1992-188 I
CERTIFICATE C k COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
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Date
This is to certify that work requested to be done as shown by Permit No. 2`
has been completed.
This structure may be occupied as a
Septic Al t+erati on
' L.ocstion
IS Sherwood Drive
C7wner Tloothy Sullivan
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. & Code Enforcement
BUILDING PERMIT X
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TOWN OF QUEENSBURY No. 92- 188
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WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Timothy Sullivan ~
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OWNER of property located at 18 Sherwood Drive Street, Road or Ave.
in the Town of Queensbury, To Construct or place a Septic Alteration
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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,
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1 . OWNER'S Address is
Y
Same amll
2. CONTRACTOR or BUI LDER'S Name
Sanitary Serer
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3_ CONTRACTOR or BUILDER 'S Address fa0
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4_ ARCHITECT'S blame
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5. ARCHITECT"S Address
6. TYPE of Construction — (Please indicate by X)
( ) Wood Frame ( ) Masonry { 1 Steel S T 1p
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7. PLANS and Specifications fi
No. Septic Alteration to include : 2 seepage pits each 10 ' x 8 ' using '
#3 stone, 2 ' thickness as per plot plan specifications and application :*
B. Proposed Use
Septic Alteration
$ 25moo PERMIT FEE PAID — THIS PERMIT EXPIRES April 28th 19 94
(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 t�-.-� Q z y r A_pri 1 'l9 9�
SIGNED BYE, �/~ ! �' for the Town of Queensbury
BuiId1ng and Zo V na I nspector
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/ f TOWN OF QUEENSSURY �
APPLICATIOfi FOR SEPTIC i j� �iTJ$BUFt ,
RECEIVED
DATE *. ` ?p APR 2 7 1992
LOCATION OF PROPERTY FOR INSTALLATION
BLDG, & CODE DEPT.
Owner ' s Name . E !
Address : rS_ k -
Installer ' s Name Telephone : 71 '
Number of bedrooms ( residential only ) `
Total daily flow ( compute @ 150 gal per bedroom ) C7 +�
Topography : Circle one : at � Rol Iing 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 ? Feet
Percolation test ; Circle one : � 4'ot~required required
Rate - Min . Per Inch
Domestic water supply : Circle one : ieipa�; Well Other
If domestic water supply is a wel . un
Separation . Water supply from any septic absorption feet .
F7x-i 5 i- r-/ C.
PROPOSED SYSTEM . Septic Tank ' ` gal . ( minimum size . 1 , 000 gal )
TILE FIELD : Each Trench feet/Total system length feet
SEEPAGE PIT( S ) : Number of /Size each f D feet
by..&L _f eet
Size of stone to be used f _s /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 .
2 7.
SIGNATURE OF RESPONSIBLE PERSON . DATE : "7 '2"'
Sdstte System Insoectionss
w . All applisatioas for sepCic syscest installation , alteration or repair .
as required by the Town of Queensbury Sanitary Savage Ordtnanca . &hall
be submittdd co Cho building Department at least 24 hour* 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 . ) sire and dimOnsionS of all tanks , distribution boxese
vile fields anJlor drywalls
B - Nu system shall be covered before inspection and approval by the
Uuild ing Inspuccor . Failure to comply with this requiromenc may
rusulc in the uncovering; or chd system by the installer and a fine
Uf 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 CUM of inspection may -
rusulC in an immediate work stoppage .
D . Should unforeseen problems during construction prevent proper installa—
tion , aledrscton or rup.►ir of an approved systam. a new propos4t1 must
Gu submICt3d co the Quwansbury (Suilding Department before further
c: onscruccian .
Town of Quo*osbury
BUILDING and CODES DEPARTHRW
Bay and Haviland Roads
Quednsbury . New York 128+04
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flown 0/ Queenjlury /P/ , r
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R. D. 1 Sox 98
(}ueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME _..,..� -�
L.00AT I ON
DATE �� , PERMIT NO.
SOIL TYPE L "� Clay
Percolation Test Required? YES - , NO
Percolation rate - Min/Inch -
TYPE of SYSTEM:
Absorption field , total length' ,
Length of each trench' _
Depth of trenches
size of grave �. -�
SEEPAGE P ITS4Nurnber of) _ . �......_
Size- "_ftm x j 0 f
Gravel size ::F>
PIPING : Size All 'Type
Bldg . to tank
Tank to dist . box `tom
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Dist. box to f field/ NO partial
Openings sealed? ES
LOCATION/SEPARATION 1`4J✓6ft.
Foundation to tan ti n t(o f It
to ab rp
Absorption to 1 t line +9 'y
Separation of its
LOCATION OF STEM C1N PRO RTY (circle one)
Front - ea - Left side - Right side -
CCMMEN T5 :
SYSTEM USE APPROVED ES NO
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