1992-116 4 i
CERTIFICATE f"vi �CO1MP''LIA.T�TCE
TOWN OF QUEEN58URY
WARREN COUNTY, NEW YORK
Elite l " 194!-
s. ` --CQ ram
This is to certify that work requested to be done as shown by Permit No,.92-115
has been completed.
This structure may be occupied as a SeDti c AZ terati on
aHoward Street
Owner Diane Carpenter
By Order Town Board
TOWN OF +QUEENSSURY
Director of Bldg. & Code Enforcement
t-� m
BUILDING PERMIT
� ac
TOWN OF QUEENSBURY
No. 92-116 w
WARREN COUNTY, NEW YORK
a
c*
PERMISSION is hereby granted to Diane Carpenter
Y
1=
OWNER of property located at Howard Street Street, Road or Ave. �1
in the Town of Queensbury, To Construct or place a Septic Alteration _ ed
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.
a
1_ OWNER'S Address is ^�
Columbia Avenue IG]
Queensbury, MY 12804 cn
t*
2, CONTRACTOR or $UI LOE RS Name
Ivan Bell '
n
3_ CONTRACTOR or BUILDER 'S Address
W
C+
�.
4_ ARCHITECT"$ Name p
5, ARCHITECT'S Address
6, TYPE of construction — (Please indicate by DC)
( I Wood Frame ( ) Masonry ( } Steel ( }
7. PLANS and Specifications iON
o Septic Alteration to include : 1000 gal tank with 126 ' of Tile Field
#2 using stone , 1 ' thickness as per plot plan specifications and application
S. Proposed Use
Septic Alteration
s 25. 4O PERMIT FEE PAID — THIS PERMIT EXPIRES April 3 , lg 94
(If a longer period is required an application for an extension must be made to the 8uitding and Zoning inspector of the
town of Queensbury before the expiration date.)
Dated at the Town of Queensbury th i Oay rd Aril 19 92
SIGNED BY for the Town of Queensbury
Building and Zoni n"ttor
A,
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL FERMI Permit # ~/ / Go
Fee Paid
FOWL: nF QUEENSBUk ,
Reviewed By o;ECEfVE0
Date :
LOCATION OF PROPERTY FOR INSTALLATION : NAJLA) CrrA yh� 0Ll Lf 31992
Owner ' s Name * r ,� Y� s� r �t x r,-, ,tom :Sze BLIDG—o"r-v$OE KEPT.
Owner ' s Mailing Address : r_} t./. A,?nl r r � [ � t� c' "t Zr -e, r"rQb or V ` Y7
Installer ' s Name : �'T'�9 ,�y- / sr l / Phone # : Z9 ,?5r19L/
Number of bedrooms ( if residential ) :
Total daily flow ( residential - compute @ 150 gal . per bedroom ) :
Topography-Circle One : 4QD Rolling Steep Slope % of Slope
Soil Nature- Circle One : an Loam Clay Other /Depth :
Ground Water-At What Depth ? Feet
Bedrock or Impervious Material -At What Depth ? _ : i' Feet
Percolation Test- Circle One : Not Required Required/ Rate "Min . Per Inch
Domestic Water Supply- Circle One : iT4unici well Other
If domestic water supply is a well -
Separation : Water supply from any septic absorption �/)/7 feet
PROPOSED SYSTEH9 Septic Tank ) a gal . ( Minimum size : 1 , 000 gal . )
Tile Field : Each Trench 2_ feet//Total System Length /2 a5 _ feet
Seepage Pit ( s ) : Number of / Size each : A ft . x ;LV1q ft ,
Size of Stone to be used : # / Depth or Thickness / feet
HOLDING TANK SYSTEM IF REQUIRE
No . of Tanks Size of Each j Gal .
Alarm system and associated electrical work to be inspected by a certified
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 : _ ry - 3- 9 2
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 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 to any water supply
5 ) size and dimensions of all tanks , distribution boxes , tile fields
and/or drywells
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 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 result
in an immediate work stoppage .
D . Should unforeseen problems during construction prevent proper installation ,
alteration or repair of an approved system , a new proposal must be submitted
to the Queensbury Building Department before further construction .
Town of Queensbury
Building & -- , Code . Enforcement
Department
531 Bay Road ' = .
Queensbury NY 12804
Remarks :
TOWN OF QUEENSBURY
BUILDING AND CODES DEPARTMENT
531 BAY ROAD
QUEENSBURY , NEW YORK 12804
TELEPHONE ( 518) 745- 4447
BUILDING INSPECTOR' S REPORT
REQUEST FOR INSPECTION RECEIVED _
NAME sl
t
LOCATION c � 1l44 k1lF� ��1��
DATE __. PERMIT # =
TYPE OF STRUCTURE 5i �C ' x�l " -- `
RECHECK APPROVED
N/A YES NO
— CfOTINGS/PIERS _—
`)<MONOLITHIC POUR FORM
REINFORCEMENT IN PLACE
THE CONTRACTOR IS RESPONSIBLE
FOR PROVIDING PROTECTION FROM
FREEZING FOR 48 HOURS FOLLOWING
THE PLACEMENT OF THE CONCRETE.
MATERIALS FOR THIS PURPO ON SITE
FOUNDATION/WALL OUR
REINFORCEMENT IN PLACE
FOUNDATION/DAMPRO FIN
BACKFILL APPROVAL
ROUGH PLUMBING
PLUMBING VENT/VEN N P ACE
PLUMBING UNDER SL
FRAMING :
JACK STUDS/HE ERS
BRACING/GRID NG _
JOIST HANGS
JACK POSTS/ IN BEAM
HEATING ROU - IN
INSULATION •
FOUNDATI N WAL S INTER OR
FOUNDATION WALLS EXTERIOR R-
FLOORS R-
WALLS R-
CEILING R-
DUCT WORK OR PIPING IN UNHEATED
SPACES
REMARKS .
AJ r7
tr6c � � ` f
ARRIVE I . r =� r`
DEPART.
INSPECTOR
lourre n Queen
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Box 88
Queensbury, New York 12801
SEPTIC DISPOS,,AAL SYSTEM INSPECTION
NAME �17- A
LOCATIOP
DATE 6 �/2/ig. PERMIT NO. f
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM : '
AbSorption f eld , total lOngth�
Length of ea h trench , 4
Depth of tre hes 21
size of grave ' ,
SEEPAGE PITS4N er of -
Size- ft.
Gravel size
PIPING : Size Type
Bldg. to tank - �
Tank to dist . s, Grp
Diet . box f ftS art_.-r
Openings seaea d? 1�ES r70 Partial
LOCATION/SE ARATIONS :"
Foundation to tank
Foundation" to absorptl4n eft . !
AbSorpticYn to lot line ,
Separation of pits .v t.
LOCATI _ SYSTEM ON PRZ EPcircle one]
Front - Rear Left side Right side
CCMMLWT
SYSTEM USE APPROVED X No
Building ns actor
01/86 and vl
40 Wow CA a
1 Q C ac - -, ,r .. Ow � of RECFNEE) sE u� k
BLDG. & CODE D
i
C
3
to
c�u TOWN OF QUEENSBU Y
n BUILDING c i3 EPT.
REVIEWED BY
DATE 44