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CERTIFICATE ®E COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW. YORK
Date November 13, 1990
-(- Gi 0
This is to ertify that work requested to be done as shown by Permit No. 90-681
has been completed.
This structure may be occupied as a septic system
Location 17 Greenway North
KENNETH SHAW
Owner
By Order Town Board
TOWN OF QUEENSBURY
C€6.7-,/
Director of Bldg: be Code Enforcement
BUILDING PERMIT -�
TOWN OF QUEENSBURY No. 90-681
WARREN COUNTY, NEW YORK .o
PERMISSION is hereby granted to KENNETH SHAW
OWNER of property located at
17 Greenway North Street, Road or Ave.
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 to
2. CONTRACTOR or BUILDER'S Name [D
Sanders Excavating c
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address N
CD
6. TYPE of Construction—(Please indicate by X)
0
( )Wood Frame ( ) Masonry ( ) Steel ( ) •
7. PLANS and Specifications
�._
No. Sewage alteration as per plot plan, specifications, and application.
to include, 200 feet of tile field with #2 stone at 1 foot.
8. Proposed Use
CD
Septic system
csm
$ 25.00 91
PERMIT FEE PAID —THIS PERMIT EXPIRES October 4 19
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the -5
town of Queensbury before the expiration date.) cF
0
Dated at the Town of Queensbury this 4th Day of October 19 90
SIGNED BY r it e" 4 for the Town of Queensbury
Building and Zoning Inspector
TOW O • /NSBURY
7 - .5 APPLICATION FO' '.E l %! SPOSALU�RERI�i'TQUE NSBURY
RECEIVED
EI ED
. 41
DATE: �n,7 . - 9b OCT ® 2 1990
LOCATION OF PROPERTY FOR INSTALLATION / re,, t41az i no r%�1
%� �LDG. i;- fi� e
Owner' s Name: ,c 57"e_.
Address: / 7 (•--y'�en e� y� Dr�1'1 r�/ep 1=c IA"
r�
Installer' s Name: 3ieotit Telephone: -7 9'3--2)/S_.
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: Flat 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: t re uir required
Rate - ----- Min. Per Inch
Domestic water supply: Circle one: Well Other
If domestic water supply is a. well:
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /&7t gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench -�/O feet/Total system length 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:
1
•
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 co 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 co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
rile 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
result in the uncovering of the system by the installer and a fine
of up to $250.00.
C. An approved copy of chit 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
bu submitted co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
k.:narks: •
74,
down oil Queeniurty
• BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Oueensbury, New York 12801 %'*/
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME c� /1--/!66-1
LOCAT I ON / Av-O�7,,,(/7Lt1O"L/�Zi'
DATE /0 //(t) PERMIT 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 trenc)i '
Depth of trenches-3
Size of gravel '-2 07;7e4_
SEEPAGE PITS{Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank
Tank to (list. box
Dist. boa: to field/pit
Openings sealed? YES NO ' Partial
LOCATION/SEPARATIONS: .
Foundation to tank ft.
Foundation to abscrption Zkep ft.
Absorption to lot line /o- '/5 ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front -441D- Left side'~ Right side -
COMMENTS:
!/ 1'
4,y
i•
/ l:
SYSTEM USE APPROVED ' NO
�.. °t,,
BuOing Insp- t`or
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- .t.,•! .747 ("),-tiZENISBURY - k -
'
I OCT - 2 1990
1 %le • 1 .
3LDG7 8,-C.OIDE DEPT.
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