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1991-431 --- -,-• CERTIFICATE OF COMPLIANCE • TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 71 9 ez \k„ Likq This is to certify that work requested to be done as shown by Permit No. 91-431 has been completed. This structure may be occupied as a Septic Alteration 43 Caroline Street Location Peter Temeles Owner By Order Town Board TOWN OF QUEENSBURY • Director of Bldg. & Code Enforcement � PPP BUILDING PERMIT TOWN OF QUEENSBURY 1-431 No. 9 WARREN COUNTY, NEW YORK ' o PERMISSION is hereby granted to Peter Temel es . OWNER of property located at 43 Caroline Street Street, Road or Ave. OD Iv 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. cD 1. OWNER'S Address is CD Same fD fD 2. CONTRACTOR or BUILDER'S Name Queensbury Sewer 3. CONTRACTOR or BUILDER'S Address fD N 4. ARCHITECT'S Name N fD _ e+ 5. ARCHITECT'S Address �• t"! CD 6. TYPE of Construction-(Please indicate by X) r1• ( )Wood Frame ( ) Masonry ( )Steel ( ) 7. PLANS and Specifications No. Septic alteration to include: 120' of Tile Field as per plot plan specifications and application 8. Proposed Use Septic Alteration $ 25.00 PERMIT FEE PAID -THIS PERMIT EXPIRES June 20, 1g 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 2 0th Day of � June 19 91 SIGNED BY for the Town of Queensbury Building and Zoning Id 'ctor , OF QUEENSBURY fiailifti - j APPLICATI i RSEPTIC DISPOSAL PER MIT DATE: %svoko,_ 0 - . 3/ r LOCATION OF PROP Y FIR INSTALLATION 4 3 - Owner' s Name: .�. ��� L. �� erne/eS Address: 8 ---. Installer' s Name: Ott ee, &-v Telephone: 7 &2L?'VF Number of bedrooms (residential only) 7 Total daily flow (compute @ 150 gal per bedroom) ?0-0 Topography: Circle one: 4 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? Feet Percolation test: Circle one: not required 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. PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal ) TILE FIELD: Each Trench Q feet/Total system length //f2fc) .. feet SEEPAGE PIT(S): Number of /Size each feet by feet Size of stone to be used if /Depth or Thickness feet ***************************** HOLDING TANK SYSTEM IF REQUIRED NO. of Tanks Size of Each Gal . *Alarm system and associated electrical Mork 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. SIGNATURE OF RESPONSIBLE PERSON: DATE: J 11 /— 7/ 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 Co the Building Department at lease 24 hours before start of construction and shall include a plot plan showing: 1.) the proposed location of the system 2.) location• and distance co 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 drywalls B. Nu system shall be covered before inspection and approval by the auilding Inspector. Failure to comply with this requirement may rusult in the uncovering of thd system by the installer and a fine uf up co $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 installa— tion, alteration or repair of an approved system, a new proposal must bu submitted co the Queensbury Building Department before, further construc c ion. Town of Queensbury BUILDING and CODES DEPARTMENT Bay and Haviland Roads Queensbury, New York 12804 kumarks: • • �o -v90 • awn o/ Q /,urcy BUILDING and ZONINDEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 • SEPTIC DISPOSAL SYSTEM INSPECTION NAME S I emei es) 90 LOCATION 24 �j ectiY P DATE (p / O PERMIT NO. / SOIL TYPE - eilal- Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, 'total length /3(13 Length of each trench 'yD Depth of trenches a 51 / Size of gravel . 1` SEEPAGE PITS4Number of) Size- ft. X Gravel size PIPING: ;,Size, Type Bldg. to tank Jct,'t' Tank to dist. box � p�C Dist. box to field/pit `'G leh5S Openings sealed? igy " ;ENO Partial LOCATION/SEPARATIONS: . ' Foundation to tank {'`L[ 1`'f t. Foundation to absorption fd12%.ft. Absorption to lot line jb ft. Separation of pits LOCATION • SYSTEM;ION PROPERTY(c`ircle one) Front 411011 Left side - Right 'side - COMMENTS: • � ill 1 � 1 l,\ SYSTEM USE APPROVED' • Buildin Ins ector • 01/86 and vl awn o/ Queenilury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME Sw�� (J-efi . LOCATION ' 2 ovc n\_4 r\ e SAY P DATE ( (? / )61 PERMIT NO. qi -4s 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 Depth of trenches Size of gravel SEEPAGE PITS{Number of) Size- ft. X ft. Gravel size PIPING: Size Type Bldg. to tank Tank to dist. box Dist. box to field/pit Openings sealed? YES NO Partial LOCATION/SEPARATIONS: Foundation to tank ft. Foundation to absorption ft. Absorption to lot line ft. Separation of pits ft. LOCATION OF SYSTEM ON PROPERTY(circle one) Front - Rear - Left side - Right side - COMMENTS: SYSTEM USE APPROVED YES NO Building Inspector 01/86 and vl ---2r--'--vL-- 'et---- - 0 Q i ,,,,j . ?° 11� (� O / 1 f V t u c