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---
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toN'411 ���
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