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1992-071 "TrA 1 CERTIFICATE OF COMPLIANCE TOWN OF QU'E'ENSSURY WARREN COUNTY, NEW YORK Date_. e 2 __ 19 i This is to certify that work requested to be done as shown by Permit No& has been completed. } occupied as a Septi ocAl terati On This structure may be �{ Location © uo ..5w Twin C n nel s Road l I Carol Lambert Owner By Order Town Board } OrOWN OF QUEENSBURY j Director of Bldg- do Code Enforcement BUILDING PERMIT smal TOWN • OF QUEENSBURY No. 92_071 x WARREN COUNTY, NEW YORK x o PERMISSION is hereby granted to Carol Lambert t W OWNER of property located at Box 588 Twin Channel l s Road street. Road or Ave. l in the Town of Queensbury, To Construct or place a Septic Al terat'i on =.1 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. 3 1. OYMER'S Address isMIS Sam V 2. CONTRACTOR or BUILOCR'S Name Queensbury Sewer 3. CONTRACTOR or SUILDER'S Address t f 4. ARCHITECT'S Name J J tv J J S. ARCHITECT'S Address d N G. TYPE of Construction — (Please Indicate by X) e-h ( I Wood Frame ( ) Masonry I ! Steel I Y n' fL J 7_ PLANS and Specifications No. Septic alteration as per plot plan specifications and application d J a. Proposed Use Septic Alteration 25. 00 PERMIT FEE PAID — THIS PERMIT EXPIRES March g ' 19 94 (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 Queensbu t3th _ a f March 19 � t for the Town of Queensbury SIGNED BY Building a onirg I nspector TOWN OF QUEENSSURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # '� "l1 �r Fee Paid Dater — C �� Reviewed B LOCATION OF PROPERTY FOR INSTALLATION : V1 Owner ' s Name : C# C +r Owner ' s Mailing Address : C5 X . , � 17 Installer ' s Name : U '[ Phone # : cx Number of bedrooms ( if residential ) : .� TOWN OF QUEENSBUR'r Total daily flow ( residential - compute @ 150 gal . per bedroom ) : RECEIVED Topography- Circle One : 5PTaft ) Rolling Steep Slope % of Slope MAR 6- 1992 Soil Nature-Circle One : and Loam Clay Other /Dep BL[] CODE DEFT, Ground Water-At What Depth ? Feet Bedrock or Impervious Material -At What Depth ? Feet Percolation Test-Circle One : Required Required/Rate Min . Per Inch Domestic Water Supply-Circle One : .. MsFn7 pa Well Other If domestic water supply is a y� Separation : Water supply from any septic absorption feet PROPOSED SYSTEM- Septic Tank ,,,e' �..- 5 gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench feet//Total System Length feet Seepage Pit ( s ) : Numb o '�' / Size each : t . x ft . Size of Stone to be used : # / Depth or Thickness C feet HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Sizelof Each Gal . Alarm system and associated electrical work to be inspected by a certified 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 : ��� . 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 alT tanks , distribution boxes , tile fields and/or drywells B . No 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 to produce said plot plan at time of inspection may result in an immediate work stoppage . D . Should unforeseen problems during construction prevent proper installation , 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 & Code Enforcement Department 531 Bay Road Queensbury NY 12804 Remarks : _.Jow" o/ Queerl3hetry //W� BUILDING and ZONING DEPARTMENT Say and Haviland Road. R. O. i Box 98 Queensbury. New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME y LOCAT I Ohl �J ' C�r fa'_1117, }11 e" 4 DATE �� PERMIT NO .� ScrIL TYPE Sand Loam Clay - NO Percolation Test Required? Percolation rate - Min/Inch _ TYPE Of SYSTEM : Absorption field , total length Length of each trench Depth of trenches Size of gravel SEEPAGE PITS{Nv¢nber of) ,�- Size- .T:jfft. X t . Gravel size . ze Type PIPING : 'Bldg * to tank Tank, to list. box DISt. box to field/ t No Partial Openings sealed? Y S LOCATION/SEPARATIONS : f t. Foundation to tank ft Foundation to absor i f Absorption to lot 1 ne Separation of pits LOCATION OF SYS ON PR gRTY (circle one) Front - Rear - L ft side Right side - COMMENT _.• -a Co u -- AldD EiZ- t5� I? &VZ-VC C9 �' M [z- , L ---a M 6B C- -r! ----, SYSTEM USE APPROVED YE NO ti Bui ding ins ctor C3 [71/SFa and vl yl e. ws, c v a r xs �- rJ s +aL ; 'WN OF QUEENSBUR t +r.(NEIVED MAR 6 1992 BLDG. 8. CODE DEPT, cj� I 1v Fc � O IFz