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1991-381 2 r S ^( raw ' . [AV 7 CERTIFICATE :OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK • Date IJrJiYL ;, 19 - U This is to certify that work requested to be done as shown by Permit No. 91-381 has been completed. This structure may be occupied as a Septic Alteration Location Ri1 Glen Lake Owner William Sullivan By Order Town Board TOWN OF QUEENSBURY Director of Bldg. & Code Enforcement e BUILDING PERMIT a x a TOWN OF QUEENSBURY No. • 91-381 a WARREN COUNTY, NEW YORK w 00 1 1-1pPilliam Sullivan PERMISSION is hereby granted to I iv OWNER of property located at Cor Sullivan & Glen Lake Street, Road or Ave. NC 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 a approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. N c 1. OWNER'S Address is —a. RD#1 Glen LAke a 6 2. CONTRACTOR or BUILDER'S Name N D. Granger & Sons 0 rD 3. CONTRACTOR or BUILDER'S Address a pr rD rn 4. ARCHITECT'S Name CD IV e . 5. ARCHITECT'S Address r+ rD -1 r+ :• 6. TYPE of Construction—(Please indicate by X) ( 1 Wood Frame ( ) Masonry ( )Steel ( I 7. PLANS and Specifications No. Septic alteration to include: 1000 gal Septic Tank 8. Proposed Use Septic Alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES dune 4, 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 4t�_ Day of 7 .1i ne 19 91 SIGNED BY C ! ):2 " % for the Town of Queensbury Building and Zoning Inspector TOWN of aul=r�sBuR� ow ��j TOWN OF QUEENSBURY �?�C.;Ei� APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # "/AW Feemq�,i i Date: �'� 0 g/ R l.il��e �yOt'1F WEPT LOCATION 0 PRO ERTY FOR INSTALLATION: f(14(( 4iC-F'i1.U,gi1%1' 8L t_ J / Owner' s Name: _ 1U11 tc 3M3)( 1tLaiGlk. Owner' s Mailing Address: R u>*- 1 Gct.t.L L R(.uL_ Installer' s Name: 1, t 'RL- Phone #: --NIz©97? Number of bedrooms (if residential ): -a Total daily flow (residential-compute @ 150 gal . per bedroom) : S b© Topography-Circle One: 411, Rolling Steep Slope % of Slope Soil Nature-Circle One: and Loam Clay Other /Depth: Ground Water-At What Depth? 6 O 4- — Feet Bedrock or Impervious Material-At What Depth? a Feet Percolation Test-Circle One: Not Required Required/Rate//y-Min. Per Inch Domestic Water Supply-Circle One: Municipal 41110 Other If domestic water supply is a well - j Separation: Water supply from any septic absorption .PR feet] s _4j) e-e--3 TVE "AI PROPOSED SYSTEM: Septic Tan 4566 gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench A feet//Total System Length feet Seepage Pit(s): Number of / Size each: ft. x ft. Size of Stone to be used: # . / Depth or Thickness '' 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 revers side of t s sheet and agree to abide by these and all requirements of the Tow of Queen ury Sanitary Sewage Disposal Ordinance. T®watNAeaE. ; f 7 o 1'YON DATE: -C-3 v/ / REVIEWED BY 41 „ .0..A. o-YLQ4 in pe-0-4 1)1(1'`'--- DATE $18(1 _ - _ . • • . awn o/ Queenatury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYST6V. INSPECTION NAME 4/1l'r 71 4/ • LOCATION 5 x' ! 4!c. 0f //�CY DATE t/J / V PERMIT NO. 91%,311 4 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 /', `/ 1 Depth of trenches // 11 Size of gravel I ` SEEPAGE PITS{Number of) 4j , j �' Size- ft. X ft. \ / '7 ( / Gravel size i / PIPING: Side, Type Bldg. to tank .�*s , �KC Tank to dist. box //XL-- Dist. box to field/ ' ; \ Openings sealed? -YES NO Partial LOCATION/SEPARATIONS: ,, I /---/ Foundation to tank ,(L eft',Foundation to absorption t. f/57 Absorption to lot line )' f . Separation of pits ft. LOCATION OF SYSTEMON ,P,KTE Y(circle one) Front Rear Left sie l Right side - COMMENTS: d , --;----SC, -7Ctr Aki-7(?'' ipo* '., 4/rti-fP/7,112, ',,,/, i i - - vr 71,:aS (3 ,-V(:.'"? A l A . 9. 7 7/ J ,,,,/ MO ,67' \ .,y SYSTEM USE APPROVED 'YE NO i.g'/77; i Building inspector 01/86 and vl 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 2,4 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 �Q j f nsbury NY 12804 Remarks: . • 1 z s—o Case. 4 t` ��,s4, ,1 ` 1 P L. — '6,,,,, ,,,,) c! C - d Jf' / _______ -- Z �l (d tses 9 �..( -.,Sr.,„ 4 , , 6,06 ._ ,