1990-764 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date November 5 19 90
This is to certify that work requested to be done as shown. by Permit No. 90-764
shown.
has been completed.
This structure may be occupied as a Septic system
4 Apple Lane
Location
Owner CHARLES H. TALL
By Order Town Board
TOWN OF QUEENSBURY •
Director of Bldg. ac Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-764 -o
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to CHARLES H TALL cs
OWNER of property located at 4 Apple Lane 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
I-
r
c-)
2. CONTRACTOR or BUILDER'S Name
Di
Condon's Septic & Drain Service m
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) [D
r
( 1 Wood Frame ( 1 Masonry ( )Steel ( )
7. PLANS and Specifications
"'Sewage alteration to include two 8'x8' Seepage pits with #3 stone at
two foot.
8. Proposed Use
Septic system
to
CD
$ 25.00 PERMIT•FEE PAID —THIS PERMIT EXPIRES November 5 19 92
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the Di
town of Queensbury before the expiration date.) --'
c-'-
Dated at the Town of Queensbury this 5th Day of November 19 90
o
SIGNED BY ! G/L'i j� for the Town of Queensbury
Building and Zoning Inspec`tbr
a seS Pr A r LJ l I id L'A . L3 I.:A. r
/ ;��.-‘licait APPLICATION FOR
�! SEPTIC DISPOSAL PERMIT -
Co Yo P N O\/ 2 799 V
DATE 1/ ` / ,`-%��•,I. et CODE DEPT.
LOCATION OF PROPERTY FOR INSTALLATION ' /# kan)E.
Owner's Name: et i�: /hi/ Telephone:✓ 7 9 e- ,fit/Z Z
Address: y AD, ie 4...a iti p
(71
j r
Installer's Name. D/v 0 AIS' <SF✓� G � l 1,I cc / .Telephone: 7l0 — � �y
Number of bedrooms (residential only)
Total daily flow (compute (0 150 gal per bedroom) yj.c0
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: San Loam clay Other /Depth: Feet
Ground Water: At what depth? 0 Feet
Bedrock or Impervious Material: At what depth? 4/,f) 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 moo gal. (mtnimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of / Size each 6 feet by feet
Size of stone to be used # 3 /Depth or Thickness Z� V feet
*************************
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: T ' I/1 (L /��,�
DATE: / /.—-)---" 90
OVER
a
•
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 to any water supply
5.) size and dimensions of all tanks, distribution boxes,
cile fields and/or drywells - -
ate •
B. No 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 in§taller 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. . 1
D. Should unforeseen problems during construction prevent,,proper installa •
—
tion, alteration or repair of an approved system, a new proposal .must
be submitted to the Queensbury Building Department before further
construction.
Town o{f Queensbury •
BUILDING--and—CODES DEPARTMENT
Bay and Haviland Roads
rQueensbui'y_, New York 12804
kumarks: .
•
_awn o/ Queenilury
BI4ILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
P/RI
SEPTIC DISPOSAL SYSTEM INSPECTIONC
NAME C+i jt.(yA j cai
LOCATION 2 aw .
DATE (1/5_/ q0 PERMIT NO. � -r4
SOIL TYPEn -,- Loam - Clay -
Percolation Test Required? YES _ NO
Percolation rate - Min/Inch •%
TYPE of SYSTEM:
Absorption field, total lengthy
Length of each trench
Depth of trenches . i •
Size of gravel
SEEPAGE PITS{Numb of)
Size- Tft. X y ft. P--;'1,41 j
Gravel size .
PIPING: Size/ Type
Bldg. to tank
Tank to clist. box 44.
Dist. box to field/pit 4
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank fft.
Foundation to abscrption !2 ft.
Absorption to lot line o ft.
Separation of pits ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS:
•
SYSTEM USE APPROVED ES NO
Bui ng Inspec r
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