1991-165 1 f'
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CERTIFICATE OF COMPLIANCE ..
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date /r'�?i5s.� ,�.t39 J
This is to certify that work requested to be done as ahoy by Permit No. 91-1.65
has been completed.
This structure may be occupied as a Septic Alteration
Location 1 Green way Circle "..
Owner David Capron
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enforcement
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BUILDING PERMIT
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TOWN OF QUEENSBURY No. 91-165
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to David Capron
OWNER of property located at 1 Greenway Circle 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 C
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 4.G
Condon's Septic & Drain
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3. CONTRACTOR or BUILDER'S Address
12 2 Grant Avenue
Glens Falls, NY 'N
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address �•
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( I Masonry ( )Steel ( )
7. PLANS and Specifications
No. 2 seepage pits each 8' x 8' with #3 Stone as per plot plan specificat- ons
and appliation
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 9, 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 9th Day of April 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning I nspdctor
AOM TOWN OF QUEENSBURY
aka) APPLICATION FOR SEPTIC DISPOSAL1.MI�p QUEENSnuri ti
1145P711
DATE:
LOCATION OF PROPERTY FOR INSTALLATION I efiCE/ZROC-V / R 91991
Owner's Name: Pik- (I; "i> EAP O/l) BUILDING & CODE DEPT.
Address: / '�cs dZ ' '17)1u Cr CIF (cifFcis iR 0 J- dur,-6—ti7
R i4uL Telephone: 7l�k.S VL
Installer' s Name:�ttic�i� S ����-E-ram `
Number of bedrooms (residential only) 3 ''JJ
Total daily flow (compute @ 150 gal per bedroom) / :5 6
Topography: Circle one: 411111 Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? f'L�y4 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: Municipal Well Other
If domestic water supply is a. well :
Separation: Water supply from any septic absorption feet.
C'(( ft�yCQ�1CY
PROPOSED SYSTEM: Septic Tank/40 G r/� gal . -f 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 #. 15 /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: eMnv,i(e DATE: yJ
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"Sii'pti §y `cam Inspections:
A. All applications for septic system 'installstion, 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 di§canto- to lot lines
3.) location and distance to. scructures
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
Building Inspector. Failure to comply with this requirement may •
r.sulc 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 to produce said plot plan at. cime 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
be submitted to the Queensbury Building Department before further
construction. •
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Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Havilind Roads
Queensbury, New York 12804
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keniarkc: •
\ 1,00 ' ' 130e4
.own o/ Queeniltiry
BUILDING and ZONING DEPARTMENT
Bay and iaviland Road, R.D. 1 Box 98
Quee;nsbury, New York 12801
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,SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME_ 'NQ f vdl)
LOCATION I G y ii00I Q CA CI
DATE it //) PERMIT NO. 11 —J( 5
SOIL TYPE - ._ - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate Min/Inch •
TYPE of SYSTEM:
Absorption field, otal length
Length of each tren h '
Depth of trenches /
Size of gravel \
SEEPAGE PITS{Numbe o ) . 7
Size- ( t. x f ft /
Gravel size ,#'`__ ,/
PIPING: Size/ Type
Bldg. to tank j VC_
Tank to dist. box cIV4 to
_
Dist. box to field/pit .4/ "
Openings sealed? YES.s( NO Partial
LOCATION/SEPARATIONS`f
Foundation to tank /a f t.
S'
Foundation to absorption ft. •
Absorption to lots line ft. .
Separation of pits ft.
LOCATION OF SYSTEM ON PROPER'I Y(circle one) .
Front E Left side - Ri ht side -
COMMENTS:
/
/
SYSTEM USE APPROVED�a NO
Bui ing Inspec or
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TOWN OF
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BUILDING & CODE DEPT
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REVIEWED BY , Aibzin.4.,a,mr
DATE 51 --
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