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1991-252
CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date May 6 19 91 This is to certify that work requested to be done as shown by Permit No. 91-252 has been completed. This structure may be occupied as a Septic Alteration Location 75 Main cS 'wrest Owner Bernard Davi no! By Order Town Board TOWN OF QUEENSBURY Director,of.Bldg. do Code Enforcement BUILDING PERMIT TOWN OF QUEENSBURY No 91-252 WARREN COUNTY, NEW YORK • Tom:y (vic I30, —/ -a � o PERMISSION is hereby granted to Barnard Davignonrsa •l OWNER of property located at 75 Main Street Street, Road or Ave. cc 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 a a 2. CONTRACTOR or BUILDER'S Name Sanitary Sewer ca 3. CONTRACTOR or BUILDER'S Address W 4. ARCHITECT'S Name N 5. ARCHITECT'S Address Vf fD r+ 6. TYPE of Construction—(Please indicate by X) f1 a ( )Wood Frame ( 1 Masonry ( ) Steel ( ) c+ t9 •S 7. PLANS and Specifications a No Septic alteration to include: 200' of Tile Field with #2 stone, 1' thickness 8. Proposed Use Septic Alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES April 30, 19 93 (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 this 30th Day of April i9 91 SIGNED BY for the Town of Queensbury Building and Zoning Inspector To) ' OF QUEENSBURY I #zij APPLICAT a i'• SEPTIC DISPOSAL PERMIT. TOWN OF QUEENSBURY i.14 RECEIVEDDATE: y-3 0 ' c tIF 1 LOCATION OF PROPERTY FOR INSTALLATION APR 3 0 1991 Owner's Name: ge P,,rvir .;`;�. :A , : w� .�,: BLDG. & CODE DEPT. Address: 7g-• Ph s,i S 7—g-f.�:77-- " . Installer' s Name: J , irk opt, _ Telephone: `7 qi - 2. -r, Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) 1s3 Topography: Circle one: 0 Rolling Steep Slope % of Slope Soil Nature: Circle one: 41, Loam Clay Other /Depth: Ground Water: At what depth? Feet Bedrock or Impervious Material : At what depth? Feet Percolation test: Circle one: (ot requ_ hell required Rate - Min. Per Inch Domestic water supply: Circle one: tunicip& Well Other If domestic water supply is a well : Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank 1 O 0 0 gal . (minimum size:,.-1,000 gal ) TILE FIELD: Each Trench .5-0 feet/Total system length ,?©D feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used #.. 2- /Depth or Thickness / feet - ***************************** HOLDING TANK SYSTEM IF REQUIRED , NO. of Tanks Size of Each Gal . *Alas 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. SIGNATURE OF RESPONSIBLE PERSON: /7 b_L DATE: -2c'5r a 1 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 co 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 co structures 4.) location and distance co any water supply . 5.) size .and_ dimensions _of all tanks, distribution boxes, tile fields anal/or drywalls B. Nu system shall be covered before inspection and approval by the Building Inspector. Failure to comply with this requirement may rasulc 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 co produce said plot plan at time of inspection may result in in an immediate work stoppage. D. Should unforeseen problems during construction prevent proper inscalla- cion, alteration or repair of an approved system, a new proposal must bu submitted to the Queensbury Building Department before further construccion. Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 kuni rks: • • 4 . awn.-n.- o/ QueenJture4 • BUILDING and ZONING DEPARTMENT >92 Bay and Haviland Road, R.D. 1 Box 98 . Queensbury, New York 12801 i"../����/ SEPTIC DISPOSAL SYSTEM INSPECTION NAME .CV/y2/L/I. / l//,,f-qi , LOCATION Z1- �'/2l//W4�f DATE 7`� / 9/ PERMIT NO. g/-, 'j,Z, SOIL TYPE - and - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch lo TYPE of SYSTEM;; Absorption field, total length pZe.0 Length of each trench :) ,' Depth of trenches, 02/ • Size of gravel .Z `' SEEPAGE PITS{Number of) . c Size- ft. X ft. • Gravel size '\ " PIPING: `+ Size Type Bldg. to tank .`h J Cel, Tank to dist. box ii, $4-0 V Dist. box to field/pit; ,in 0 Openings sealed? YES'''?, NO Partial LOCATION/SEPARATIONS. V\ Foundation to tank I ') ft. Foundation to absorption /( ft.. Absorption to lot line 0,14_ft. Separation of pits / ft. • LOCATION 0 YSTEM OI4• PROPERTY(circle one) •Front -i-. - Left 'fide - Right_ side - COMMENT` - . /A \ /AAAif . \ . ree/ , J I SYSTEM USE APPROVED Bu g Inspector 01/86 and vl TOWN OF QUEENSSURY RECEIVED APR 3 01991. 1.4-ko`,S BLDG. & CODE DEPT. 80' ak2ArG e.. SCh. 0 a ir4 6Art.. a ' DIsr. Deg r0 .sD'