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-...' --- - - CERTIFICATE OF COMPLIANCE
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• . ,' ' TOWN OF QUEENSBURY
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WARREN COUNTY, NEW YORK .
• . Date .1torin 9R 19 _91 ..
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Thisis to certify that work requested to be done as shown by Permit No. 91350
bas".been completed. .
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This structure may be occupied as a Spntic Al
Location RD#5 Box 67 Nall Rd
Owner noman & Joyce Teator •
. . By Order Town Board
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. TOWN OF QUEENSBURY • .
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. ... • Director of Bldg. & Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-350
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to Norman & Joyce Teator
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OWNER of property located at Hall Rd Street, Road or Ave. CO
in the Town of Queensbury,To Construct or place a Septic Alteration r�D
at the above location in accordance to application together with plot plans and other information hereto filed and
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approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
1. OWNER'S Address is O
RD#5 Box 67 Hall Road a
Queensbury, NY 12804
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2. CONTRACTOR or BUILDER'S Name C-1
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Sanitary Sewers •
3. CONTRACTOR or BUILDER'S Address a
4. ARCHITECT'S Name
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
Septic Alteration to include:
No-1000 gal . Septic Tank, 2 seepage pits each 6' x 8' using #3 Stone, 1' Thickness
as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES June 27, 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 27th Day of i> June 19 91
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SIGNED BY - 3 for the Town of Queensbury
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Building and Zoning Inspector
7q3- 5/37- Ai e u , a.9e1.
tpriti TOWN OF QUEENSBURY r
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # CO — 350
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Fee Paid a5, 06
TOWN OF QUEENSBUR
Date: May 25 , 1991 Reviewed By RECEIVED
LOCATION OF PROPERTY FOR INSTALLATION: Hall Road MAY 241991
Owner' s Name: Norman & Joyce Teator BLDG. ,& CODE DEPT
Owner' s Mailing Address: RD #5 , Box 67 Hall Road-Town of Queensbury , NY
Installer' s Name: Sanitary Sewers Phone #: 792-7257
Number of bedrooms (if residential ) : 3
Total daily flow (residential-compute @ 150 gal . per bedroom) : 450
Topography-Circle One: Flat Rolling Steep Slope % of. Slope 5
Soil Nature-Circle One: Sand L-aam C.1-a ' Other /Depth:
Ground Water-At What Depth? Below 10 Feet
Bedrock or Impervious Material-At What Depth? Below 10 Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal isis Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption -= 3J feet
PROPOSED SYSTEM: Septic Tank 1000 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of 2 / Size each: 6 ft. x 8 ft.
Size of Stone to be used: # 3 / Depth or Thickness 1 feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size of Each Gal .
Alarm system and associated electrical work to be inspected by a certified .
agency.
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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: - �,�� P� "r✓� , DATE: G / / ?/
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 all tanks, distribution boxes, tile fields
and/or drywells
B. No 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 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:
awn of Queenibur y
BUILDING and ZONING DEPARTMENT / afi'L/
Bay and Haviland Road, R.D. 1 Box 98 •
Oueensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME96-vac,- \Ir k./
LOCATION
DATE i U /Q/ PERMIT NO. 9/-07S0
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 '
Depth of trenches
Size of gravel
SEEPAGE PITS{Number of) • cR
Size- 6 ft. X - g ft'. 9-c:7
Gravel size
PIPING: 1Size Type
Bldg. to tank 9 5' YO
Tank to dist. box
Dist. box to field/pit,; Y ` is
Openings sealed? - �(NO Partial
LOCATION/SEPARATIONS:
fi
Foundation to tank ,,1 A t.
Foundation to absorpti. ' . •
-
. Absorption to'lot ln- n t.
/
Separation of pits. ft.
LOCATION OF SYSTEM ON • •�•. - circle one)
Front - Rear - Left ide . Right side -
COMMENTS:
!tag •
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SYSTEM USE APPROVED YES NO
. B i ding I Spector
01/86 and vl
DEED REFERENCE:
MARGUERITE C. MELLON
TO
NORMAN E. & JOYCE X ,TEATOR
DATED JUNE A(0, 0978
IN BOOK 615 PACE 704
NOTE:
PROPOSED IMPROVEMENT TO
SEPTIC SYSTEM TO INCLUDE
NEW 1000 GAL SEPTIC TANK,
PUMP WITH ALARM do TWO
6' X 8' DRY WELLS WITH
TRAFFIC COVERS
MAP REFERENCE:
MAP OF A SURVEY OF A PARCEL OF LAND
PREPARED FOR LEONARD H. do ROSE P. JOHNSON
BY RICHARD W. BENNETT
DATED AUGUST 17, 1988
MAP OF MISS EDITH HEROLD' S
SUBDIVISION OF PART OF LOTS 18-19— 34
QUEENSBURY TRACT
BY H.D. CHAMBERS, SURVEYOR
DAT4D APRIL 1925
FILED APRIL 25, 1925
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AS BUILT
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RECEIVED
JUN 2 51991
BLDG. & CODE DEPT.
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