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1992-220 _. .. _, .l. i r.�A(;yr0.I""�':a .:..'SR'"n ..}r r%A .,.Y,:fe, �A-;.,yP � .....'r.-.q�.-.'e77 .. '. oe Wl CE R,TI FICATE OF COMPLIANCE TOWN OF +QUEENSBURY WARREN COUNTY, NEW YORK Date 14 /=!L 50 or This is to certify that work requested to be done as shown by Permit No. 92'220 has been completed. This structure may be occupied as a _ Septic Alteration iteration Location 15 Montray Rd pa,r„ Charles Moore BY Order Town Board TOWN OF 4QUEEN-SOURY Director of Bldg. do Code Enforcement m BUILDING PERMIT &C TOWN OF QUEENSBUR.Y No. 92-220 ' WARREN COUNTY, NEW YORK 3 V t PERMISSION is hereby granted to Charles Moore OWNER of property located at 15 MOntray Road 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 M approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. flf fn 1. OWNER'S Address is Same' � 2. CONTRACTOR or SUI LDER'S Name Condon ' s Septic A Drain Service r~*I a 3. CONTRACTOR or BUILDER'S Address ' d �+C 4. ARCHITECT'S Name try RI S. ARCHITECT'S Address t'f r e* 6. TYPE of Construction — (Please indicate by K) ( ) Wood Frame ; I Masonry ( I steel ; 1 T. PLANS and Specifications Septic Alteration to include : NiD- 1000 gal . tank with 2 seepage pits each 8' x 8 ' using #3 stone 2 ' thickness as per plot plan specifications and application S. Proposed Use Septic Alteration $ 25. 00 PERMIT FEE PAID --- THIS PERMIT EXPIRES May 11 . tg 94 (If a longer period is required an application for an extension must be made to the Building and Zoning inspector of the [own of Oueensbury before the expi rat lon date.l Dated at the Town of Queensbury this lth D ofof May 1992 SIGNED BY for the Town of Queensbury Building and Zoning ctor TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # /Fee Paid --- ' Date : {/ Reviewed B i JVvT4-0V-0rIEENSBUH LOCATION OF PROPERTY FOR INSTALLATION : RECEIVE© Owner ' s Name : CPAR LE5 02 QDoQ (S - -�7FL. 9- 1992 Owner ' s Mailing Address : 1 S� I� [3A � I°ry D ^G. & e�&DE DEFT. Instal ler ' s Name : © ky f X c� 41- 3),44,OV SFA Phone # : 7'7 Number of bedrooms ( if residential ) : I Total daily flow ( residential - compute @ 150 gal . per bedroom ) . Topography- Circle One : 0at Rolling Steep Slope % of Slope Soil Nature- Circle One : Sand Loam Clay Other /Depth . Ground Water-At What Depth ? Feet Bedrock or Impervious Material -At What Depth? /lff Feet Percolation Test- Circle One : Nat Requir Required/Rate Min . Per Inch Domestic Water Supply-Circle One : Munici Well Other If domestic water supply is a well - Separation : Water supply from any septic absorption feet Ar EW PROPOSED SYSTEM: Septic Tank 10C)p gal . ( Minimum size : 1 , 000 gal . ) Tile Field : Each Trench feet//Total System Length �y feet Seepage Pits ) ; Number of Size each : ft . x p ft . Size of Stone to be used : # / 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 a certified 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 : 5 / � 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 : ._../own o/ Qmeensh"ry BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. I Box 98 Oueensbury, New York 12601 SEPTIC DISPOSAL SYSTEM INSPECTION NAME Nj0 kD,4 �9 f LOCAT ION ./. �1 ZXAXILW DATE �-�/ `jj. PERMIT W. 9.2 SOIL TYPE - "nd//� 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 PITS4Nun ]K Of) Size- ft_ 3{ r ft_ Gravel size PIPING : Size _ P e Bldg . to tank _ r7 {Tank to dist . box 01sto box to field Openings sealed? Y artial LOCATION/SEPARAT IONS : a _ Foundation to tank ft. f" Foundation to absarpt ' n ft . �'C+t Absorption to lot li ! ft . Separation of pits �ft. LOCATION OF SYSTEM PROPER(circle one) Front - Rear - Lef side - Right side - COMMENTS : ti SYSTEM USE APPROVED S NO `• 1 B zldi spng in 01/86 and vl plo OF WINE Jill III mLLI za m a H wW � w LU ? r, a OC o u ro- 0 0cr 4 a LUM � u ti ILL wr Allis za 0 m o q; 000 �3 pill ' �3 S (?11YKp#pJ 7:?Ogy S �c�TNv ZMY6IS %T4L - 3 y 00 ul rioYfH