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1992-204 ., -.. .._r. :" F. . -.TT.". o-kw .. �..W.'r �"„=w,�+ .. n. v._ _"•!fTi'._ 7-_7rwp . T � CERTIFICATE C]F` C0MPLIANCE TOWN OF QUEEN58URY WARREN COUNTY, NEW Y©RK i 'FYI ct r� l� 19 3 Date _ E S 1 5 , rq3 This is to certify that worst requested to be done as shown by Permit No. 92-204 I has been completed. ( This structure may be occupied as a Septic Alteration ! Lxtcation 12 Greenway Road Owner Gordon Poole By Order Town Board 'r4�WN OF QUEEN58URY Director of Bldg. & Code Enforcement "04 Val fW BUILDING PERMIT " TOWN OF +QUEENSBUR'Yr 6 No. 92-204 WARREN COUNTY, NEW YORK ..t r*s 1 PERMISSION is hereby granted to Gordon Poole OWNER of property located at 12 Greenway Rd Street, Road or Ave_ in the Town of Oueensbury, To Construct or place a Septic Al terati fin 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 ell II�� M .lam 2. CONTRACTOR or BUILDER S Name Horning Star a CONTRACTOR or BUILDERS Address ~ N.T fb 4. ARCHITECT'S Name r*C 5_ ARCHITECT'S Address N 5. TYPE of Construction — [Please indicate by X) � ash ter. i ) Wood Frame i 1 Masonry I } Steel 1 ] f9 7. PLANS and Specifications Septic Alteration to include: rim 40. 1000 Gal . Tank with 200 ' of Tile field using #2 stone , 14" Thickness as per plot plan nPeCificatinns and application B. Proposed Use Septic Alteration $ 25- 00 PERMIT FEE PAIL} — THIS PERMIT EXPIRES May 5 ,�� (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_I Dated at the Town of Queensbury 5th pay o May 19 92 f SIGNED BY for the Town of Queensbury Building and Zo Inspector TOWN OF QUEENSBURY �., -- APPLICATIOH FOR SEPTIC DISPOSAL PERMIT -cyye, Bum . DATE : y 2 LOCATION OF PROPERTY FOR INSTALLATION / Gf r , - z. Srrs E 1 992 Owner ' s Name : v c{v v avL oa .., __ ,(]E KEPT. Address : / ,�L G rrti ✓ rz i� C_� ssc�7 r 7 ✓� Installer ' s Name : Telephone : c.> Number of bedrooms ( residential only ) Total daily flow ( compute 0 150 gal per bedroom ) Topography : Circle one : Flat Rollin Steep Slope t of Slope Soil Nature : Circle one : an Loam Clay Other /Depth : Ground Water : At what depth ? Feet Bedrock or Impervious Material : At what depth? Feet Percolation test : Circle one : not required required Rate - Min . Per Inch Domestic water supply : Circle one : nic p 1 Well Other If domestic water supply is a well : Separation : Water supply from any septic absorption feet . PROPOSED SYSTEM: Septic Tank T �dCoc� gal . (minimum size : 1 ,000 gal ) TILE FIELD : Each Trench 5-e3 feet/Total system length ',Ad>0 feet SEEPAGE PIT( S ) : Number of /Size each feet by feet Size of stone to be used a /Depth or Thickness feet enk,�errir*sr��,r+r,rirdrk,ir,tr�rx�dr�ryrr�r,�r ao-,ina�r HIOLDING TANK SYSTEM IF REQUIRED N0 . of Tanks Size of Each Gal . *Alarm system and associated electrical work 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 Ordinance . z SIGNATURE OF RESPONSIBLE PERSON . a___�z C�� �„ DATE : Seestia System! Insn.rc t ions : A , All applications for septic systesl installation , alteration or repair , as required by the 'Town of Queensbury Sanitary Sewage Ordinance , small be subnitcad Co the "uilding Department at least 24 hourm before start of construction and Shall include a plot plan showing : 1 . ) the proposed location of Cho syste■ 2 . ) location and discance to loc lines 3 , ) location and distance to structures 4 , ) location and distance to ,any water supply 5 , ) size and dimensions of all tanks , distribution boxes , Lila fields anal /or drywells B , NV system shall be covered before inspaccion and approval by Cho Uuilding Inspuctor . Failure to comply with this requirrment sexy rfaeu in the uncovering of the system by the installer and a fine! ut upp to � 250 , QO . C . An approved copy of the plot plan shall be available on the construction Aiice . Failure cc Produce said plot plan at ties of inspection say rusult in an imseediace work stoppage , D , should unforeseen problems during construction prevent proper inscalla— cion . alteration or r,epuir of an approved syscas, a new proposal must bu su'bmLcred to the +Quoonsbury building Departmone before further COita t ruc t ion , Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Qu& ensbury , Now York 12804 BUILDING and ZONING DEPAfiTM£NT Bay and Havikand Road, R.D. 1 Box 98 Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION La �y DATE */Y—Z�PERMIT NO , SOIL TYPE - Sand -- Loam - Clay _ Percolation Test Required? YES - NO Percolation rate - Min/Inch _ TYPE of SYSTEM: Absorption field , total length "'?.r"i''� Length of each tr ch cY - Depth of txenches Size of gravel --- SEEPAGE PITS#Number ) Size- ft_ X r Gravel size PIP I'NG : S ze Type Bldg . to tank Tank to list . boas Dist. box to field/p -- epenings sealed? ES NO Partial LOCATION/SEP^ARATIONS : Foundation to tank " ft. �, A{ Foundation to absorption ft . [f All Absorption to lot line ft- Separation of pits f LOCATION OF SYSTEM ON PRCYPR (circle one) Front - Rear - Left side - Right side CCMMENTS : P� P � SYSTEM USE APPROVED YES NO Bui ding 01nectcr 01/86 and vl Ln LU � x z FF tailIt GIL cu W r Im rm 'De 1<' C4 Wt I i.. �+x. kEr. 4 - k..' j r �q/ jGe.. ri�� /yl< S G. '�.. '1' 't Im .: © ; > k �n w k r rcy F el I , 1'?JC-2V r^.�Hi p _ 5 ^i SaFrxE wrtjr� F ..-� - �- .M 1' % ',L �' '`g Mrr t :» f"F w.It %1 .1 1� ) r I - I, % IG IaVA :x r.s4 .�.� is lw, . <N s`9tya t w w -•ra,,,•^ . 'rr' y r x '. ' ;j.` m ;y it . _ v a '� -_-_..., Y, e. .: Y- f"' "T f' t r:''� r . It I.e I f 4 �Yy. _ T •S : lw GG le I IL a yyj[ L'� i ,r GIGG..�b+S.V� fv.{•. ?+.. �a.'�. " 1 h y t:; ^ x:Fy v nr^ati` t{. $�'x ._ k+�a .GGM +i`�iG X,+L�t ,y. K ,. 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