1991-177 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date �„1r2,4.I'... /.h ➢9 f
This is to certify that work requested to be done as shown by Permit No. 91-177
has been completed. `
This structure may be occupied as a aamntil ki1 tarn ti^�E� I
Location 5 Buena Vista
er Dominick Mull vans
Own
By Order, Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
f A =9
BUILDING PERMIT
TOWN OF QUEENSBURY a
No. 91-177
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Dominick Mu1 vany
0
OWNER of property located at 5 Buena Vista Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Septic Alteration 1`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.
1. OWNER'S Address is
Same
a
2. CONTRACTOR or BUILDER'S Name c`
Daniel & George Drellos
Samitary Sewer
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
CD
a
IC
5. ARCHITECT'S Address y
6. TYPE of Construction—(Please indicate by X)
N
( 1 Wood Frame ( ) Masonry ( )Steel ( )
c n
7. PLANS and Specifications
No. Septic Alteration to include: 2 seepage pits each 8' x 8' with
#3 Stone, 2'Thickness -�
a
8. Proposed Use 0'
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 12, 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 Day.of' April 19 91
/...5--
SIGNED BY / for the Town of Queensbury
Building and Zoning Inspe o� or
r
TOWN OF QUEENSB1�tY 1
�� gi—/77
Wll OF 4UEENS6URY
APPLICATIOU FOR SEPTIC DISPOSA )
DATE: 11— l - C,
APR 10 1991
LOCATION OF PROPERTY FOR INSTALLATION Lv Q'xt (/I,t 7I - r Dept
Owner's Name: D PA flu LV
Address: R\leJaA Ifld;
Installer' s Name: JJ u erkti criELLIAr Telephone: 9a
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) L15-0
Topography: Circle one: 400 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: nicipa Well Other
If domestic water supply is a wellMu:
Separation: Water supply from any septic absorption feet.
( cK1crI& (.)
PROPOSED SYSTEM: Septic Tank 1000 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPA E PIT(S): Number of /Size each d'n feet
by Y feet
Size of stone to be used #. --2 /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.
SIGNATURE OF RESPONSIBLE PERSON: DATE: /14: /0— 9/
„ ; r 5 p'a y.. /',
SeptaCste■ Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
bd 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 co any water supply
5.) size and dimensions of all tanki, distribution boxes,
tile fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspuccor. Failure to comply with this requirement may
rusulc 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 may rusult in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or ropuir of an approved system, a new proposal must
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
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kunt rks:
.awn J0- p
_/own o1 QueenJbur, . ,3
BUILC2ING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION /
NAME \1)1 U(;�aPam, i (7^vY1,;
n .
i
LOCATION 1 •
,,
DATE 4 / 42 PERMIT NO. C.,! / 7 7
SOIL TYPE - Sand - Loam - Clay - .1 t�'
Percolation Test Required? YES - NO
Percolation rate - Min/Inch _ x'
: f
TYPE of SYSTEM:
Absorption field, total length I Aff
Length of each trench t, if'
Depth of trenches ' t'
Size of gravel I _
SEEPAGE PITS{Number of) ' q t;`
Size- aft. X (�ft. 'i . ,,)
Gravel size .*?a '1 ,`'
PIPING: Size ,;pe
Bldg. to tank 4 ii " , C
Tank to dist. box �
Dist. box to field/pit //2 &
Openings sealed? YES NOn Partial
LOCATION/SEPARATIONS:
Foundation to tank f t.
Foundation to absorption /a `ft. . '
Absorption to lot line t ft.
Separation of pits
LOCATION OF SYSTEM ON PR(iPERTY'•(circle one)
Front Left side- Rig l,t side -
COMMENTS:
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I .
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1 ,,
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SYSTEM USE APPROVED capNO
4.: , / ,idtiAll
B i ding Ins,.ector
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TOWN OF OUEENSBURY
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BUILDING & CODE DEPT.
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TOWN OF QUEENS8UkY
BUILDING & COD DEPT.
DEPT,
REVIEWED BY
DATE