1990-849 ••5
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY,
WARREN COUNTY, NEW YORK
Date January 8 is, 91
This is tec'ertify that work requested to be done as shown by Permit No. 90-849
has been completed.
This structure may be occupied as a Sewaoe alteration
Location la Mnnrtmnd nri
Owner David Friers
By.Oider Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY• No 90-849
WARREN COUNTY, NEW YORKco
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PERMISSION is hereby granted to David Friers
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OWNER of property located at 14 Moorwood DRi ve 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
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Sanitary Sewer
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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)
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( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
No. Sewage alterations as per plot plan specifications and application `a
including: 2 Seepage pits each 6' x 8' with #3 stone, 2' Thickness
8. Proposed Use
Sewage alteration
$ 9.si_DO PERMIT FEE PAID —THIS PERMIT EXPIRES December 31, 19 9a.
(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 31,1,1- Day of D tie rtheil- 19 go `n
SIGNED BY pt, 54(4--;0/th-t. for the Town of QueensburyBuildingandningInspector
A � TOWN OF QUEENSBURY
� � APPLICATION) FOR SEPTIC DISPOSAL PERMIT l
DATE:
LOCATION OF PROPERTY FOR INSTALLATION l M O p f v
Owner' s Name: )f V i i.) f/',-L —
Address: ) 4 1/(4 O1/4yWpo A Installer' s Name: CJaL ,.Y,✓ d/ w Lr Telephone:� P `7.! -7.2s.„
Number of bedrooms (residential only) .3
Total daily flow (compute @ 150 gal per bedroom) 'yam
Topography: Circle one: Flat Rolling Steep Slope % of Slope .
Soil Nature: Circle one: dr 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 - Mina Per Inch
Domestic water supply: Circle one: .Xicipaj Well Other
If domestic water supply is a, well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank i/ O oD gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length ( feet
SEEPAGE PIT(S): Number of /Size each 6 . feet
by p feet
Size of stone to be. used #.: c_.? /Depth or Thickness Z—' feet
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HOLDING, TANK SYSTEM IF REQUIRED
NO. of Tanks 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 Qu bury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: ja-AP- 5J
. r
1
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 co 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,
tile fields and/or drywalls
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.
C. An approved copy of the plot plan shall be available on the construction
site. Failure co produce said plot plan at time of inspection may •
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rusulc 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 co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
kvm;irks: -
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Jown,,o/ Queeniur, .
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 .
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \-MCA.v I 0 Y^ it S
LOCATION I !-1 c 6Y I.f c-,:cyl V)r i v n
DATE l A.}- PERMIT N/eO. QO-- (4c1
SOIL TYPE - Sand - Loam - Clay - •
Percolation Tst Requed? YES - NO
Percolation rate - Mi '/Inch
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TYPE of SYSTEM: \‘
Absorption field, \to al length
Length of each tren h
Depth of trenches ' e
Size of gravel j e • _
SEEPAGE PITS-ENumbet df) _') ._
Size- 6 ft. X fl. f 2 f S;-0,✓-
Gravel size , -_ J� It
PIPING: SUe Type
Bldg. to tank T-14f£
Tank to dist. bo : f de_
Dist. box to field/.._, 4 pvc-
Openings sealed?, , ® Partial ,
LOCATION/SEPARAtIONS:
Foundation to tlnk 2.5 t. J--
Foundation to absorption _ fit.
Absorption to lot line f Q/[_-
Separation of p•'ts ft
LO •TION OF SYS EM ON PROPERTY circle one)
ron Rear - eft side - Right sde -
COMMENTS: a
•3A -Alr ftaz4 T6 /1/5 i�L ',
( Al4s Tr,✓ Se!ll c- I A.vm& '�
SYSTEM USE .APPROVED S NO
Bui din I sp ctor
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