1991-185 bpi {
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CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date /7 /,, 45 19 1/
This is to certify that work requested to be done as shown by Permit No. 91 1 5
has been completed.
This structure may be occupied as a septic alteration
Bx 533 .Sanders "Rd
Location
RICHARD PHILLIPS
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
•
BUILDING PERMIT
TOWN OF QUEENSBURY ,
No. 91-185 .D
WARREN COUNTY, NEW YORK
0
PERMISSION is hereby granted to RICHARD PHILLIPS cn
OWNER of property located at Sanders Road 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is
Box 533 Sanders Rd
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2. CONTRACTOR or BUILDER'S Name r—
r
Sanitary Sewer Service
3. CONTRACTOR or BUILDER'S Address J.
PO Box 224
Glens Falls NY 12801 n.
4. ARCHITECT'S Name
5. ARCHITECT'S Address
lS3
(71
6. TYPE of Construction—(Please indicate by X) N
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( )Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications
No. Septic alteration to include 1000 gallon tank, 1 10x8' Seepage Pit
as per plot plan, specifications and application.
8. Proposed Use
Septic alteration
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$ 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.)
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Dated at the Town of Queensbury his-----J2th Day 7 April 19 91
0
SIGNED BY v/ _) for the Town of Queensbury
B lui ding and Zd ing Inspector
'OW TOWN OF QUEENSBURY I
aiT F QUEENS814
. 'LICATIOf1 FOR SEPTIC DISPOS14L.
DATE: r/ I ( RIRda
APR 111991
LOCATION OF PROPERTY FOR INSTAf TION 0
BUILDING a< DEPT.
Owner's Name: R ‘c-kri R.D h t, op,r-
Address: Re6 JMiu S C �
Installer' s Name: l T A Ox� Telephone:
rz� 7 9 d —ads,?
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) /ems
Topography: Circle one: Flat 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: gEri.i required
Rate - Min. Per Inch
Domestic water supply: Circle one: _ Municipa Well Other
If domestic water supply is a we
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank F' O a gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of f /Size each /f v feet
by ? feet
Size of stone to be used #.� /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: ,t,od„/ .,^�'��."�— DATE: / ��� 9
7.J3 .,tsg'1-t!' -
7 f rA ft P i i 1�: Syr ".
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"J`` "SpC'i � sl►sta• 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 'leasc 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 co structures
4.) location and distance co any water supply
-5.) size--and—dinansions of-=all--cankc---d-ist-ribueion boxes,--- -- • -- - -- - - -
cile 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
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
rusulc in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installs—
cion. alteration or rupuir of an approved system, a new proposal must •
bu submitted co the Quuansbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Rh:marks:
1 �3 .
•
,. awn o f Queenilury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION •
NAME t:\\a . c \cA L C-0Q
LOCATION y.ET" 3 3 ) S",tpv)(�,a S �J
DATE 17' / /5 PERMIT NO. 9 / / , 5
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
ki
¢ ,.
TYPE of SYSTEM: 7: .
Absorption field, total length
Length of each trench - /
Depth of trenches , / •
Size of gravel_
SEEPAGE P TS{Number of) /' •
Size- ,ft. X c- ;ft. .
Gravel size , i !
PIPING: tkt1/2 iz J1 Type
Bldg. to tank //G
Tank to dist. box ,/ (/ e.
Dist. box to field/pint / "
Openings sealed? y'rES NO Partial
LOCATION/SEPARATIOIS: ±�
Foundation to tank '1 _ It.
Foundation to absorption )5 ft.
Absorption to lot line `, is ft.
Separation of pits �h, ft.
LOCATION OF SYSTEM ON PROPE! • - one)
Front - Rear / Left side,- Right side -
COMMENTS: .
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. / •
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SYSTEM USE APPROVED 0 NO
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