1991-008 i9
CERTIFICATE OF COMPLIANCE
(3A \ Liz2, TOWN OF QUEENSBURY
ARREN COUNTY, NEW YORK
Date /..20..-1/4QG ,4A 19
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This is to certify that work requested to be done as shown by Permit No. 91-008
has been completed.
This structure may be occupied as a Sewage Alteration
Location 45 Wintergreen
OwnerDonald F. Collette
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY 3
No. 91-008
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Donald F. Collette ~'
OWNER of property located at 45 Wintergreen Street, Road or Ave. `s'
in the Town of Queensbury,To Construct or place a Sewage Alteration N
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
2. CONTRACTOR or BUILDER'S Name
O
Ken Collette
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name O
5. ARCHITECT'S Address a'
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6. TYPE of Construction— (Please indicate by X) -5
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( )Wood Frame ( ) Masonry ( ) Steel ( ) rD
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7. PLANS and Specifications p'
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No. Sewage alteration as per plot plan specifications and application
including: One additional seepage pit 6' x 8' , #3 size stone
to
8. Proposed Use CD
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Sewage alteration m
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$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 15, 19 93
(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 15th Day of/ January 19 91
SIGNED BY G��✓' -� / for the Town of Queensbury
Building and ZonirigtI nspector
TOWN OF QUEENSBURY
APPLICATIOf1 FOR SEPTIC DISPOSAL PERMIT
DATE: //
LOCATION OF PROPERTY FOR INSTALLATION 16 _ Arrc--oeA, 1-A
jW1-4 OF QUEENSBUR
Owner' s Name: pe N.62 iot_ f ila. l`!-G FRFCEWEE1
Address: r-IS(ii,"/.I�-o 1--‘4- ; /J,./ g ' " /1
7AN S 1991
Installer' s Name: /ci,u a,) /<<a G7--e_ Telephone:. 7 97 9,e7S/
BLDG. & CODE OEP 1.
Number of bedrooms (residential only) 3
Total daily flow (compute @ 150 gal per bedroom) L/.5 0
Topography: Circle one: Flat Rollin Steep Slope % of Slope
Soil Nature: Circle one: CLID Loam Clay Other /Depth:
Ground Water: At what depth? CS Feet
Bedrock or Impervious Material : At what depth? /V 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, we
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ( ,e,j,.2�rirz gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench /feet/Total system length feet
EEPAGE PIT(S): Number of / /Size each 6 feet
er\JAY 2 feet
Size of stone to be used #. 5 /Depth or Thickness feet
*****************************
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 Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON'
C-1// 4Y/ DATE: /- -9/
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 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,
tile fields and/or drywalls
B. Nu 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
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
•
k6niarks:
c_7 Cokr\%Pft\I
(' � _Down of Queeniburty
I, BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTIOON
NAME r _ s "�'� 1\k1CJ
LOCATION 5 i c\ y Y'esvy\
DATE ri? / S.- PERMIT NO. 9J -- CJ �3
SOIL TYPE - Sand Loam - Clay -
Percolation Test Required? YES 7 '0
Percolation rate - Min/Inch ,f '
TYPE of SYSTEM:
Absorption field, total leng�`�
Length of each trench ' ,
Depth of trenches � 1
Size of gravel h, i /
SEEPAGE PITS{Number of) ' ( /i1 Ct-1,7, ;)
l�
Size- ft. X ' ft 1). 4 y mac..
Gravel size .3 V
PIPING: Size Type
Bldg. to tank 14 tO VL
Tank to dist. box 1 tr
Dist. box to field/. ' c(
Openings sealed? , YES \NO Partial
LOCATION/SEPARATIONS: a
Foundation to tank Ea 75)‘ ft.
Foundation to absorption S-j ft. .
Absorption to lc t line ----lift.
Separation 'of pits eft,
LOCATION OF SYSTEM.ON RROPERTY(bircle one)
Front - Rear/- -Left sid - Right\side -
COMMENTS: �, -- �\
a
4`t
•
•
•
SYSTEM 'USE APPROVED YES N
. Buildin nspector
01/86 and vl
.own o/ Queenitur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ,.47-zeziz.-77 ��zC�
LOCAT ION - 3-
DATE/// /9/ PERMIT NO. 9/ 1
SOIL TYPE - -and - Loam - Clay - •
Percolation Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: •
Absorption field, total length
Length of each trench'
Depth of t -nches
Size of grai'el_
SEEPAGE PIT N •-r of) •
Size- ft`. X _$ ft.
Gravel size
PIPING: Size Type
Bldg. to to
Tank to di-' . ".ox 1 L�
Dist. box to fi`-ld/r.'- y, PC/CJ
ON Openings sealed:', NO Partial
LOCATION/SEPARAT DNS:
Foundation to tan • ft.
•
Foundation to absorption _ LJQ ft.
Absorption to lot line
Separation of pits ? ft.
LOCATION • SYSTEM ON• PROPERTY(circle one)
Front - - Left side - Right side -
COMMENT .
6k Cod
•
..„„„ •
SYSTEM USE APPROVED YE N
B lding spector
01/86 and vl
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N OF QU ENSBUR
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JAN 8 1991
I . BLDG. & CODE DEPT.
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