1990-773 •
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date October 26 19 90
This is to certify that work requested to be done as shown by Permit No. Q11®7:43
has lien'completed;
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This: structure may be occupied as a sRnti c cvctPm
Location Route 9-Lake George Road
FRANK'S PIZZA/Maria Fasulo, Owner
ter
By Order Town Board
TOWN OF QUEENSBURY
Director of'Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY No 90_733
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to FRANK'S PIZ7A, Maria Fasulo
OWNER of property located at Route 9-Lake George Road 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
14 Wincrest Dr
Queensbury NY 12804
2. CONTRACTOR or BUILDER'S Name
Condon's Septic & Drain Service
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
73
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( I Masonry ( I Steel ( )
7. PLANS and Specifications
No. Sewage alteration to include 1000 gallon grease tank; 1500 gallon
septic tank; 1500 gallon settling tank and two 8'x8' Seepage pits with 3 feet
8 Pfroposed"Use
Septic system
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$ a5_00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 26 19 92 fD
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(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.) r+
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Dated at the Town of Queensbury this Day of • 19 90
SIGNED BY - z for the Town of Queensbury
Building and Zoning'i ctor
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APPLICATION FOR r OF QUEENSBURt
SEPTIC DISPOSAL. PERMIT
OCT 2 3 1990
BLDG. & CODE DEPT.
DATE /0 — j9 -go
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LOCATION OF PROPERTY FOR INSTALLATION JC+e q $ /4/9 (W.c6/vs E v/^y
�9'✓✓, J, FOSS cfU Telephone: /1l 6r rt
Owner's Name: ]Cj �7 9O/ , A-11/ S
Address: l(J r 1u C rc 1 - 7 `Dik C u FiF w R o r,
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Installer's Name:��4/ T 1?f.9 �� �;C..( ,1 /9-►11) —Cr A Telephone: 7Pe--'.h--y L
Number of bedrooms (residential only) /L Y S fr NI 0ALf/4C/ Y
Total daily flow (compute Cd 150 gal per bedroom)
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: Municipal Well Other
If domestic water supply is a well:
Separation: Water supply from septic absorption feet
PROPOSED SYSTEM: Septic Tank I4'.57J gal.-(m-iiti-r3tvm-size: 1,000 gal.) �a
a;d,dl vZq • 0. OD O
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of / Size each feet by e feet
Size of stone to be used # /Depth or Thickness feet
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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: id 1 l ^ c20
OVER
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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 1
be submitted toHthe B'uilding '•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 -�
• 2,0 :;location and distance to lot lines
3.) location and distance to structures
4.) location and distance :to, any water supply .� r' `-` i
5.) size "andAimensions of all 'tanks, distribution boxes,
file 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 uncove.rinb2o'f the 'syscem by the i stiller 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 may
result in an immediate work stoppage.
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D. Should unforeseen problems during construction prevent proper.installa—
Lion, 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
kWmarks:
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JoWn o/ Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME C'� -4` //-W.4/
LOCATION / 9
DATE /0/9b / go PERMIT NO. Q0_-`71
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SOIL TYPE - d .oam - Clay
Percolation Test Re. 'red? YES - NO
Percolation rate - Mi Inch
TYPE of SYSTEM:
Absorption field, total 'ength
Length of each trench
Depth of trenches '
Size of gravel_ •
SEEPAGE PITS{Number of)
Size- .2 ft. X g' ft. ,'is 15 'at2 ux /
Gravel size ,#,3 1
PIPING: Size ! Type
Bldg. to tank 917,
Tank to dist. box
Dist. boa: to field/p't y R P
Openings sealed? 46740 N' Partial
LOCATION/SEPARATIONS:
Foundation to tank /O ft.
Foundation to abscrption .I./; ft.
Absorption to lot line i ft.
Separation of pits f /02 ' ft.
LOCATION OF SYSTEM ON PRbPERTY(circle one)
Front - Rear - Left side - Right site -
CgMMENTS:
(>00 T/2cra\
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SYSTEM USE APPROVED 0 NO
Buildin nspector
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