1991-007 •
0 i
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date January in_ 19 a1
361
This is to certify that work requested to be done as shown by Permit No. 91-007
has been completed.
•
This structure may be occupied as a Septic' Al to rati on
lnration - Lot t•rPcwnnd CArr1P
Owner Frank Parillo
By Order Town Board
TOWN OF QUEENSBURY
f
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY X
No. 91_0Q7
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Forest Trai l or Park N
OWNER of property located at Lot 37 Gregwood Circle Street, Road or Ave.
l0
in the Town of Queensbury,To Construct or place a Septic 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
Frank Parillo
Wilton, NY o
2. CONTRACTOR or BUILDER'S Name. w
Morning Star Septic
m
3. CONTRACTOR or BUILDER'S Address
0
0
czL
n
4. ARCHITECT'S Name —+
fD
m
O
fD
5. ARCHITECT'S Address
c+
Z
0)
J.
6. TYPE of Construction— (Please indicate by X)
( )Wood Frame ( ) Masonry ( )Steel ( ) 0)
7. PLANS and Specifications
No. Replace old tank with 1000gal Tank as per plot plan specifications
and application
8. Proposed Use
Septic Alteration
f7
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES January 9 19 9M
(If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the -5
town of Queensbury before the expiration date.)
c+
0
Dated at the Town of Queensbury this r9thh Day of .Jan a ry 19 91
SIGNED BY 716/ �J/ for the Town of Queensbury
Building and Zoning Inspector
/ TOWN OF QUEENSBURY
�I �;,,�• APPLICATION FOR SEPTIC DISPOSAL PERMIT t
DATE: 7 .-- 9/
LOCATION OF PROPERTY FOR INSTALLATION 'V ?',.-LEZ B V atrck
Owner's Name: 2, G r� 11 n
Address: , 6.,, JF�N 799�i
Installer' s Name: , Ark.l.t. Te aaneP ?207 U
Number of bedrooms (residential only) 'Z
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one:�an Loam Clay Other /Depth:
Ground Water: At what depth? — Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: 0requir required
Rate - Min. Per Inch
Domestic water supply: Circle one: Munici 1 Well Other
If domestic water supply is a. we
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank ,,rh^) gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length ..--- feet
SEEPAGE PIT(S): Number of /Size each ______
feet
bye' feet
Size of stone to be used #. - /Depth or Thickness c-----___ 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 PERSOR ,�. i C 4 DATE: /--2 - ',-
•
•
•
•
•
Septic System Inspections: 2
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 to structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
tile fields any!/or drywalls •
B. Na system shall be covered before inspection and approval by the
Uuilding Inspector. Failure to comply with this requirement may
rasulc in the uncovering of the system by the installer and a fine
of up to $250.00.
•
C. An approved copy of the, plot plan shall be available on the construction
lice. Failure to. produce said plot plan at time of inspection may
• result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or' rapuir of an approved system, a new proposal must •
bg submitted co the Queensbury Building Department before further
construction.
•
•
• Town of Queensbury .
BUILDING and CODES DEPARTMENT
• Bay and Haviland Roads
Queensbury, New York 12804
•
kgrnarks: •
Jocun of Queensbury
' BU)'LDTNI and ZONING DEPARTMENT` ����� j"
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
•
NAME rr J4 I
LOCATION ct 3'/ Aigoi-0-4---, dz -'
DATE_ i/si 9/'''.PERMIT NO. Q/-4O 7 f
ji.
SOIL TYPE arIllt Loam - Clay - ,.0'
Percolation Test Required? YES - NO &
Percolation rate - Min/Inch _ /
f
TYPE of SYSTEM: :
Absorption field, total, length .}`
Length of each trench
Depth of trenches ' ARETIOW
Size of gravel_ ik
SEEPAGE PITS{Number Tf)Yd
Size- ft. X _ t.
Gravel size d'
PIPING: Si - `'.; 'Type
Bldg. to tank ,G
Tank to dist. box
Dist. box to field/pit +:`4
Openings sealed? YES N$ Partial
1
Y
LOCATION/SEPARATIONS: 3 `A
Foundation to tank ft.
Foundation to absorption i ft.
Absorption to lot line ft
Separation of pits i ft:
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - Right side -
COMMENTS: tj
g 9.,(apeptr:7Eri--k ,1
4 j
000 g""( '��C I ''.
/ z'.
/
SYSTEM USE APPROVED YE
Builds Inspector •
01/86 and vl .
/ed/
JWN OF QUEENSBUR't
RECE!w-7r1
1/
• , 5° C\c' ‘91")1(4
JAN 7 1991
BLDG. & CODE DEPT. -
rk'N's
• ‘r-• '0
•.19
44(
Pr
40
..•
cP.
•
•
AArettu 411")(711
1
0