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CERTIFICATE (JF COMPLIANCE
TOWN OF QU'EENSBURY
WARREN COUNTY, NEW YORK
Date April 23 19 .22
This is to Certify that work requested to be clone as shown by Permit No.
has been completed.
This structure may be occupied as a Se ri C SYSteYEI
7 Harris Street
Location
Nikki DeCenzo
Owncr
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
BUILDING PERiIIIIT LC
i
TOWN OF QUEENSBURY
No. 92- 17 2
WARREN COUNTY, NEW YORK � bDN
No'k
V
PERMISSION is hereby granted to Nikki DeCenzo °
OWNER of property located at 7 Harris Street Street, Road or Ave,
in the Town of Oueensbury, To Construct or place a SeRti c Al teralti on
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.
h1
O
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1. OWNER'S Address is
s
Smile
J
OWN
2, CONTRACTOR or SUI LOERS Name
Jack Hail Plumbing Heating
792-7114 s
3. CONTRACTOR or BUILDER 'S Address
30
IN
e+
d. ARCHITECT'S Name 2
CD
5_ ARCHITECT'S Address
Va
rp
sp
r&h
J*
6_ TYPE of Construction — (Please indicate by X)
wood Frame ( ) Masonry ; ) steel ( I
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7. PLANS and Specifications J
No. Septic Alteration to include: 200 ' of Tile Field using #2 stone �
1 ' thickness as per plot plan specifications and application
8, Proposed Use
Septic Alteration
$ 25 an PERMIT FEE PAID — THIS PERMIT EXPIRES April 24 .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 Ousensbu ry before the expiration date.)
Dated at the Town of Queensbury this _ 24th Oay of Apri 7 1992
SIGNED BY r al P� —1;r% _ for the Town tat Queensbury
Bull Ong and onpng I nstpe
TOWN OF GIUEENSBLIRY
TOWN OF QUEENSBURY RECEIVED
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # _qAe - 1T2
APR 2 2 1992 Fee Pa d
Date :
. jr- r c � _ EILDGa Ada CODE QGa %wed By , h
LOCATION OF PROPERTY FOR INSTALLATION :
Owner ' s Name : n ikIV ) Qe4,e" 2-c� � ra�
Owner ' s Mailing Address : 'r ly� rrrsS�-
Installer ' s Name : ��a ��+� ,�- 4ZZ Phone # :
Number of bedrooms ( if residential ) :
Total daily flow ( residential - compute @ 150 gal . per bedroom ) : h/
Topography-Circle One : Flat Rolling Steep Slope % of Slope
Soil Nature- Circle One : and Loam Clay Other /Depth :
Ground Water-At What Depth ? 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 : el�u Well Other
If domestic water supply is a we
Separation : 'Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank leodo sLqal . ( Minimum size : 1 . 000 gal . )
� 0
Tile Field : Each Trench feet//Total 'System Length .2 C) feet
Seepage Pit ( s ) : Number of / Size each : ft . x ft .
Size of Stone to be used : # / Depth or Thickness / feet
HOLDING TANK SYSTEM IF REQUIRED
No . of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by a certified
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 : DATE :
Septic System Inspections :
A . All applications for septic system installation , alteration or repair ,
as required by the Town of Queensbury Sanitary Sewage Ordinance , shall
be submitted to the Building Department at least 24 hours before start
of construction and shall include a plot plan showing :
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 ) size and dimensions of all tanks , distribution boxes , tile fields
and/or drywells
B . No system shall be covered before inspection and approval by the Building
Inspector . Failure to comply with this requirement may result in the
uncovering of the system by the installer and a fine of 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 time of inspection may result
in an immediate work stoppage .
D . Should unforeseen problems during construction prevent proper installation ,
alteration or repair of an approved system , a new proposal must be submitted
to the Queensbury Building Department before further construction .
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks :
flown 0/ Qmeervj4ury lqr7?
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
(]ueensbury, New York 12801
SEPTIC DISPOSAL. SYSTEM INSPECTION
Lam'
LOCAT I ON
DATE x f PERMIT NO . Z .C�
SOIL TYPE - an - Loam - Clay -
SOIL TYPE
ion Test Required? YESPerc '
Percolation rate - Min/inch
TYPE of SYSTEM:
Absorption field , total length
Length of each tx enc 2 _ rf
Depth of trenches
Size of gravel_ =,±-'
SEEPAGE PITS4N of) - r
Size-
Grave ize. Size Ype
PIPING : .1?,&Y��5 of _0
Bldg , to tank 4 fa �
Tank to listo box pac[
Dist_ box to field/ t NO partial
openings sealed?
LOCATION/SF,pARATIONS gT Alls�'+ ft-
Foundation to tank
Foundation to abs tion £t.p--
line ft •
Abs ro ption to to fto
separation of p is
LOCATIONQ OF SY TEM ON P'ROPE Y (circle one]
Front - ea
eft side - Ri ht side -
CCtyMENTs :
SYSTEM USE APPROVED
O
14WO
b~i
fa C� 06 B ilding I pector
01/86 and VI
TOWN OF QUEENSSUR
RECEIVED
APR 2 2 1992
SLDGo S CODE DEPT.
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TOWN OF QUEENSBURY
BUILDING C0 DEPT.
REVIEWED BY /J _
1
DATE