1992-246 C.TiR I�"ICATE O k CC ►TVtPLI AN+CE
TOWN OF QUEENSSURY
WARREN COUNTY, NEW YORK
This is to certify that work requested to be done as shown by Permit No. 921111111246
has been completed.
This structure may be occupied as is Septic Alteration���``�''�.L=� r � " '�•
L.ocarion _ RD#4 Box 276 Central Avenge
C7wner John Gra
By Order Town Board
TOWN OF iQUEENSSURY
,/' N
Director of Bldg. do Code Enforcement
d
ae
BUILDING PERMIT �
TOWN OF #QUEENSBUR.Y No. 42-246
WARREN COUNTY, NEW YOR K
1
.ar
PERMISSION is hereby granted to John Srav
OWNER of property located at RD#4 DoX 276 Central Avenue Street, Road or Ave_
in the Town of Oueensbu oration r �
ry, To Construct or place a Selat C ral t
at the above location in accordance to application together with plot plans and other information hereto filed and %C
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. G
0
1. OWNER'S Address is
Same
2. CONTRACTOR or BUILDERS Name
Fred Smith
oa
ye
3- CONTRACTOR or BUILDERS Address
N
V
f,71
LY
11y
4. ARCHITECT'S Name e+
W
330
4C
(D
S. ARCHITECT'S Address
tv
tti
6_ TYPE of Construction — (Please indicate by X)
{ I Wood Frame ( 1 Masonry { ) Steel I I
con
40
fD
7. PLANS and Specifications
r�F
Septic Alteration to include;, M
No• 1000 Sal . tank with 200 ' of Tile Field using #2 stone as per plot plan � y.
s cificatiarns and a ication
a_ Proposed Use p
r+
Septic Alteration
$ 25000 PERMIT FEE PAID — THIS PERMIT EXPIRES 14aY 19s 19 94
(1f 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 t 91:h ay
Ma 1992
SIGNED BY for the Town of Queensbury
uiId1ng and Zo nI III lrrspector
TOWN OF QUEENSEURY
APPLICA T'LON FOR MOWN DE G'UEENSBUk ,
RECEIVED
> SEPTIC DISPOSAL PERMIT MAY 18 1992
BLDG. & CODE DEFT.
DATE
LOCATION OF PROPERTY FOR INSTALLATION "� ` 0 ji�� � G3C ► f �J
Owner's Narm~�e: �., O t) ,(/ ,r C � Telephone: 7 ! �` s v
Address: L� el N o C +mil /�1E'-a I �U r
In:: saller's Name:./end �I" Telephone:
Number of bedrooms (residential only)
Total daily flow (compute (d 150 gal per bedroom) `-'' 0
Topography; Circle one: Rolling Steep Slope 06 of Slope
Soil Nature: Circle one an Loam Clay Other. /Depot: Feet
Ground Water : At what depth? ` '` Feet
Bedrock or Impervious Material. At what depth ? ` '� Feet
..-.
Percolation test : Circle one: not required required rate NJ min . inch.
Domestic water supply: circle one< Well Other ,
If domestic water supply is a well: r' 7
Separation: Water supply from septic absorption feet
PROPOSED SYSTERI : Septic Tank-166.0— _ _gal. ( minimum size: 1 , 000 crate)
TILE FIELD: Each Trench 60_feet/Total system length cr 60 feet
SEEPAGE PIT(S): Number of / Size: each feet by feet
Size of stone to be used # .Z—(Depth or Thickness feet
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 Sanitar Sew ge Disposal Ordinance.
SIGNATURE OF RESPONSIBLE PERSON :
DATE: / ,/ .� ,
OVER
^ ._J'ocvn o� �ueprt.s6atrt�
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R-D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME
LOCATION
_ r /�
DATE .�i'.�'�r2 J"�'�' PERMIT N6.
SOIL TYPES - Sand - Loam - Clay
Percolation Test Required? YES
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field , total length n
Length of each trench_ _ r
Depth of trenches -
Size of gravel_
SEEPAGE P ITS4Nuhrber of) ~"`
Size- ft. X ft .
Gravel size -
PIPING : Sizeav Type
Bldg , to tank
Tank to disc . box
Distw box to field/ �l c-
openings sealed? YE 0 Partial
LCT3T1C)N/SEPARATTC)NS : 6
Foundation to tank i e ft
Foundation to absorpti# t f
Absorption to lot lin ft
Separation of pits a t.
LOCATIONYST _i�B�ERTY (circle one )
Front ear 3Ceft ,sidA Right side -
CCMMENT
SYSTEM USE APPROVEraing
N
Buns ct r
01/86 and vl
i -OWN OF QUEENSi
RECErVE€)
MAY 1 8 1992
eLDG. 81 COCle OEPT.
4�
h o
`y
QL
4 TOWN OF +�UEFPSsgi3R'�
co
REVIEWED BV `
�► V
4 (
7 ����