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1991-258 CERTIFICATE OF COMPLIANCE . TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date ,49 19 .1/ e f - This is to certify that work requested to be done as shown by Permit No. 91258 has been completed. This structure may be occupied as a Septic Alteration Location 18 Centenial Drive Owner Albert Grosskopf By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement • , . I I BUILDING PERMIT ro TOWN OF QUEENSBURY No. 91-258 WARREN COUNTY, NEW YORK co o •l lv PERMISSION is hereby granted to Albert Grosskopf 0 OWNER of property located at 18 Centenial Drive 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 O' fD Same c, O 2. CONTRACTOR or BUILDER'S Name Condon's Septic c • 3. CONTRACTOR or BUILDER'S Address CO 12 2 Grant Ave Glens Falls, NY 12801 fD CD 4. ARCHITECT'S Name -L. 5. ARCHITECT'S Address N CD 10 -I. n 6. TYPE of Construction-(Please indicate by X) ( )Wood Frame ( ) Masonry ( ) Steel ( ) CD r+ 7. PLANS and Specifications • O No Septic Alteration to include: 2 seepage pits each 8' x 8' using o 03 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 �� �� for the Town of Queensbury Building and Zoning Inspector / TOWN OF QUEENSBURY 1 ur ` � APPLICATIOfi FOR SEPTIC DISP I,� IUUEENBBLlRIr .. - � / RECEIVED DATE: j AY 11991 LOCATION OF PROPERTY FOR INSTALLATION )(g CP41 f�i1J[e)/ _P KW Owner's Name: AI 13 b / N0 SS P j- BLDG. & CODE DEFT; Address: F ' CAN- 'Flu,x f Installer' s Name: el) /tl aN S � -6/G Telephone: Nt-8..�(-12, • Number of bedrooms (residential only) 3 Total daily flow (compute @ 150 gal per bedroom) ` 3 O Topography: Circle one: Flat Rolling Steep Slope % of Slope Soil Nature: Circle one: Sand Loam Clay Other /Depth: Ground Water: At what depth? /1/��} Feet . Bedrock or Impervious Material : At what depth? /1.174 Feet Percolation test: Circle one: of requirea> required . Rate - Min. Per Inch Domestic water supply: Circle one: MunicipalD Well Other If domestic water supply is a well : Separation: Water supply from any septic absorption feet. PROPOSED SYSTEM: Septic Tank X gal . (minimum size: '1,000 gal ) TILE FIELD: Each Trench feet/Total system length feet SEEPAGE PIT(S): Number of /Size each feet by R feet Size of stone to be used it- 3 /Depth or Thickness 2- feet HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks Size of Each Gal . *Alarm , system and associated electrical Mork 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 COD r::±8 APT. -Tze, SIG OF IBLE PERSON: DATE: 57- 7_ l RiEVIE LD D y , DATE �'l , Sesti S etas Inspectioni• • A. All applications for septic sysces installation, alteration or repair ' as required by the Town of Queensbury Sanitary Sewage Ordinance, shall be subsiccad to the Building Deparesenc at Isaac 24 hours before start of construction and shall include a plot plan showing: 1.) the proposed locac_ion of cho sysces 2.) location and distance co lot lines • 3.) location and distance co structures - 4.) location and distance to any water supply S.) size and dimensions of all tanks, distribution boxes, cile fields and/or drywalls B. Nu 'system shall be covered, before inspection and approval by the Building Inspuccor. . Failure co comply with this requirement may result in the uncovering of chg •.syscem 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 site. Failure co produce said plot plan ac time of inspection say rusulc in an ,immediace work stoppage. • D. -Should unforeseen problems during construction prevent proper installa— cion, alcaracion or repair of an approved system, a new proposal suss bu submiccad co the Queensbury Building Department before further construction. .Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads . Queensbury, New York 12804 kumarks': • • • • • cc�� • •' 0Wn o/ Queens urty . 42 , • •� BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 • SEPTIC DISPOSAL SYSTEMINSPECTION NAME G\r0SO SL(O c / ) ' J)1'] ,-\-- LOCATION I g CQv\A-en i ciLl) 1; `y 1 DATE / R PERMIT NO. 9/ J(),�(? SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES, - NO Percolation rate - Min/Inch • TYPE of SYSTEM: Absorption field, total length Length of each trench ' �I Depth of trenches ' 1 • / Size of gravel I SEEPAGE PITS{Number of) at rr 2(_ej c J. Size- ft. X ft. I; .i Gravel size .4 -jy, 1( (j PIPING: Size Pi type Bldg. to tank I C- I . . Tank to dist. box 'II/X_- Dist. box to field/pit Openings sealed? kgsk NO Partial 1 LOCATION/SEPARATIONS: ! Foundation to tank ? ft. Foundation to absorptio li ft. Absorption to lot line ft i.e., Separation of pits l ft. LOCATION SYSTEM O PROPERTYtcircle one) Front - Rear - Left side - Right side - COMMENTS: AT-5 I fS i/44-tL1 • .=Yu 0 i+tom 5-te-t3/ , .0r . . 0-0NAJ C L, P Lc P L/r'r'\ 4L,r)ii 1 1�-c D -- °C� SYSTEM USE APPROVED G N 0 B ilding I pector /0.-:1s 01/86 and vl _awn of Queenilury • BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME M_A-4-4-Jt(itfri LOCATION / 00A..172AA-1.4/. DATE /1 / 67 ( , PERMIT NO. 6?1 -2.5Y SOIL TYPE - Sand - Loam - Clay. - Percolation Test Required? - NO , Percolation rate - Min/InchG' TYPE of SYSTEM: • Absorption field, total lOngth Length of each trench „•• Depth of trenches ' Size of gravel: SEEPAGE PITS4NuMber of) Size- ft. X Gravel size PIPING: Size Type Bldg. to tank • - Tank to dist. box Dist. box to field/Pit:,' Openings sealed? YES NO Partial LOCATION/SEpARATIONB':;. Foundation to tank/ 1 ft. Foundation to absOrption ft. Absorption to lc* 114 ft. Separation of pits !!', ' ft. LOCATION OF SYSTEM ONPROPERTY(circle one) Front - Rear Left side - Right side - COMMENTS: t' t - zasitit/2-77-1[4-f 5 PT-. <-• _•• ,\ • SYSTEM USE APPROVED NO , • Bu lding In ector 01/86 md vl • • 4-i-GEP,--`T (..c'ickos.� kt t- Cd N7Oit1 s Ef ic ,f zvA/) /rU s . 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