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92-142 i �}Yk 1 CERTIFICATE f 1F COMPLIANCE TOWN OF QUEENSSURY WARREN COUNTY. NEW YORK E s j Date April 200 _ 19 M � -' 92-142 This is to certify that work requested to be done as shown by Permit No. i has been completed. This structure may be occupied as a Septic Alteration Location Route 9 i I� OL� JOP K Owner Milt LathgELIrading Restone existing Drj Well to stop gray crater on surface of Ground while plans for proper system By Order Town Board are being drawn and approved TOWN OF Gt1[3EE SStIRY Director of Bldg. do Cade Enforcement r f � d BUILDING PERMIT TOWN OF QUEENSBURY No. 92_142 WARREN COUNTY, NEW YORK w a+ PERMISSION is hereby granted to Trading Post 1 OWNER of property located at Route 9 Street, Road or Ave_ in the Town of oueensbury, To Construct or place a Septic Al terati on at the above location in accordance to application together with plot plans and other information hereto filed and " 1 w approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. ¢ J. t_ OWNERS address is un Milt Lathem c th 2. CONTRACTOR or BUILDERS Name Queensbury Sewer 0 3. CONTRACTOR or BUILDER'S Address c 4. ARCHITECT'S Name yf 'X3 rah J. 5. ARCHITECT'S Address ram" t't• 6_ TYPE of Construction — (Please indicate by X) I Wood Frame I I Masonry I I Steel 11 7. PLANS and Specifications No, Septic Alteration to include : Restone 8 ' x 10 ' Drywell using #3 stone 2 ' Thickness as per plot plan specifications and application B. Proposed Use Septic Alteration $ 35• 00 PERMIT FEE PAID — TEAS PERMIT EXPIRES April 14f i9 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.l Dated at the Town of Queensbury this 14th Day of April 19 92 SIGNED BY for the Town of Queensbury Building and Zoning or '1 TOWN OF QUEENS APPLICATION FOR SEPTIC DISPOS RMIT Permit # -c�� 7 Fee Paid � Date : 3 r _ Reviewed By LOCATION OF PROPERTY FOR INSTALLATION : el , , Owner ' s Name : Y'V c- Owner ' s Mailing Address z�c Installer ' s Name : ( • in CO U � ��sr � LS .<=) ���- Phone # : Number of bedrooms ( if residential ) : Total daily flow ( residential - compute @ 150 gal . per bedroom ) : Topography- Circle One : at Rolling Steep Slope % of Slo Soil Nature-Circle One : an Loam Clay Other / : +A PSI g� Ground Water-At What Depth? Feet BUILDING 8R CODE DEPT, Bedrock or Impervious Material -At What Depth? Feet Percolation Test-Circle One : of Requ-ir Required/ Rate Min . Per Inch Domestic Water Supply-Circle One : �Municipa Well Other If domestic water supply is aj v Separation : Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench feet//Total System Length feet Seepage Pit ( s ) : Number of f Size each : ft , x ft . Size of Stone to be used : # f Depth or Thickness feet X HOLDING TANK SYSTEM IF REQUIRED No . of Tanks Sizelof 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 : c 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 . Co 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 : /OG[fI} D� �iLf.le'fo'/3 ".i �4lMf� BUILDING and ZONING DEPARTMENT Bay and Ha►riland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEMINSPECTION iVAME /CsxQt'r f�-C^ LOCATJ / J I,ON � DATE 1 PERMIT NO. SOIL TYPE - Sand - Loam - Clay -� Percolation Test. Required? YES Percolation rate - Min/Inch TYPE of SYSTEM : Absorption field , tal ngth Length of each tren h Depth of trenches Size of gravel SEEPAGE PITS{NUmber f) Size- ft. X _ t. Gravel size PIPING : i.ze 'type Bldg * to tank Tank to +fist. b Dist. box to f1 ld/ 1 Openings sealed. E NO Partial LOCATION/SEPA TI INS : Foundation t ft. Foundation t orpti n owftft�ft. Absorption to t line ft. Separation of is ft. LOCATION OF S TEM ON ROPERTY (circle One) Front - Rear Left si e - Right side - C CIKMENT S SYSTEM USE APPROVE" YES NO ors /eT _ u.1. ng Inspector 01/86 and vl TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT 531 BAY ROAD QUEENSBURYNEW TELEPHONE * ( 518)©R92- 58324 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPE�C,TION RECEIVED NAME C - LOCATION DATE Li P2.PERNIT ! TYPE OF STRUCTURE RECHECK APPROVED N/A YESI NO FOOTINGS/PIERS I MONOLITHIC POUR FORM REINFORCEMENT IN PLACE THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING PROTECTION FROM FREEZING - FOR 48 HOURS FOLLOWING THE PLACEMENT OF THE CONCRETE. MATERIALS FOR THIS PURPOSE ON SITE FOUNDATION/WALL POUR REINFORCEMENT IN PLACE FOUNDATION/DAMPROOFING BACKFILL APPROVAL ROUGH PLUMBING PLUMBING VENT PLUMBING UNDER SLAB FRAMING : JACK STUDS /HEADERS BRACING/BRIDGING - JOIST HANGERS --- JACK POSTS /MAIN BEAD! . FIRESTOPPING WALLS CEILING FIREWALLS HEATING ROUGH- IN I INSULATION : k FOUNDATION WALLS INTERIOR R- FOUNDATION WALLS EXTERIOR R- FLOORS R- WA LLS R- CEILING R- DUCT WORK OR PIPING IN UNHEATED j SPACES 11 REMARKS : ARRIVE DEPART INSPECTOR w E i �J} r ` tL fn,IC1 � � r � i` i S 1