1991-257 1'`
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®2 7
has been completed.
This structure may be occupied as a
Septic Alteration
Location 8 Crestwood Dr.
Owner Reiand J. Ot v l
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
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BUILDING PERMIT �X
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TOWN OF QUEENSBURY
• No. 91-257 •
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Roland J. Duval a
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OWNER of property located at 8 Crestwood Dr. 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.
1. OWNER'S Address is
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Same c�
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2. CONTRACTOR or BUILDER'S Name
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Queensbury Sewer a
3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name N
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5. ARCHITECT'S Address
CD
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6. TYPE of Construction—(Please indicate by X) O
( )Wood Frame ( ) Masonry ( ) Steel (
7. PLANS and Specifications
No Septic alteration to include: 1000 gal tank w/2 seepage pits each 8'
x 8' using 13 stone, 2' thickness
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 this 2nd Day of May 19 91
SIGNED BY /.� /1//r for the Town of Queensbury
Budding and Zoning Inspector
TOWN-OF, EENSBUR 'E ri.= ,,' g
s#14V j APPLICATION FOR SEPTIC DISPOSAL ,PERMIT_.
_ c / 2.. '..ri......... a .. CC'�%�P�S�' 1��-:-,9."Te,
DATE: ,� a 6 ( 4`EV:E VtiL s^� ®: " •
LOCATION OP P PERTY FOR INSTALLATION DATE Q�
Owner's NameT 1 c,V 14 0 a--
Address: g 0 (i 1/
Installer' s Name: 0-4Telephone: / Vir
Number of bedrooms (residential only)
TOWN OF QUEENSaURy
Total daily flow (compute @ 150 gal per bedroom) f,( RECEIVED
Topography: Circle one: Flat oiling Steep Slope % of Slope
MAY l 1991
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what depth? Feet �LDG• CODE DEFT
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: of require. required
Rate - Min. Per Inch
Domestic water supply: Circle one: unicip.a-i Well Other
If domestic water supply is a, well :
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank Z ! gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEP PIT(S): Number of /Size each 7 feet
by 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 .
*Alarms 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: �� �
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 scare
of ,construction and shall include a plot plan showing:
1.) the, proposed location of the system
2.) location and distance co lot lines
3.). location and distance to structures
4.) location and distance co any water supply
-4.) size and dimensions of all tanks, distribution boxes,
rile 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
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 co produce said plot plan at time of inspection may result in an immediate work stoppage.
D. Should unforeseen problems during construction prevent .proper installa—
tion, 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 and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
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k.:marks: •
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Jocun o� Queen3bury
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
•
NAME ()/a h oL OV Vet /
LOCATION g Cfi,CS't—G'iJ" . .
DATE 6/3/ 9/ PERMIT NO. 9/ — 0752/
SOIL TYPE - Sand - Loam - Clay - •
Percolation Test Required? YES - NO/
Percolation rate - Min/Inch 1 .11
TYPE of SYSTEM: /
•
Absorption fib.,-total length
_
Length of each trench • r, ��
Depth ofof trenches_
of graver ! .1
SEEPAGE •ITS{Numbe of)•
Size- h�, ft. X ft. • //,
Gravel size 3 �(
PIPING: Size ;Ty e
Bldg. to tank • ,kf5'T/ 6
Tank to dist. box _
-field/pit /4'L-
_ _ Dist. box- to -field/pit -_! - -tVc—
Openings sealed? (yES ) NO'r ,;j Partial
LOCATION/SEPARATIONS: :4
Foundation to tank )C 1_/�t.
Foundation to absorption/
Absorption to lot line W;` L ;'ft.
Separation of pits
LOCATION OF SYSTEM ON. PROPERTY',(circle one)
Front -Rear - Left side - Right side -
COMMENTS: '7
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•
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SYSTEM USE APPROVED NO
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Building In Vector
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TOWN OF OLIEENSBURN,
RECEIVED
MAY 11991
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BLDG, & CODE DEPT.
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