1992-218 1
CERTIFI+C.ATE (JF COMPLIANCE 1
TOWN OF OUEENSBURY
i
WARREN COUNTY, NEW YORK
G Date
i
i
92-218
This is to certify that work requested to be done as shown by Permit No*
hss been completed.
i
I Sipptic Alteration
This structure may be occupied as a
Lot 0127 Homstead Park 'zWLocation
Owner Homstead Village
By Order Town Board
I1 TOWN OP QUEBNSBUfty
l
Director of Bldg. & Code Enforcement
i
i
S
BUILDING PERMIT
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YOR K
PERMISSION is hereby granted to Homestead Village 1�..
OWNER of property located at Luzerne Rd Lot #127 Street, Road of Ave.
in the Town of Queensbury, To Construct or place a S Dt� 7 C 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.
tp
1- OWNER'S Address is
!>Lt
�N
J
n�
2, CONTRACTOR or BUILOER `S Name '
Ivan Bell
r
3- CONTRACTOR or BUILDER'S Address QY
i'I'
■tF
t�
fV
V
4, ARCHITECT'S Name
r
5. ARCHITECT'S Address
hl
f9
rP
&. TYPE of construction — (Please indicate by X)
I ) Wood Frame ( ) Masonry i 1 Steel ( )
CA
7- PLANS and Specifications fli
Septic Alteration to include:
No- 1000 gal _ tank with 200 ' of tile field using #2 stone , I ' thickness
ifications and application A
S. Proposed Use
Septic Alteration
$ 25 _00 PERMIT FEE PAID — THIS PERMIT EXPIRES Mav 11 , ig '94
(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 h Iy of
May ,s 92
SIGNED BY f r~ for the Town of Gueensbury
Building and Zoni nspector
TOWN OF QUEENSBURYr'
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit #
Fee Pai
Date : _ - / / - ! 1 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION : Z u r /It
Owner ' s Name : H o ,ro, -t. 5- t{ c. � 7`r 4 � �
P F. l^c:,, , gUh :
Owner ' s Mailing Address : t-/ 7 - 11
Installer ' s Name : . 27(jr a a 11 Phone # : MAY 11 7
992
Number of bedrooms ( i f residential ) : 7 �t & 1.0t3E DEPT.
Total daily flow ( residential - compute @ 150 gal . per bedroom ) : 'C/ 6 Q
Topography-Circle One : Ta Rolling Steep Slope % of Slope
Soil Nature-Circle One : Fj d Loam Clay Other /Depth :
Ground Water-At What Depth ?
Bedrock or Impervious Material -At What Depth? �16�) Feet
Percolation Test- Circle One : of equire Required/Rate Min . Per Inch
Domestic Water Supply-Circle One : unici Well Other
If domestic water supply is a we
Separation : Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank ;,-,�, �r� gal . ( Minimum size : I , O00 gal . )
Tile Field : Each Trench �IrL) feet//Total System Length - - feet
Seepage Pit ( s ) : Number of Size each : ft . x ft .
Size of Stone to be used : # / Depth or Thickness -r feet
HOLDING TANK SYSTEM IF REQUIRED
No . of Tanks Sizelof Each Gal .
Alarm system and associated electrical work to be inspected by a certified
agency. ***ror* ***
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 .
DATE :
SIGNATURE OF RESPOKSIBLE PERSON : =/� _
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 :
flown o/ Queen36urt�
BUILDING and ZONING DEPARTMENT
Bay and liaviland Road. R .0, 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCAT ION
DATE , I PERMIT NO .
SOIL TYPE San - Loam - Clay -
Percolation Test Required? YES
-
Percolation rate - Min/inch _
TYPE of SYSTEM:
Absorption field , total length
Length of each trench alz:>
Depth of trenches -
size �F-- -
of gravel
SEEPAGE PITS-ENuinber of)
Size- ft. X
Gravel size
PIPING : size r7 Pe
Bldg * to tank �!
Tank to list_ box -=E
Dist , box to field/►it
Openings sealed? Gig) NO Partial
LOCATION/SE'PARATION S : . f t
Foundation to tank ft . �
Foundation to absorptic' n �, � T,
Absorption to lot line ft.
tj
Separation of pits ft.
L10CATION OF SYSTEM ON P PERTY (cirele one)
Front -- Rear ft Bid Right side
J COMMENTS
SYSTEM USE APPROVED 'YES NO
c" `"'
Bui ding in pec r
L
01/86 and vl
I OWN OF QUEENSBL h ,
RECEIVED
MAY 11 1992
+; 1, BLDG. & (3 E DE
t>) � )o
I
6