LDER'S Name 0 Sanitary Sewer N 3. CONTRACTOR or BUILDER'S Address CD —h —h rD 4. ARCHITECT'S Name 5. ARCHITECT'S Address rn 0 6. TYPE of Construction—(Please indicate by X) X 0 ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications NoSewage alteration to include 1000 gallon tank and 200 feet of tile • field with #2 stone at 1 ft. 8. Proposed Use Septic system V) CD cn CD $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 2 19 91 Q, (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the c.i. town of Queensbury before the expiration date.) rip Sv (-'- Dated at the Town of Queensbury this 2nd Day of October 19 90 0' l SIGNED BY �/1:� r for the Town of Queensbury Building and Zoning Inspector ��. TOWN OF EENSBURY f4- �� // ! APPLICATION FOR S SPOSAL PERMIT / OWN OF 'QUEENSBURy DATE: JO 1 - 90 RECEIVED LOCATION OF PROPERTY FOR INSTALLATION 6GPj7/X�n/ ' OCT d 1 mo Owner's Name:." FF/ie OZrO,t/ BLDG. & CODE ut:PT, Address: / Installer's Name: AN j'7, / L Telephone: 7 9 - Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) L Topography: Circle one: Rolling Steep Slope % of Slope Soil Nature: Circle one: Loam Clay Other _ /Depth: Ground Water: At what depth? Feet Bedrock or Impervious Material : At what depth? Feet Percolation test: Circle one: of require required Rate - Min. Per Inch Domestic water supply: Circle one: 'unicipal Well Other If domestic water supply is a: wel : Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank /000 gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench O 0 feet/Total system length -O feet SEEPAGE PIT(S): Number of. /Size each feet by feet Size of stone to be used #. ) _ /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 PERSON: DATE: /©�/ Pc) 1 r. 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 co any water supply 5.) size and dimensions of all tanks, distribution boxes, tile 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 rusulc in the uncovering of the system by the installer and a fine uf 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 cime:of inspection say result in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper installa- cion, 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: Y // _awn o/ Queenitury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME A&/ &&ö2 } LOCATION 0 0,0 x) , DATE/o% i 9i PERMIT NO. 6 SOIL TYPE - - and - Loam - Clay Percolation est Required? /YES - NO Percolation rate - Mi)i/Inch' TYPE of SYSTEM: / / Absorption field, total1ilength 0 % Length of each trench' Q Depth of trenches ' Size of gravel SEEPAGE PITS{Numberyof) Size- ft. X ;t ft. Gravel size 1,1 PIPING: / Se/ Type Bldg. to tank I 0, 4 PO: Tank to dist. bo hl le pft Dist. box to feld;rpit pvC/ Openings sealed? II YES NO Partial I LOCATION/SEPARATIONS: Foundationo tank ft. ' Foundation to absorption a() ft. Absorption/to lot Cline Separation of pit ft. • LOCATION OF SYSTEi1 ON PROP -TX(circle one) Front - Rear - Left side Right si e - COMMENTS: A • SYSTEM USE APPROVED NO B. i ding Inspec or 01/86 and vl . . • cw)).),-va o'OWN OF QUEENSBURY RECEIVED OCT - 1 1990' BLDG. & CODE DE. T. 1-11")3C gst sk) • a c 60e • 1000 _ 9rirc • ....Tepr 40 Ltol .)? TON4 OF CIUM,.0.2*MY Zoning Administratotr Date.