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1991-127 A s e CERTIFICATE OF COMPLIANCE ,,. TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date (/ iAL/ '9 19 2 This is to certify that work requested to be done as shorn by Permit No. 91 427 has been completed. This structure may be occupied as a Sant t' Al t rati nn Location 8 Pi newnln'l Nall tsar Owner Gerald Beauont By Order Town Board TOWN OF QUEENSBURY r .„/ Director of Bldg. do Code Enforcement BUILDING PERMIT • TOWN OF QUEENSBURY No. 91-127 WARREN COUNTY, NEW YORK c 1/40 PERMISSION is hereby granted to Gerald Beaumont a ctt OWNER of property located at 8 Pinewood Hollow Street, Road or Ave. 1-1 0 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 Same 0 3. CONTRACTOR or BUILDER'S Address c+ 00 O 4. ARCHITECT'S Name co O C. Vf 5. ARCHITECT'S Address '17 c+ n 6. TYPE of Construction—(Please indicate by X) co ( )Wood Frame ( ) Masonry ( ) Steel ( ) 0 7. PLANS and Specifications No. Septic alteration to include: 50' Tile field using #3 Stone, 2' • thickness. 8. Proposed Use Septic alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES March 29 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 29th ` Day of March 19 91 SIGNED BY / 2/%: =�'� for the Town of Queensbury Building and Zo4ng Inspector TOWN OF QUEENSBURY P-956 31rza APPLICATIOI FOR SEPTIC DISPOSAL PERMIT DATE: -/ ca 7/91 TOWN OF QUEENSBU nn R� LOCATION OF PROPERTY FOR INSTALLATION 8 eto\J - l.)0e p 1 RECEIVED Owner' s Name: C �/�� r id�M c�,.�" MAR 2 8 1991 Address: b 10crJ4.- woof) L-vcA—) BLDG. & CODE DEPT. Installer' s Name: Telephone: Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) LiZa Topography: Circle one: 4111, Rolling Steep Slope % of Slope Soil Nature: Circle one: Sand 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 - Min. Per Inch Domestic water supply: Circle one: unicipal Well Other If domestic water supply is a well : Separation: Water supply from any septic absorption feet. X PROPOSED SYSTEM: Septic Tank (COO gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench `/ feet/Total system length S 6 feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used it _? /Depth or Thickness - feet r**************************** /� HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks 0/"I 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:/ 41-` -4/W/"'(-' DATE: J/7 �f • cc� / awn o/ Queen u r y t r BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME i hiil Q a LOCATION J PERMITfNO. �-/a 7 SOIL TYPE Loam - Clay - Percolation Test Required? YES.%:- NO Percolation rate - Min/Inch j a �• TYPE of SYSTEM: • Absorption field, total length o .70 Length of each trench �j Depth of trenches' p, Size of gravel etaL / SEEPAGE PITSfNumber, of)t Size- ft. X :; ft; Gravel size ;; I PIPING: , y Size Type Bldg. to tank 6XrG Tank to dist. box Dist. box to field/ ._ G� Openings sealed? NO Partial 111 LOCATION/SEPARATIONS: Foundation to to ik q g.�/4 ft. Foundation to absorption ,2p ft. Absorption to lot line a,p ft. Separation of pits • ft. LOCATION OF SYSTEM ION PROPERTY(circle one) Front - r1 Leftt side - Right side - COMMENTS:. Y / � t /„, SYSTEM USE APPROV YES O Buil ng nspector • 01/86 and vl a/•o)-1-06 . I I . . -,-- 4-0-SE 'WI 'sr? ..9.L.a s ......V 7 d..1 .+7,1 =. 'el'i I i •ire'STAN. 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