1991-255 .. v . 1. :! •. '' -'v tl'!+ - v .. - I . - ^ 1,.f v ..
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date May 6 19 L9 1
This is to certify that work requested to be done as shown by Permit No. 91-255
has been completed.
This structure may be occupied as a cPptir a1 rarat onn
Location 3 `Newcomb 'Street
Alfred Viger
Owner
By Order Town Board
TOWN OF QUEENSBURY
(DiAx
Director of,Bldg. do Code Enforcement
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BUILDING PERMIT
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TOWN OF QUEENSBURY o
No. 91-255,,'
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Alfred Vigar
OWNER of property located at 3 Newcomb Street 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.
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1. OWNER'S Address isCD
Same
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2. CONTRACTOR or BUILDER'S Name
Ivan Bell
3. CONTRACTOR or BUILDER'S Address W
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address c+
6. TYPE of Construction— (Please indicate by X) + co
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( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No Septic Alteration to include: 2 seepage pits each 8' x 8' with
#3 Stone, 2' Thickness o'
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES May 2, 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 the-2fld Day of- May 19 91
SIGNED BY C / ,!1r , for the Town of Queensbury
Burl ing and Zonindyfispector
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/�► TOWN OF QUEENSBURY i
'AVM APPLICATIOfN FOR SEPTIC DISPOSAL PERMIT ' 7
DATE: L/ 3 O S 1 �Y
LOCATION OF PROPERTY FOR INSTALLATION ,3 i-
Owner's Name:
Address: 3 A7y zz, e_orrl 6 S71 (9(J -c-v7 3)5v�'' q41
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Installer' s Name: vG ,3-// Telephone: 79
Number of bedrooms (residential only) -3 : r
Total daily flow (compute @ 150 gal per bedroom) LI SO
Topography: Circle one: GDP Rolling Steep Slope % of Slope
Soil Nature: Circle one: dit4 Loam Clay Other /Depth:
Ground Water: At what. depth? Feet
TOWN OF OLIEENOURV
Bedrock or Impervious Material : At what depth? °7 I MEWED
.Percolation test: Circle one: [not requirie_p required MAY 1 0 1991
Rate - Min. Per Inch
ELDG. 8& CODE CEPTa
Domestic water supply: Circle one: (ifynicipaj Well Other
If domestic water supply is a well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank do /a0 D gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of /Size each feet
by g- feet
Size of stone to be used #. .3 /Depth or Thickness 2 feet
****************************
HOLDING TANK SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
*Alarm 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: DATE: 6 G 1
SSotiC System Inspections:
A. All applications for septic system installation, alteration or repair,
ai required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submitted co the Building Department at least 24 hours before start
oi construction and shall include a plot plan showing:
1.) the proposed location of tho system
2.) location and distance co 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,
tilts fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspuctor. Failure to comply with this requirement may
result in_ che. uncovering 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
sits. Failure co produce said plot plan at time of inspection may
rusulc in_an..immediate. work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or rupuir of an approved system, a new proposal must
bu submitted to the Queunsbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
k.aMarks: •
' Ilt5r\-(P\ /1j //li/00)()
own or Queensbur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D..1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME ) C�Q J� --(C)
LOCATION o. U P,(,l flg\\--) <
DATE 5 / r . PERMIT NO. 9/ �(255
SOIL TYPE - Sa d 0:"- Clay -
Percolation tR . ired? YES - NO
Percolation rate ''- Min/Inch
4
TYPE of SYSTEM: t.
Absorption field, total length
Length of each trench
Depth of trenches [
Size of gravel , ,;
SEEPAGE PITS-fNumber of) " vA
Size-. C, ft. X q- ft. 4„2-1 . --Q_
Gravel size � 3 V
PIPING: Size t' Type
Bldg. to tank f t 511-- ,:
Tank to dist. box aL C
Dist. box to field/p -/
Openings sealed? / E `'NO Partial
LOCATION/SEPARATIONS:
Foundation to tank � g'�" ft.
Foundation to absorption ;I c,5 ft. .
Absorption to lot line r6,216 ft.
Separation of pits j /<P ft.
LOCATION O SYSTEM ON PROPERTY(circle one)
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Fronte Left side - Right side -
COMMENTS: //ob4--
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SYSTEM USE APPROVED ii I/
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Buis d 4 g Inspector '
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