1991-211 t
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date (944.d d&19 _ZZ
This is to certify that work requested to be done as shown by Permit No. 91-211
has been completed.
Septic Alteration
" This structure may be occupied as a
74 Boulevard
Location
Owner TfiA Engwer
By Order Town Board
• TOWN OF QUEENSBURY
/49/2,
• Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-211 0
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Todd Engwer
OWNER of property located at 74 Boulevard Street, Road or Ave. N
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 ..l
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. a
1. OWNER'S Address is m
Same
2. CONTRACTOR or BUILDER'S Name V
Condon's Septic & Drain
0
CD
3. CONTRACTOR or BUILDER'S Address
0
a
N
CD
4. ARCHITECT'S Name
Ch
5. ARCHITECT'S Address fta
e*
0
6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( )Steel ( )
7. PLANS and Specifications
No. Septic alteration to include: 1000 gal septic tank w/1 seepage pit,
#3 Stone as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 16, 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 16th Day of April 19 91
SIGNED BY fir--- GU?z- A for the Town of Queensbury
Building and Zoning Inspector
��► • TOWN O QUEENSBURY 1/
6 #; APP errn IC DISPOSA PERMIT „2///
TOWN OF OLIEENSWRi
DATE: '-/ /( aber. g s ��'` ,•�
LOCATION OF PROPERTY FOR INSTALLATION '7 al Sou f g r/mo �L - �F`
44Q 1.0( 17 mil
Owner' s Name: /D q E11) U)F i
BUILDING & CODE DEPT.
Address: 7k-/ Q0V/e1/4R.b
Installer' s Name: C C)njcf6/i) 4 SFo r G� ,72/Z4f no Telephone: 778
Number Of bedrooms (residential only) ` -
Total daily flow (compute @ 150 gal per bedroom) 306
Topography: Circle one: 411111 Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? 0vA Feet
Bedrock or Impervious Material : At what depth? /0 Feet .
Percolation test: Circle one: not required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Municipai) Well Other
If domestic water supply is a. well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /boo g41 gal . (minimum size: 1,000_gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of / /Size each `d feet
by q feet
Size of stone to be used #. /Depth or Thickness 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.
SIGNATURE OF RESPONSIBLE PERSON: 7 DATE: 1./PJ
`/ -?/
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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 subsicced .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 to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks. distribution boxes.
vile fields and/or drywalls
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 co $250.00.
•
C. An approved copy of the plot- plan shall be available on the construction
site. Failure co produce said plot plan at time of inspection say
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 ■ust
Be submitted co the Queensbury Building Department before further
construction.
•
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
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Remarks:
_awn of Queen. urcy
. BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
t..
SEPTIC DISPOSAL SYSTEM INSPECTION
.l-� �e
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NAME /D c ��cf. ,cst. ,
LOCATION 7'/ 6 v le va-s2..-1
DATE 41 / /g' PERMIT NO. 2/ -02//
SOIL TYPE - de,- Loam'- Clay -
Percolation Test Required? ::YES - NO
Percolation rate - Min/Inch:
TYPE of SYSTEM:
Absorption field, total length
Length of each trench r .
Depth of trenches
Size of gravel
SEEPAGE PITS{Number of) , i '
Size- 5k ft. X ft.; .4 ra ' S4-gr-2-14.
Gravel size Ae , # /! I
PIPING: Size Type
Bldg. to tank X'41 5c-4. LID.
Tank to dist. box ;;YSr _ oodc-
Dist. box to field/pit`
Openings sealed? '� NO Partial
r
LOCATION/SEPARATIONS:2
Foundation to tank; F, /Z ft.
Foundation to absorption ft.
Absorption to lot line /p ft.
Separation of pits ft.
LOCATION OF SYSTEM ONi, PROPERTY(circle one)
Front -Rear -d'Left side - Right side -
COMM i'
H
1
SYSTEM USE APPROVE,4111111
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2,/
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