1991-150 CERTIFICATE OF COMPLIANCE -
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date /. 'n./J /.t19 /
I Lo- D' 7°
This is to certify that work requested to be done as shown by Permit No. 91-150
has been completed.
This structure may be occupied as a Septic Alteration
Location 13 Westland A` eAna®P
Owner John ir°aba to
By Order Town Board
TOWN OF QUEENSBURY
a.. i-s'/1/7,7
• Director of Bldg. do Code Enforcement
•
BUILDING PERMIT
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TOWN OF QUEENSBURY
No. 91-150 t
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to John Morabito o0
OWNER of property located at 13 iestl and Avenue Street, Road or Ave. ~'
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in the Town of Queensbury,To Construct or place a Septic Alteration w
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
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2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer 0
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3. CONTRACTOR or BUILDER'S Address 0
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4. ARCHITECT'S Name e+
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5. ARCHITECT'S Address rD
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6. TYPE of Construction—(Please indicate by X) ,, n
( )Wood Frame ( ) Masonry ( )Steel ( )
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7. PLANS and Specifications
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No. 2 seepage pits each 8' x 8' with #3 stone, 2' Thickness as per plot 00
plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 9, 19
92
(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 9th Day of April 19 91
i
SIGNED BY ���/ for the Town of Queensbury
Building and Zoning nspector
e: TOWN OF.QUEENSBURY 1
} � APPLICATION FOR SE DISPOSAL PERMIT
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/ 4t,---' ' 1/7/C
LOCATION OF PROPERTY FOR INSTALLATION I3 -� - Pr-L i ".
Owner's Name: a®t1,J l-0,(7 .,b ,` %)
Address: 13 (/JQ —y,A.,. 4u-. .
Installer's Name: vPirsqrL J f,,j,.`y Telephone: -7 9 2 --7 2 s-t7
Number of bedrooms (residential only) ,.;__
Total daily flow (compute @ 150 gal per bedroom) ' .7
Topography: Circle one: , Rolling Steep Slope % of Slope
i
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? Feet TOWS'' "'r •"'""7.181;.t3t3MY
_ . ,car
Bedrock or Impervious Material : At what depth?re P , ' Feet
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Percolation test: Circle one: not requid requi a! APR 41991
Rate - Min. Per Inch BU LDING ik CODE DEFT•
Domestic water supply: Circle one: unicipa Well Other
If domestic water supply is a. we
Separation: Water supply from any septic absorption feet.
( EcT i,J(P)
PROPOSED SYSTEM: Septic Tank I O0c gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length pfeet
SEEPA E PIT(S): Number of 2� /Size each P` feet
by A- feet
Size of stone to be used #.. i /Depth or Thickness 2___ 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. /
l
SIGNATURE OF RESPONSIBLE PERSON: AeAr DATE: 9"--Q/
logic 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 co the Building Department at least 24 hours before start
of construction and shall include a plot ,plan shoving:.
1.) the proposed location of the system
2.) location and distance to lot linen
3.) location and distance to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks, distribution boxes.
tile—tielda and/or drywalls - - -
B. Nu sy,.scpm, shall be covered before inspection and approval by the
uuilai*g.,,Inspuccor. vFailure to comply with this requirement may
ras} p.epl•c in`
;he uncover4Of the system by the installer and a fins
o f ll� i $"a 5 0.00. 4
{ 4
C. An apppro, ed? copy`.r off ch =aplo c plan shall be available on the construction
site. Failure co produce said plot plan at time of inspection may -
raaVentinWiglavipAwtork stoppage.
D. Should unforeseen problems during construction prevent proper installa—
cion. alteration or rap:&ir of an approved system, a new proposal music
bu submitted to the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
• Bay and Haviland Roads
Queensbury, New York 12804
l hmarks: :.
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• aWn o f Queenitury
r BUILDING and ZONING DEPARTMENT. PM
4 Bay and Haviland Road, R.D. 1 Box 98
' Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ��91 , -hi 0 (IL
LOCATION /' UIrwwI/a. , 4'
DATE 4///Ul / 9( PERMIT NO. g/r/,`�6
SOIL TYPE �.0% - Loam - Clay - //
Percolation st Required? YES NO
Percolation r to - Min/Inch /
TYPE of SYSTEM:
Absorption field, total lengt
Length of each tree h •
Depth of trenches • \ ,/ •
Size of gravel ,I •
SEEPAGE PITS4Number of k „Z
Size- g" ft. X ft. 4 a ' S-y �_
Gravel size , - ��,yi
PIPING: Si r Type
Bldg. to tank r3� '----- —
Tank to dist. box , p'I C
Dist. box to field/pits cc`"Iii ce
Openings sealed? YES/ NO , Partial
LOCATION/SEPARATIONS
Foundation to tank / ��J3"j�t:
Foundation to absorption ,,R,5 ft '
Absorption to lot line /p ft. .
Separation of pits • l 6 ft.
LOCATION OF SYSTEM'ON. PROPERTY(circle one) .
Front - Rear�Lefit. si - Right side:-
COMMENTS:
1
SYSTEM USE APPROVED
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00 Building In ector •
01/86 and vl .
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D i.5/- 3 a,
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TOWN OF OUEENSBURY
paaMEM ,
APR 41991
/ . BUILDING & CODE DEFT. v,,
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