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1992-140 �., .+„ _:,.���i w',I::a7�Fj'�T, .b ,_. �; , , ;: .. ... .. gY•Ly .r n� ._ :. y,;cr+. _.yl,. : ,C.,,,.,.r.y.q..:-r..�_�. . a f.�. � n T., � s I 1 3 i CERTIFICATE OF COMPLIANCE J r R TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK i G ' ©ate. Apri 1 20 t 199Z k 92- 140 This is to certify that work requested to be dark as shown by Permit Na. Ihas been completed. E Tbis structure may be occupied as a Septic Alteration # Stinnysi de Rd ' i..orcation e�J'' _= Thoa as Graff Own i By Order Town Board TrOWN OF QUEENSSURY j Director of Bldg. t5t Code Enforcement ti L �o BUILDING PERMIT ,y >K TOWN OF QUEENSBURY a No. 92- 140 x WARREN COUNTY* NEW YORK tr PERMISSION is hereby granted to Thomas Graff - 1 .tp. OWNER of property located at Sunny-side d Street, Road or Ave_ in the Town of Queensbury, To Construct or place a at the above location in accordance to application together with plot plans and other information hereto filed and Cn approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. M 1_ OWNER'S Address is S anle ? N 2. CONTRACTOR or Sill LIDE WS Name Queensbury Sewer 3. CONTRACTOR or B U I LOE R'S Address t/7 C CC tlt 0. 4. ARCHITECT`S Name f6 0. 5_ ARCHITECT'S Address Cn td 6. TYPE of Construction — (Please indicate by X) n ( I Wood Frame i f Masonry t i Steel ( 1 PF tb 7. PLANS and Specifications d Septic Alteration to include : ]LOW gal Tank as per plot plan specifications and application 8, Proposed Use Septic Alteration s 26, OO PERMIT FEE PAID — THIS PERMIT 'EXPIRES April 160 ig94 (If a longer period is required an application tar an extension must be made to the Building and Zoning inspector of the town of Queensbury before the axpi rat ion date.) Dated at the Town of Queensbury this [3a of April 19 92 7 SIGNED BY / r for the Town of Queensbury Building and zoning l txor TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # - I�U Fee Paid Ef ate : 0L' �� � ( �{ Reviewed By LOCATION OF PROPERTY FOR INSTALLATION : s C_..c ►'� tt L4 Owner ' s Name : ( 1 OWN OF UUEENSBU" Owner ' s Mailing Address : D Installer ' s Name : - 5 s2e '-� Phone # : ~- 3� Number of bedrooms ( if residential ) : �C gLp�. & CODE UEPT. ( . Total daily flow ( residential - compute @ 150 gal . per bedroom ) : Topography- Circle One : Flat Rolling Steep Slope % of Slope Soil Nature-Circle One : San4 > Loam Clay Other /Depth : Ground Water-At What Depth ? Feet Bedrock or Impervious Material -At What Depth ? Feet Percolation Test- Circle One : N,o"t 4jquire RequiredfRate Min . Per Inch Domestic Water Supply-Circle One : Municipal ,�� Other If domestic water supply is a well - Separation : Water supply from AnX septic absorption Grrcf' feet PROPOSED SYSTEM: Septic Tank,,, ze � 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 : # / Depth or Thickness feet HOLDING TANK SYSTEM IF REQUIRE No . of Tanks Size of Each Gal . Alarm system and associated electrical work to be inspected by a certified agency. �r�r ** * 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 * L 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 alT__ttanks , distribution boxes , tile fields and/or drywells Be No system shall be cowered 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 : BLgLDING and ZONING DEPARTMENT Bay and Haw+land Road, R.U. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATIONI__ 7C {r�I{`�Pi r •�' -� DATE ��+� / PERMIT NO ._ � SOIL TYPE San y - Loc?tX! - clay percolatio Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: l Absorption field , tot length Length of each trench Depth of trenches_ Size of gravel__ _� ---- SEEPAGE PITS4Number oft _�----�- -- Size- ft. X _ ft. Gravel size S Typ PIPING : Bldga to tank. Tank to disc . box Dist. box to Field/ ' openings sealed? NO partial U:)CATION/SEPAPATI S : �yt7 ft. ie + Ta ?OkLL Foundation to t . ft . Foundation to a sorpti ft. Absorption to of line ft. Separation of pits LOCATION OF YSTEM ON ROPERTY (circle one) Front - Re - Left side - Right side - CCmmENTS - -fq y 1% P SYSTEM USE APPROVER: YES Bui1ld!Ag sp for O1/86 and v1 awn n/ Queensiurry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Sox 98 }� Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME �__-�4 -1104' 100e . LOCATION // DATE 40 Y/ PERMITNO* SOIL TYPE - Sand - Loam - clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch F TYPE of SYSTEMS: Absorption field , to al length Length of each trenc _ Depth of trenches Size of gravel_ SEEPAGE PITS{Number o ) Size- ft. X S't Gravel size PIPING : S e Type Bldg . to tank Tank to dist . box Dist. box to field/pi openings sealed? Y N Partial LOCATION/SEPARATION Foundation to tank f Foundation to abs tion ft . Absorption to to line fto separation of pi s ft . LOCATION OF SYS ON PROPERTY (circle one ) Front - Rear eft side - Right side - CCIRME:NTS : SYSTEM USE APPROVED YE iiZ dtAq Inspector 01/86 and vl � aAx j , 7Ac ere i I 3 Par, r