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1991-231 - --7ri • • ..$ -- -CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date May 6 19 91 • 91-231 This is to certify that work requested to be done as shown by Permit No. • has been completed. This structure may be occupied as a septic alteration • Box 205 West Mountain Road Location MARK SHELDON Owner By Order Town Board TOWN OF QUEENSBURY • Director of Bldg. & Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No. 91-231 WARREN COUNTY, NEW YORK co co PERMISSION is hereby granted to Mark Shel don OWNER of property located at Box 205 West Mountain Road Street, Road or Ave. in the Town of Queensbury,To Construct or place a Septic Alteration 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. 1. OWNER'S Address is same cn 2. CONTRACTOR or BUILDER'S Name rn r— Signolelli & Son Inc. 3. CONTRACTOR or BUILDER'S Address p' h 4. ARCHITECT'S Name 5. ARCHITECT'S Address m 0 N 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( I Masonry ( )Steel ( ) c+ 7. PLANS and Specifications so- t No. Septic alteration to include 200 feet of tile field with #3 stone at 1 ft depth as per plot plan, specifications and application. 8. Proposed Use septic system ra c rt $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 23 19 93 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the CD town of Queensbury before the expiration date.) spu c+ Dated at the Town of Queensbury this 23rd Day of April 19 91 SIGNED BY , g4/1',P . /, for the Town of Queensbury Bu}((d�ing-arid-Zoning Inspector / ` ' TOWN OF QUEENSBURY 1 APPLICATIO'i FOR SEPTIC DISPOSAL PERMIT �—` TOWN OF QUEENSSI.M4 DATE: y � RECElti/Fr' LOCATION OF PROPERTY FOR INSTALLATION /'��„� c Itj;T//A , c' Owner's Name: ,.I S`4I4I Address: / _ 02air A 2/ Installer's Name: ��,,, ,///l' , 2 ,, � Telephone: 7 ' Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) Vs-z Topography: Circle one: Fla Rolling Steep Slope % of Slope Soil Nature: Circle one: fe, Loam Clay Other /Depth: Ground Water: At what depth? O Feet Bedrock or Impervious Material : At what depth? ///d- Feet Percolation test: Circle one: not req,u_rtme required Rate - / 'Iv Min. Per Inch Domestic water supply: Circle one: Music ' Well Other If domestic water supply is a wel . Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank t'`;-;,g gal . (minimum size: 1,000 gal ) 6c3, TILE FIELD: Each Trench - ' feet/Total system length ,,2()' feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used f 3 /Depth or Thickness / feet *wwww*wwwwwww*wwwwwwwwwwww*** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks o *Alarm system and associated electrical wrk atp. be:ainspected:=by. .a arm!.I.: < - I have read the regulation on the reverse MeE of—t ris- fi t Jbnd. agree of—a6f�e by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. / SIGNATURE OF RESPONSIBLE PERSON: / DATE: TOWN OF QUEENSBURY APPLICATIOM FOR SEPTIC DISPOSAL PERMIT TOWN OF QUEENSWAV.4 DATE: . ��3 7 RFCE1'FFr� LOCATION OF PROPERTY FOR INSTALLATION c-/ a377/AP'3, l_ v3e Owner's Name: /4Q,-/C 54/1ti . BLDG. .& Lv,L Address: _ c es,`/ Re Installer's Name: S7 (244 �,�� �Fc_ Telephone: 7 ' Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) 56-0 Topography: Circle one: Fla Rolling Steep Slope % of Slope Soil Nature: Circle one: 6197d, Loam Clay Other /Depth: Ground Water: At what depth? 8f . Feet Bedrock or Impervious Material : At what depth? � /�— Feet Percolation test: Circle one: not re required Rate - ) 11i. Min. Per Inch Domestic water supply: Circle one: Munic' a Well Other If domestic water supply is a wel Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tan�k6 list/1 gal . (minimum size: 1,000 gal ) r TILE FIELD: Each Trench - " feet/Total system length ,2a)' feet SEEPAGE PIT(S): Number of /Size each feet ' by feet Size of stone to be used #: 3 /Depth or Thickness / feet wwww***************r******** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks ToVi e of h u z ;,,z al rty *Alan' system and associated electrical electrical tedcr INIn tins b • a agency. r I have read the regulation on the reverse giW of—thi-s