1991-789 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date M fry- S 19 q i
This is to certify that work requested to be done as shown by Permit No. 91-789
has been completed.
This structure may be occupied as a Seot1 C system
Location Lot 70 A 71 Northwi ds
Owner Daniel & Geore Drel l os (NORTH HINDS INC.)
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY x
No. 91-789
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Northwinds Inc.
OWNER of property located at Luzerne Rd L.,`� 70�4� � 1 Street,Road or Ave.
in the Town of Queensbury,To Construct or place a Septic System
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. C
1. OWNER'S Address is
Daniel & George Drellos
PO Box 224 c.
Glens Falls, NY 12801 to
2. CONTRACTOR or BUILDER'S Name n
Same
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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Ct.
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X) rD
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( )Wood Frame ( ) Masonry ( ) Steel (
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7. PLANS and Specifications 4•LA
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Septic system to include: 1000 gal tank with 2 seepage pits each r+
No. 8' x 8' using #2 stone as per plot plan specifications and 9
application
8. Proposed Use
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Septic System
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES November 7, 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 7th Day of NOvember 19 91
SIGNED BY \1 !I for the Town of Queensbury
Building and Zonin'Inspector
TOWN OF QUEENSBURY 7_ cj57
t-11111111hL713 APPLICATIO1 FOR SEPTIC DISPOSAL PERMIT
DATE: 1 l / J 1 �'` r-• 9O
LOCATION OF PROPERTY FOR INSTALLATION r , , ,AP
Owner' s Name: Alum £/C_ 74- ad,-
r 4
Address: 7� �}� act` �- /c
Installer' s Name: ( J / t 7- r A. C' / Telephone: (�
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Number of bedrooms (residential only) /11/P '
Total daily flow (compute @ 150 gal per bedroom) /(J40
Topography: Circle one: 400 Rolling Steep Slope % of Slope
Soil Nature: Circle one: San. Loam Clay Other /Depth:
Ground Water: At what depth? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: required required
Rate - Min. Per Inch
Domestic water supply: Circle one:(nicipal) Well Other
If domestic water supply is a we1yy -
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank 100 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAG PIT(S): Number of /Size each cc> feet
by '" feet
Size of stone to be used #. 2� /Depth or Thickness feet
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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: 11 /a)Lu _ / // LL&_._DATE: /// 7 /:?//
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S+ptiC System Inspections:
A. All applications for septic system installation, alteration or repair,
as required by the Town of- Queensbury Sanitary Sewage Ordinance, shall
bi submitted co the Building Department at least 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 to structures
4.) location and distance to any water supply
5.) site and dimensions of all tanks, distribution boxes,
cile fields any!/or drywalls
B. Nu system shall be covered before inspection and approval by the
building Inspector. Failure to comply with this requirement may
rgsulc in the uncovering of c:he 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 result in 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
bu submitted co the Qugensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Que.nsbury, New York 12804
Remarks: .
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cc77 // • X/1
_awn o/ Queenibury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98_
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME /G �il2/.1/,G//tE1
LOCATION , . �Q 7�
DATE ///// 9/ PERMIT NO. 9/4j6
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SOIL TYPE - 'MVP'- Loam - Clay p
Percolation Test Required? YES/-. NO
Percolation rate - Min/Inch/
TYPE of SYSTEM: Ja
Absorption field, total length
Length of each trench ' �:';
Depth of trenches ' I
Size of gravel / f
SEEPAGE PITS{Number of ` .
Size- Sft. X f
Gravel size f'
PIPING: Side Type
Bldg. to tank
Tank to dist. box f.
Dist. box to field/pit
Openings sealed? / YES NO Partial
LOCATION/SEPARAT ONS:
Foundation to t nk eft.
Foundation to , sorption 2z ft.
Absorption toot line ft.
Separation of pits 4 ft.
LOCATION OF SYSTEM ON P4OPERTY(circle one)
Front - a er Left silo - Right side -
COMMENTS: 1
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SYSTEM USE APPROVED iS. NO
Bui ing Inspe for
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