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1992-201
.k I CERTIFICATE UP C(JIMIIPLIA �TCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK. i Date-�_ Jam - 19 92-201 This is to certify that work requested to be done as shown by Peg is No. f has been completed- This m 9 his structure ay be occupied as a Septic Alteration Locat;on 2 Hughes Court Owner James Wilson kHy ©rder Town Board k TOWN of QUEENSBURY 1 / Director of Hldg. & Code Enforcement E BUILDING PERMIT MCI TOWN OF QUEENSBURY Na. o WARREN COUNTY, NEW YORK ti r. PERMISSION is hereby granted to James Wilson r� OWNER of property located at 2 Hughs Court Street, Road or Ave. VC 46 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 approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. 1. OWNER'S Address is N SAme Na 2. CONTRACTOR or SUI LDER'S Name Queensbury Sewer +�+ n a 3_ CONTRACTOR or BUILDER'S Address Cif e+ 4_ ARCHITECT'S Name NI M S. ARCHITECT'S Address tl e+ fD 6. TYPE of Construction — (Please indicate by X) t [ y Wood Frame ( ) Masonry t ) Steel ( 1 7. PLANS and Specifications Septic Alteration to include : No- 1000 Gal , Tank with 1 seepage pit 8 ' x 8 ' using #3 stone , 2 ' thickness as per plot plan specifications and application 8. Proposed Use Septic Alteration $ 25- 00 PERMIT FEE PAID — THIS PERMIT EXPIRES MaX 4 , (lf a longer period is required an application for an extension must be made to the Ruilding and Zoning inspector of the town of Queenshu ry before the expiration date.) Dated at the Town of Queensbury this Da of May19_._92 ti SIGNED By for the Town of Queensbury Building and Zoning rotor / '} TOWN OF QUEENSBURY h S ? APPLICATION FOR SEPTIC DISPOSAL PE?btT44 OF � F+ee Paid Date : �'� ' `� ! MAY Oyu $Ld By LOCATION OF PROPERTY FOR INSTALLATION : (( G - m Owner ' s Name : Owner ` s Mailing Addres Installer ' s Name : ..� Phone Number of bedrooms ( i f residential ) : /�- Total daily flow { residential - compute @ 150 gal . per bedroom ) : Topography- Circle One : 4 at Rolling Steep Slope % of Slope Soil Nature-Circle One : Sa Loam Clay Other /Depth : Ground Water-At What Depth ? Feet Bedrock or Impervious Material -At What Depth? Feet Percolation Test-Circle One : t Reoui Required/ Rate Min . Per Inch Domestic Water Supply- Circle One :` "'''el 1 Other If domestic water supply is a well - Separation : Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank ,/r� gal . ( Minimum size : 1 ,000 gal . ) Tile Field : Each Trench r feet//Total System Length feet Seepage Pit ( s ) : Number of ! / Size each : fto x ft . Size of Stone to be used : # / Depth or Thickness feet FOLDING 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 th Town of Queensbury Sanitary Sewage Disposal Ordinance . SIGNATURE OF RESPONSIBLE PERSON : ATE = GN Q r / e 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 , the fields and/or drywel 1 s 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 ; Y awn 01 �ueens � ctr� . BUILDING and ZONING DEPARTMENT Bay and Haviland Road. R. D. 1 Box 98 oueensbury, NeW York t2801 { SEPTIC DISPOSAL SYSTEM INSPECTION NAME LOCATION nATE � _ PEWIT NO. SOIL TYPE Sand Loam - Clay Percolation st Required? YES - Percolation rate - Min/Inch TYPE of S'Y STEM : r Absorption field , total length /2 Length of each trench�/ Depth of trenches Size of gravel 3 SEEPAGE PITS4 'umber Of) Size- ft. X - ft. Gravel size PIPING : Si a Type Bldg . to tank -� Tank to dirt. X ------~ Dist* box to fi Id/pi N Partial Openings sealed. Y LOCATION/SEPARATI Foundation to tan _fGYft. Foundation to ab tion Absorption to 1 t 1 ' 1- �f-to Separation Of -its ' one) LOCATION OF S STEM pRdPE . sid - Front - Rear - Left s3,de - 3-9t g ` COMMENTS : SYSTEM USE APPROVED 0y7:S NO Building Ins c Or 7 01/86 and Vl BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R. D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME J" LOCATION c� DATE $ / , PERMIT NO. 9 Z ~ -�py SOIL TYPE - an - Loam - Clay - Percolation Test Required? YES - Percolation rate - Min/Inch _ iv TYPE of SYSTEM: Absorption field , total length Length of each trench pepth of trenches Size of gravel_ T - SEEPAGE PITS4Number of) _... Size- ft« X _ ft. Gravel size PIPING . Size YI�e Bldg . to tank. Tank to dist . box i3isto box to f field :. Openings Sealed? YES Nod Partial f f !' LOCATION/SEPARATIONSe Foundation to tank ft. Foundation to absorption - ft . Absorption to lot line, ft- separation of pits y ft. ON OF SYSTEM ON oPERTY (circle one) Fro - Rear -F=roLeft si - Right Side - ENTS : �X-2�z�/�� /G ,+ SYSTEM USE APPROVED YES Buiildln nSpector 01/86 and vl i Ww � d d aW z a p m Q _ � TOWN {fir r "1111SBURY BU !oLD1 !,4 (2 DATE � S i OWN OF OUEENSBUh RECEIVED MAY 51992 BLDGo & CODE DEPT, TOWN OF QUEENSBURY BUILDIMG & CO . D REVIEWED BY NAT t T77" .. p nnmm� a J ix ay le it ti 0 � } # � A a� w 44 h s �/ �,