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CERTIFICATE OF COMPLIANCE .
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date December 31 . 19 3.:0
This is to certify that work requested to be done as shown by Permit No. 90-839
has been completed.
This structure may be occupied as a Sewage Al terati on
• 1.nration31 t Aviation Road
Owner Richard S. Winters
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enforcement
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 90-839 -
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Richard S. Winters 'I
OWNER of property located at 131 Aviation 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 Same
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2. CONTRACTOR or BUILDER'S Name 1
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Tyler Converse c,
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) O
( )Wood Frame ( ) Masonry ( )Steel ( ) 70
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7. PLANS and Specifications
No. 2 Seepage pits 8's 8' With #2 STone
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8. Proposed Use
Sewage alteration CD
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 20, 19 92 c+
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the 0
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury this 20 Day of December 19 90
SIGNED BY / for the Town of Queensbury
Building and Zoning Inspe_ctor
AlithaTO N OF QUEENSBURY
` � APPLICATIO'1 10
SEPTIC DISPOSAL PERMIT itg:OWN OF QUEENS•BU
RECEIVED l{
DATE: /a —) ? - 70 I
11
LOCATION OF PROPERTY FOR INSTALLATION DEC 17 1990
Owner' s Name: r C. h R R p ,5, l i,} IA) TER s BLDG. & CODE DEPT.
Address: ),3 I A (j / /}- Ti oAI R.1)
Installer' s Name: r ///_ lz C. ON 0.4-,0Sr Telephone: f) l -32/0
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Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) L4- 6
Topography: Circle one: 4110 " Rolling Steep Slope % of Slope
Soil Nature: Circle one: (San)1 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.
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PROPOSED SYSTEM: Septic Tank ) 6 ° d gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench /v /L feet/Total system length feet
SEEPAGE PIT(S): Number of ,2 /Size each 5? feet
by S' feet
Size of stone to be used #. a- /Depth or Thickness feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks YL. Size of Each Gal .
*Alarm 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.
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SIGNATURE OF RESPONSIBLE PERSON: . ,,,,, U. , DATE: )c. — o-- 70
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Septic System Inspections:
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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 co lot lines
3.) location and distance co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks. distribution boxes.
tile fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
uuilding 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.
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.
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 of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads__
--- -Queensbury,- New York 12804
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Jown o/ Queenu9,
: BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 .
SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME X-e4ali (/f/Ai�l .0 %%)
LOCATION /• / U'(} 1�/��-/ --
DATE/4 / / 90 PERMIT NO. � -- 1.7
SOIL TYPE - Sand - Loam - Clay. - -,F
Percolation Test Required? YES - ,NO.
Percolation rate - Miln/Inch _ I:
I _
TYPE of SYSTEM: yI
Absorption field, total length/
Length of each trench' /
Depth of trenches ' i I. .
Size of gravel j
SEEPAGE PITS{NuMber of) ' ' I
Size- (ft. X ( It. I
Gravel size , i : /
PIPING: ( Size Type
Bldg. to tank
Tank to dist. box '1 4 '/ p//G.
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Dist. box to field/pint tit! ' PdG
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
/' . . .
Foundation to tank ft.
Foundation to absorpt a n 40 ft. • •
Absorption to lot line JD ft. .
Separation of pits . 'sG ft. -
LOCATION OF SYSTEM ON1ROPERTY(circle one)
Front - ear)- Left side -- Right side -
COMMENTS: _ .
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SYSTEM USE •APPROVED ES NO
B ding Inspec or .
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:owN ®' ( UEENSBURY
R CE1VED
° 1 DEC 171990
. BLDG. & CODE Doi .,
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