1990-811 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 19
30 '3
This is to certify that work requested to be done as shown by Permit No. 90-811
has been completed.
This structure may be occupied as a Septic System
Northwinds Mobile Park �7 /e
Location �� G-��,Kyle-
Owner Daniel & George Drel l os
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement .
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BUILDING PERMIT ;s
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TOWN OF QUEENSBURY x
No. 90-811
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Daniel & George Drel l os
OWNER of property located at Northwi nds Mobile Park Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Septic System
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 PO Box 224
120
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address O
6. TYPE of Construction—(Please indicate by X) O
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( )Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Septic System as per plot plan specifications and application
including 1000 gal . Septic Tank, 2 Seepage Pits, Each o' Stone Size #3, 2' Thickness
8. Proposed Use n
Septic system
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 4, 19 92
(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.)
Dated at the Town of Queensbury this 4th Day of December 19 90
SIGNED BY C/
for the Town of Queensbury
Building and Zoning I nspect&
I
..��� TOWN OF •EENSBURY
Act 1I
o iC APPLICATIa NS'. -V b� '
RECEIVr 5 RD
DATE: ( I —ja , g� V 3 990
LOCATION OF P RTY FOR INSTALLATION U I1v ujidA7 ��C? 4
'Owner' s Name: J)fr, j c
'� (?�J.. boe7/091,G.
Address: F 0 ( 63 J 2-2Cif ,t H,,.
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+q, ��Installer' s Name: �1 r/� Lv __ Telephone: 7 �;� .7
Number of bedrooms (residential only) ,1t)/A- NOV 3n
7990
Total daily flow (compute @ 150 gal per bedroom) /j/ 1.00 cc elo
_ Topography: Circle one: Flat Rolling_ Steep Slope _ % of Slope G4r.4) r
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: of required required
Rate - Min. Per Inch
Domestic water supply: Circle one: 41111,11, Well Other
If domestic water supply is a, wel :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /VdD gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAC3 PIT(S): Number of 2i /Size each ‘ feet
by ,)% feet
Size of stone to be used #_ /Depth or Thickness 2_ feet
*****************************
WILDING TANK-SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alan■ 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 own of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: L,DATE: /l2 O-- 93
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SeptLC System Inspections:
A. All applications for septic system installation, alteration or repair, .
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
' be sublicced 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.) locacion-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,
rile fields and/or drywalls
B. No system shall be covered before inspection and approval by the
auilding Inspector. Failure to comply with this requirement may
result in the uncoverinb,of the system by the installer and a fine
of up to $250.00.
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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 •
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result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper .installa-
Lion. 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
kwmarks: •
•
Jown of Queeñur, cl/ •
BUILDING and ZONING DEPARTMENT
• Bay and Haviland Road, R.D. 1 Box 98
' Queensbury, New.York 12801 .
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME `p//az,(1,,e.41 ,a)
LOCATION O�G�/_ /,.�/ /1
DATE.//7/92 PERMIT NO. �D -ern
SOIL TYPE San - Loam - Clay - '
Percolation st Required? YES NO,
Percolation rate - Mien/Inch _ I
TYPE of SYSTEM: ?)
•Absorption field, total length! •
Length of each trench' ' 11
Depth of trenches '
Size of gravel'_
SEEPAGE PITS4Number df) ' 0
Size- ft. X SI it. AO ' v—.,.e.._
Gravel size ! 1 a'
PIPING: Size`' Type
Bldg. to tank �1 /( - •
Tank to dist. box g i!
Dist. box to fieldf/ ( `/
Openings sealed? C lYES- NO Partial
LOCATION/SEPARATIONS: ,
Foundation to tank /1 /5 ft.
Foundation to absorption 9& ft.
Absorption to lot line /h ft.
Separation of pits / ft.
LOCATION OF SYSTEMON P
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OPERTY(-cr-cl.e one)
Front - Rear - Le , side Right side
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COMMENTS: ":4-7-ti-.-----
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SYSTEM USE APPROVED/ NO .
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Bui, di. g Inspector
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