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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSEURY F.
WARREN COUNTY, NEW YORK
Date October 25, 19 90
0
V ', / cip
This is to certify that work requested to be done as shown by Permit No. 90-587
has been completed.
This structure,may be occupied as a cAw Cp c vcf n
Location 20 Briggs Court
L L,IZABETH POWELL
Owner
By Order Town Board. .
TOWN OF QUEENSBURY.
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-687 -o
WARREN COUNTY, NEW YOR K
PERMISSION is hereby granted to I I7JkBETH POWELL ry
OWNER of property located at 20 Briggs Court 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 -o
C�
rn
2. CONTRACTOR or BUILDER'S Name
Adirondack Pools
Po
N
3. CONTRACTOR or BUILDER'S Address cr
rD
c+
4. ARCHITECT'S Name
5. ARCHITECT'S Address N
O
Z
6. TYPE of Construction—(Please indicate by X) ca
Cl,
C")
( )Wood Frame ( ) Masonry ( I Steel ( I
7. PLANS and Specifications
No. Sewage alteration to include re-location of leach fields.
8. Proposed Use
Septic system U
CD
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Octaher 18 19 g9
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the rD
town of Queensbury before the expiration date.) -5
Di
Dated at the Town of Queensbury this 18th Day of 19 g0 0
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
//-/I TOWN OF QUEENSBURY
APPLICATIONN FOR SEPTIC DISPOSAL PERMIT
DATE: /pA/yD
LOCATION OF PROPERTY FOR INSTALLATION a0 Ji/o-o1 Coc.12r Fo10'fFi ED
Owner's Name: / U,gz7Fj Awe= .0 OCT - 4 1990
Address: ,® .%i 6-G-.f CvoK7-
Installer' s Name: ./W M OAMACk PeXY-S Telephone:_
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: 0 Loam Clay Other /Depth:
Ground Water: At what depth? 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, well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench 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 .
*Alarms 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
•
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 to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields and/or drywells
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 'co $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
. rusult 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 to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks: , •
•
Down o/ Queen.dury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM Ar.oc."-C
NSPECTION
NAME if-ee(P
LOCATIONQ 406 ettal
DATE i(11W' 96 PERMIT NO. 9 ' Cf.7
SOIL TYPE _ and Loam - Clay -
Percolation Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field, total length -2)
Length of each trench 5 '
Depth of trenches g; j
Size of (gravel #
SEEPAGE PITS{Number of) ' 1
Size- ft. X
Gravel size ,
PIPING: Size / Type
Bldg. to tank
Tank to (list. box c /vC_ 3S
Dist. boa_ to field/. ' y sax- 55
Openings sealed? r 1NO Partial
LOCATION/SEPARATIONS: ,�
Foundation to tank IE:)il5kurft.
Foundation to abscr tiori 41eft.
Absorption to lot line,, /oo ft.
Separation of pits 1 — ft.
LOCATION OF SYSTEM ON ADROPERTY(circle one)
Front - - Left side - Right side -
COMMENTS:
n8idie, a9 Ate- )04(/I/a.0,1-
I
4faeJ , o / ,
C4- P4C�- -
�1
t.
SYSTEM USE APPROVE YES 1
Build' g Inspector
01/86 and vl
3_0 T H U S : S 6. A D I R O N D A C K POOLS .. INC . P . 9 2 '
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(518)798-5552 r 0.1141,L5Fax(S18) 798-1871_
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S Boulevard, ueensbur NY 1 8
OCTi Q Y� •
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NOTES AO(illO daC
(518) 798-5552 — — == Fax(518) 798-1875
t Service,iqc.
5 Boulevard, Queensbury, NY, 12804 _
Date Project Lea+ 1' D i-A r to
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Drawn by C 5 /1)— Location ?n , ff/
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Architect A -01 • '` �GJsN Q5
Job No. X £ 'g Sheet No. c)