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1991-137 d) • •- CERTIFICATE OF COMPLIANCE • TOWN OF QUEENSBURY • WARREN COUNTY, NEW YORK Date 41/24-fi 19 This is to certify that work requested to be done as shown by Permit No. al—117 • has been completed. This structure may be occupied as a Septic alteration • • Location 16 Sylvan Avenue Owner • Hike Leueult • • By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 91-137 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to Mi ke Legaul t OWNER of property located at 16 Sylvan Avenue Street, Road or Ave. 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 4. ARCHITECT'S Name 5. ARCHITECT'S Address 6. TYPE of Construction— (Please indicate by X) ( )Wood Frame ( ) Masonry ( ) Steel ( ) 7. PLANS and Specifications No. Septic alteration including 1 seepage pit 8' x 10' using #3 stone thickness 2' as per plot plan specifications and application 8. Proposed Use Septic alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 2, 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 2nd DIY of April 19 91 SIGNED BY I/__ ��, for the Town of Queensbury Building and Zonitlg Inspector �� TOWN OF QUEENSBURY ear • APPLICATIOU FOR SEPTIC DISPOSAL PERMIT DATE - LOCATION OF PROPERTY FOR: INSTAL ATION 41 Owner' s Name:- n (. Le; Address: l6 s I y,>rdr--v.•, cr l Y1 • Installer's Name: �`� p•ef�S gu ' . ,.2C<JI'' Telephone: '7 2 3 V,' Number of bedrooms (residential only) Total, daily flow (compute @ 150 gal per bedroom) 5 6-7) _ Topography: Circle one: 41111, Rolling Steep Slope • % of Slope Soil Nature: . Circle one:. 0:) Loam Clay Other /Depth: Ground Water: At what depth? Feet - Bedrock or Impervious Material : At what depth? Feet- Percolation test: Circle one: . require. required. Rate - Min. Per Inch Domestic water supply: Circle one: '.unicip. Well Other If domestic water supply is a• wel Separation: Water supply from any septic absorption feet. PROPOSED: SYSTEM: Septic Tank gal . (minimum size: 1,000 gal ) TILE FIELD: Each. Trench feet/Total system length . feet SEEPAGE . PIT(S).: ' Number of ( /Size each g feet by © feet Size of stone to be used #. 3 - /Depth or Thickness .l feet (vf ***************************** ( �it�O `P,k 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: - DATE: . / �� • • Septa System Inspections: A. All 'applicaeions '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 to 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 r,:sult 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 Queunsbury Building Department before further construction. • Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 kjniarks: • • • • S � - k;Al7 '1 on Sown o/ Queeniur, . BUILDING and ZONING DEPARTMENT • Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 2_e cr U I T } I 1 k P, LOCATION . I (p f i...col Auc.,. DATE 17 / 3 PERMIT NO. /� �//--/:1 .7 � SOIL TYPE - Loam -,+Clay - Percolation Test Required: YES - NO Percolation rate - Min/Inch _ ` TYPE of SYSTEM: ' 1'e Absorption field, total ngtl-i' Length of each trench ' r''. Depth of trenches ' . Size of gravel '" _ SEEPAGE PITS{Number of) " I Size- g ft. X /.0 ft.F` Gravel size , „'' ii; PIPING: Size Type Bldg. to tank Y' )c,S� :"! Tank to dist. box" 9 "' Dist. box to field/ • Openings sealed714. ES NO Partial i,, LOCATION/SEPARATIONS: t'rr [ Foundation tor tank cC*T ft. Foundation to absorption? 3 o ft. Absorption/to lot line 7 ft. Separation of pits :(;;„..----ft. LOCATION/OF SYSTEM ON PROPERTY(circle one) Front -,rRear - Left side - Right side - COMMENTS: ,J )• ��' c, • 0 _ .— `• 3D 'Ff p4,1 1 / i • . . SYSTEM USE APPROVED(lip Ns .AIM . Bui'di'. ,i7 n ector • 01/86 and vl ,TOWN Of el— a: �. 1 91 ro - , - , .2..2.- f_________e - - Z.:::_,--, •-•'''. yv: A _ /,, Dk., ‘ "'" A , 1), ,,,zn - Wria 4 , _<7.---0--- A . (7. Y- , �' & -ems= 7 . . v 54 I