1991-418 T,a
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date • C.6i1,f4'C.6_. ,t 7 19 1Z1
This is to certify that work requested to be done as shown by Permit No. 91-418
has been completed.
This structure may be occupied as a Septic alteration
Lot 61 Luzerne Rd
Location
Owner R-1owmPc taad
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
•
BUILDING PERMIT
TOWN OF QUEENSBURY No 91-418 a
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Homestead Village w
OWNER of property located at Lot 61 Luzerne Rd Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Septic Al tprati on p
at the above location in accordance to application together with plot plans and other information hereto filed and E
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
fD
1. OWNER'S Address is 0.
SameLIZ
.
2. CONTRACTOR or BUILDER'S Name fD
Morning Star c
414
cri
3. CONTRACTOR or BUILDER'S Address 1--�
N
fD
e+
4. ARCHITECT'S Name
e+
CD
5. ARCHITECT'S Address •
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 . Tank with 135' of Tile Field
using #2 stone 14" Thickness as per plot plan specifications and application
8. Proposed Use
Septic alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 17,19 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 tlji 17th o f June 19 91
SIGNED BY ( / for the Town of Queensbury
Building an oning Inspector
„ ..� • TOWN OF QUEENSBURY J '� /R
� APPLICATION F R PTI DISPOSAL PERMIT /
DATE: 4.;
`”)_ 9 f -rowN OF Q'i''� NSBUR'r
" RECEiVED
LOCATION OF PROPERTY FOR INSTALLATION -N-waL.,..r/I -��t'
Owner' s Name: !+�
�9 BLDG. & QODE DEPT.
Address: .... �/t h �L (
Installer's Name: Telephone: -73 'i_-z crco
Number of bedrooms (residential '�—
Total daily flow (compute @ 150 gal per bedroom)
Topography: Circle one: ( Rolling Steep Slope % of Slope
Soil Nature: Circle one: 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: unicipa,Y Well Other
If domestic water supply is a well:
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank it o o gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench r,/S—feet/Total system length /3 5-- feet
SEEPAGE PIT(S): Number of - /Size each feet
by feet
Size of stone to be used if. /Depth or Thickness r y feet
*****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alan 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 PERS a-��� DATE: 6' jY
•
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 lease 24 hours before start
of construction and shall include a plot plan shoving:
• 1.) the proposed location of the system
2.) location and distance to lot lines
3.) location and distance co structures
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 Inspuctor. 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 co produce said plot plan at time 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 co the Quesnsbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks: •
,
Toe, : -)_,Lri\k-c.
_ wn oil Queenil ur y 14/1
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 'Y�,C't-eGG`�t�
LOCATION ,),, 6r )-.1)2-,e_Aw
l r DATE lQ //5? PERMIT NO. Q j J [ V
SOIL TYPE - and Loam - Clay -
Percolation Tes Required? YES - NO
Percolation rate - Min/Inch '
.
TYPE of SYSTEM: , /
Absorption fieldk total length ! Z
Length of each tench ' 4i )
Depth of trenches" f
Size of gravel l
SEEPAGE PITS4Number of) ;:?_
Size- ft. X f k ft;
Gravel size ' .'
PIPING: '' •� Size Type
)if
Bldg. to tank
Tank to dist. box
Dist, box to field/pi
(4kc—Al_
Openings sealed?/ YESi NO Partial
LOCATION/SEPA eTIONS:
Foundation to tank , ft. Po..
Foundation to fPff absorption\ f . 9PLOTP
AJ
. Absorption to lot line \ ft
Separation/Of pits tr
LOCATION OF SYSTEM ON PROPERTY(circle one)
Front - Rear - Left ide -Right side -
COMMENTS'
'1
•
SYSTEM USE APPROVED o
1
. Building Ins.ector
01/86 and vl
. .
;..:-..
..,-- • .
0,1,-J-zei
.
1
0
i° cY
I
I
I ,
i
i i
i ozsi 6
i
. 1
i . 2, 1911
I Ti si
,, \%'
lip
a ,v,
. ..
.. .
% .
. .
. .
L./ 0
,.•,.._