1991-840 ,•
CERTIFICATE OF COMPLIANCE
• TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date %A 19
This is to certify that work requested to be done as shown by Permit No. 91-840
has been completed.
This structure may be occupied as a Seotic Alteration
Location Lots 24 Si 25 Northhinds mobile Park
Owner Geor9s A Danipl nrAtalTnc
• By Order Town Board
• TOWN OF QUEENSBURY
•
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY o
No. 91-840
WARREN COUNTY, NEW YORK ,w
'.o
PERMISSION is hereby granted to Northwi nds
OWNER of property located at Luzerne Rd Lots 24 & 25 Street, Road or Ave.
O
in the Town of Queensbury,To Construct or place a Septic alterations
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. O.
to
1. OWNER'S Address is r
Daniel Drellos `*
PO Box 224
Glens Falls, NY 12801
2. CONTRACTOR or BUILDER'S Name IV
Sanitary Sewer "'
3. CONTRACTOR or BUILDER'S Address r
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address .
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6. TYPE of Construction— (Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel ( ) 0
7. PLANS and Specifications
Septic alteration to include:
No- 1000 gal . tank with 2 seepage pits each 8' X 8' using #3 stone
Thickness 2' as per plot plan specifications and application
8. Proposed Use
Septic alterations
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 6, 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 6th Da ,of December 1991
SIGNED BY for the Town of Queensbury
Building and Zoning inspector
`�• TOWN OF QUEENSBUJ X F i.
*1 APPLICATIOtI FOR SEPTIC DISPOSAL PERMIT •:.;
DATE: /2_ V- 9/ DI:C !? 1991
LOCATION OF PROPERTY FOR INSTALLATION O (2- Uu f krer&-a'cil / .
Owner's Name: -/v,�'g._ £— -e_th r
Address: ? 0 a DV-- C P
Installer' s Name: �i✓ I k
fra Telephone: 79,2- 7a � 7
Number of bedrooms (residential only) N/4
Total daily flow (compute @ 150 gal per bedroom) Ail/4-
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Natures—Circle one: ' and Loam Clay Other /Depth:
Ground. Water: At what depth? 0 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: unicip Well Other
If domestic water supply is a wel •
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank A)0 gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of 2---_. /Size each p feet
by �� feet
-.of stone to be--u-sed—#-. ) ---- Depth r Thicknes-s _.-
-_ - ---- - /..,. -. -� _ _ -�-- =--feet--�
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,Sk-hs^ ftt 4A�.',-.'5 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
' try thim to "xlsrarea a�L~ {ts of the Town of Queensbury Sanitary Sewage Disposal
rdfhance.
BIMING /tE. DEPT.
SIG l ! - PERSON: /,-- fqJtLDATE:
DATE - 15
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lotto System Inspections,: _
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A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Savage Ordinance, shall
be 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 tho 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 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 cha installer and a fine
of up to $250.00.
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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 installa—
tion, alteration or repair of an approved system, a new proposal must
be submitted co the Queenabury Building Department before further
construction.
Town of Queenabury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
Remarks:
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(931a 2)csd- /0) zqiii
_own o/ Queeniur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
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SEPTIC DISPOSAL SYSTEM INSPECTION
NAME \%41\10.)j (\()
LOCATION ) :54 (4( clg-`)
DATE ! d I (� PERMIT NO. 9, S4-0
SOIL TYPE �a d� Loam - Clay - •
Percolation st Required? YES - NO
Percolation rate - Min/Inch
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TYPE of SYSTEM:
Absorption field, total leng 'h
Length of each trench:.- . //_--
Depth of trenches /j /
Size of gravel
SEEPAGE PITS-Number of)' 1
Size- ;j{ ft. X ft.
Gravel size , E
PIPING: /';rr !' Size Type
Bldg. to tank //ct / (,'{1 t /
Tank to dist. box 4, 4 f'C
Dist. box to field/pit';;, --�( - �r�jC'�-
rr�-�
Openings sealed? i'ES� ` NO Partial
LOCATION/SEPARATIONS: •
Foundation to tank/
Foundation to absorption{, ft
Absorption to lot(line ; ft.
Separation of pit's
LOCATION .OFSYSTEM ON PROPERTY(circle one)
Front - Rear - Left side - ight side -
COMMENTS:
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SYSTEM USE APPROVED N,O`-'
1////1- 7/11-7-/[---"/"1-'"------
ECulding Ix/spector
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