1991-097 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date March 279 19-91
This is to certify that work requested to be done as shown by Permit No. ' 91—)97
has been completed.
This structure may be occupied as a Seriti c Alteration
I ncation 14 Linden Avenue
Owner Richard A. Brown
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-097
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to Richard A. Brown a
•I
OWNER of property located at 14 Linden Avenue Street, Road or Ave.
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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
Same -
2. CONTRACTOR or BUILDER'S Name
Queensbury Sewer
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address 011
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6. TYPE of Construction—(Please indicate by X) -10
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( Mood Frame ( ) Masonry ( )Steel ( ) . _ n
7. PLANS and Specifications
No.Septic Alteration to include: 1,000 gal septic tank, 200ft of Tile
Field, #2 stone, 10" thickness as per plot plan specifications and application o•
8. Proposed Use
Septic alteration
$ 75_00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 21, 19 93
(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 Day of� March 19 91
SIGNED BY for the Town of Queensbury
Building and Zon Inspector
TOWN OF QUEENSBURY
; APPLICATION FOR SEPTIC DISPOSAL PE',
DATE - �.� ,
LOCATION OF PROPERTY FOR INSTALLATION / 5, / 1Llf
Owner's Name: OvLJI f tr o 4) K
Address:
Installer' s Name: a.... _e__4,),& (4.1-1 Telephone:
Number of bedrooms (residential only)
y)
Total daily flow (compute @ 150 gal per bedroom)
Topography: .Circle one: Rolling Steep Slope % of Slope
Soil Nature: Circle one: and Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: �t requi.r required
Rate Min. Per Inch
Domestic water supply: Circle one: uaicipa Well Other
If domestic water supply is a, well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank z/fe--¢---70 gal . (minimum size: 1,000 gal )
TILE FIELD: Each TrenchLD feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #4 /Depth or Thickness /0 �( 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 Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: ►— i? 4I DATE: i.:0 — ;/
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•
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• SeotiC System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall •
bee submitted to the Building Department at lease 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 co 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 Inspuctor. Failure to comply with this requirement may
rasult 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
bu submitted co the Queensbury Building Department before further
construction. •
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Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
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kgnwrks:
.awn o/ Qu'een.stury
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 .e:/,'AiVI -I:JCd.L-(.F--ii /
LOCATION /Y „/.77,(../4-, a4 l
DATE,' / PERMIT NO./ 7 -D17' •
SOIL TYPE - nd - Loam / Clay -
Percolation T st Required? YES - NO
Percolation ra e - Mint nch
r .
TYPE of SYSTEM: /
Absorption fiel , to `21 length a-FIu
Length of each t enc i • 56
Depth of trenche " i,i;/ .
Size of gravel
SEEPAGE PITS4Numb (I of)
Size- ft. X _ I ft.
Gravel size
PIPING: Size Type
Bldg. to tank J./ pi7i! • .
Tank to dist. bo cl 7, etre, .
Dist. box to f i#ld/p'+lt e(f(,
Openings sealed Y S NO - Partial
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LOCATION/SEPA TIONS:
Foundation tc/tank _ I eft.
Foundation / absorpti n "A ) ft.
Absorption -o lot line ft.
Separation ' f pats /'H 6, ft.
LOCATION O SYSTEM ON P•sPERT Y(circle one)
rout R r - •a:��•c�,!-" Right side -
COMMENTS:,
SYSTEM USE APPROVED ig, NO
Bu ding In ector
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