1990-833 ♦ -
CERTIFICATE OFCOMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
k Date December 21 1990
XRo 13 3-7
This is to,certify that work requested to be done as shown by Permit No. 90-833
• has been completed.
This structure may be occupied as a Sewage alteration
Location 13 Wincrest DRive
Owner Thomas Heiss
By Order Town- Board
TOWN OF QUEENSBURY
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Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 90-833
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Thomas Hei ss
OWNER of property located at 13 Wlncrest Drive 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
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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
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5. ARCHITECT'S Address ,5
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications sL
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No. Sewage alteration as per plot plan specification and application sv
including: 2 Seepage pits 8' x 8' #2 Stone, thickness 2'
8. Proposed Use -
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Sewage alteration
$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES December 14, 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 14th Day of December 19 90
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
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_/� APPLICATION FOR
--: SEPTIC DISPOSAL PERMIT '�
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DATE I )-- - ( 1-- — ?D DEC 13 1990
QI LaG_A CODt DEPT.
LOCATION OF PROPERTY FOR INSTALLATION 13 tO t f?1 C rF S - D, , ,
Owner's Name: /&yba Ile/SS Telephone: 793 --Ca/ L/
Address: 1.3 la to?/O-FS74 DA. 6 u&c.'vs 5 u e Y /1
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Installer's Name: mfl/c & I JF - c (-�.. /gAiIVJ'4 Telephone: 77f-- g-S-Vi�
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Number of bedrooms (residential only)
Total daily flow (compute la. 150 gal per bedroom) c/(0
Topography: Circle one:CO Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth: Feet
Ground Water: At what depth? 0/4 Feet
Bedrock or Impervious Material: At what depth? /7/ A Feet
Percolation test: Circle one: Ct 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 TankeC(STI 4,1. (minimum size: 1.000 gal.)
TILE FIELD: Each Trench feet/Total system length • feet
SEEPAGE PIT(S): Number of 2- ' / Size each 0- feet by feet
Size of stone to be used # 7-/Depth or Thickness ' Z 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: - CJQ ( 1L7
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DATE: 1 )-- / )—— PO .
OVER
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- - - -Septic System Inspections:
A. All applications, for septic system installation, alteration or.
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 4iitance 'to lot lines )
• 3.) location and- distance to structures,
44\ loCation and. distance . to any water supply: •
5.) size and dimensions of all tanks, distribution boxes,
tile 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 uncovering 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 -
result in an immediate work stoOpage.
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. •
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Town of, Queensbury •
BUILDING'and t0DES DEPARTMENT
Bay Bay and Haviland Roads •
• Queensbury, New York 12804
Remarks:
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BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME e4 ���� y / hown S •
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LOCATION LA); c r e si" r u'
DATE/4:71 /)O PERMIT NO. 90--833
SOIL TYPE Clay -
Percolation Test Required? YES CNO)
Percolation rate - Min/Inch _
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TYPE of SYSTEM:
Absorption fiel otal length
Length of trench ,/
Dept trenche
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'ze of gr _
SEEPAGE PITS{Number off)
Size- (e)-ft. X Ts I t. •
Gravel size , 3
PIPING: Size Type
Bldg. to tank �( S4(�(o PUc-
_ _Tank_to dist. box
Dist. box to f—/pi fir/
Openings sealed? .,;;ES- NO Partial
LOCATION/SEPARATIONS:
Foundation to tank jC 111:-v6
Foundation to absorp on ft. i9e7re-'
Absorption to lot li e ft. p2/q//7.
Separation of pits ft.
LOCATION OF SYSTEM oN PROPERTY(circle one)
Front - 4:00- Lef {side - Right side -
COMMENTS:
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SYSTEM USE APPROVED S N
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