he! tan `a-gree- ra6fi e by these and all requirements of the Town of Queensbury Sanitary Sewage Disposal Ordinance. SIGNATURE OF RESPONSIBLE PERSON: , DATE: 1 t )1111 Septic System Inspections: tic system installation, ulceration or repair. A. all applications for sop 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 showing: 1.) the proposed location of cho system 2.) location and distance co lot lines 3.) location and distance to structures 4.) location and distance co any water supply S.) size and dimensions of all tanks. distribution boxes. cili fields and/or drywalls B. Nu system shall be covered before inspection and approval by the uuilding Inspuccor. Failure to comply with this requirement may rdsulc in the uncoverinb of the 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 rusulc in an imme,diace work stoppage. D. Should unforeseen problems during construction prevent proper installa— cion, alteration or r.apdir of an approved system, a new proposal must be submitted co the Quuunsbury Building Department before further construction. Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 Remarks: • Jocun o� Queeniur1 BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC /DIISPO/SALr�SYSTEM INSPECTION NAME LOCATION �2/ 4 L DATE y// j/ PERMIT NO. 7/,3/ / / 3✓" SOIL TYPE - Sand - Loam - Clay -/ Percolation Test Requi%red? YESr- NO Percolation rate - Min/Inch / : rt� TYPE of SYSTEM: d Absorption field, to 1 length Length of each trench' Depth of trenches ' Size of gravel + _ SEEPAGE PITS{Number of,) Hj Size- ft. X ft�. Gravel size ` PIPING: Size Type Bldg. to tank Tank to dist. box f'';j Dist. box to field/pit Openings sealed? XES NO Partial LOCATION/SEPARATIONS;' Foundation to tank. ft. Foundation to absorption ft. Absorption to lot lire ft. Separation of pits ft. LOCATION OF SYSTEM oN PROPERTY(circle one) . Front - Rear 2- Left side - Right side - COMMENTS: ,. N • rdlti SYSTEM USE APPROVED YES NO ,E; (71Y Buildi g Inspector 01/86 and vl Jocun o/ Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC/ /� DISPOSAL//SYSTEM INSPECTION NAME J22/1 c/'1 e f`4-) LOCATION /Lc s / ,77/7 /- /7/k2/G;Uf // DATE `� /./ PERMIT NO. 9/ `"123/ / SOIL TYPE - San % - Loam - Clay _ Percolation Test Required? YES 1 I . Percolation rate - Min/Inch _ 1`4/7- TYPE of SYSTEM: I ' Absorption field, total length /c2tr61 / Length of each trench _;; ( 0 `r / ,/ 20'/ Depth of trenches ' ( Size of gravel q 1 SEEPAGE PITS{Number of) Size- ft. X _ /i-t.( i/ 1 / Gravel size iy J ' '— I / PIPING: / / EYize Type Bldg. to tank ' a Tank to dist. box _ 1 ,/ Dist. box to field/pit 1 / Openings sealed? YES NO ' Par•'tial LOCATION/SEPARATIONS: ' Foundation to tank ',ff. Foundation to absorption _ it. Absorption to lot line ,ft. Separation of pits rift. LOCATION OF SYSTEM ON PROPERTY1(circle one) Front - Rear - Left side - fRight side - COMMENTS: f' , / l 0 .._ ),.;r77/ -� ,,,,�ti�z &,,,/7 te -A,---57'e 1- .:-) 6 '1"---',' i ! SYSTEM USE APPROVED YES NOS' `�� / . //a /),�. _ /10S- Building Inspector 01/86 and vl • Jown of Queeni4urj • BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 • SEPTIC DISPOSAL SYSTEM SYSTTEM INSPECTION NAME 1/16,lz- ,S4z4 • LOCATION 024 —1,Jn,,/ M(fJ DATE �3/ F/ PERMIT NO. 9.7—g3/ SOIL TYPE - Sand/- Loam - Clay - Percolation Test Required? ,EYES - NO Percolation rate - Min/Inch + ,A)/1.-- TYPE of SYSTEM: ; • Absorption field, total length c ?c ) Length of each• trench' rt p' ,"c/I2a ' Depth of trenches ,9',43 1 • Size of gravel SEEPAGE PI���Number of) Size- r /v/q Gravel size . PIPING: Sizes Type Bldg. to tank 4/1'. /20 Tank to dist. box Dist. box to field/pit ti PG/6- Openings sealed? Y ', r! NO Partial LOCATION/SEPARATIONS: Foundation to tank \ ft. Foundation to absorption" ft. Absorption to lot line i' / ! ft. Separation of pits ft. LOCATION^-SYSTEM ON PROPERTY;,(circle one) . Front - (Rear/- Left side;' - Right side - COMMENTS: tk . �. SYSTEM USE APPROVED YES NO i�. • _ Building I, spector 01/86 and vl ,'( ( k TOWN F UEWNS3URY (2�3(''' BI LD N( ' et COD :* DEPT. o 31 REVIEWED I ] d / S Q P<,G DATE yP jf t--- \(i toN'411 ��� � � Q °! z7 ZQ �' i