1991-469 -CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date abeira, ID 19 9/
This is to certify that work requested to be done as shown by Permit No. qi-404
has been completed.
This structure may be occupied as a Septic Alteration
Location 55 Richardson St Ext
Robert L. Moors
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-469
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Robert L. Moors
OWNER of property located at 55 Richardson St Ext. Street, Road or Ave.
0
i
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 X
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. g
1. OWNER'S Address is
Same
v
2. CONTRACTOR or BUILDER'S Name
Carl Dingman
to)
3. CONTRACTOR or BUILDER'S Address 0
V
Cr
X
4. ARCHITECT'S Name
tI:
CD
ro
5. ARCHITECT'S Address
ei
CD
6. TYPE of Construction— (Please indicate by X) a
r+
( )Wood Frame ( I Masonry ( 1 Steel ( ) o
7. PLANS and Specifications
Septic alteration to include:
No. 1000 gal tank with 250 ' of tile field using 03 stone, 2' thickness
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 1, 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 1St Day of July 19 91
SIGNED BY for the Town of Queensbury
Building and Zoningg ctor
•
yOWN OF QUEENSBUF
Ant:
RECEIVED
5.1t � TOWN OF QUEENSBURY (�I / c}
APPLICATION FOR SEPTIC DISPOSJIME I$I1991 Permit # //- __
Fee Paid /
BLDG. & CODE DEPT.
Date: 6 - 02.g--s Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: SS- M.cA04gZQ/S oe S4 1 /_7 , Cal s�/�G(
Owner's Name: cwN '
Owner's Mailing Address: S It `dh,4_1t j S of:, ExiL G/'e-ivS /04
Installer' s Name: ( IA-t OJAI ? ,1l Phone #: �� --( 9/P3
Number of bedrooms (if residential ) : -
Total daily flow (residential-compute @ 150 gal . per bedroom): '0---0
Topography-Circle One: ra, Rolling -Steep Slope % of Slope
Soil Nature-Circle One: Sande' Loam Clay Other /Depth:
Ground Water-At What Depth? 4( 1- Feet
Bedrock or Impervious Material-At What Depth? /1"f•— Feet
Percolation Test-Circle One:Z1 of Require tequired/Rate Min. Per Inch
Domestic Water Supply-Circle One: unicipal Well Other
If domestic water supply is a -
Separation: Water supply from any septic absorption y 4/4f- feet
PROPOSED SYSTEM: Septic Tank /O O 4 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench S cj feet//Total System Length a c K) feet
Seepa • s : o Size e ft x ft
Size of Stone to be used: # 3 / Depth or Thickness ' 9-_ feet
.*********.
! G TA • RE'
- No. o` • ks e of Ea : - . Gal .
• - - - Id ass. ' . ed elect .- work to b- 'spected . ertified
cy.
***********. **
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: YOL.A.11141031JDATE: (Q
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, 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
Queensbury NY 12804
Remarks:
l .
Jocun of Q y
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
P
NAME PA� D`3'7'5
LOCATION �' l%a�" ;fl ; _,.
DATE �/ / r/ (�PERMIT NO. "I 1 L/6. r%. •
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch ! :
TYPE of SYSTEM: /
Absorption field, total lengrth -',1,<-0
Length of each trench ,,/3- '
Depth of trenches ' L_-
Size of gravel 1 -0-7..--i
SEEPAGE PITS{Number of)!` __
Size- ft. X 1:'�
Gravel
Pa-PING: ° Size Type
. Bldg. to tank \.4/ L-f P t/._Tank to dist. box u Pe,
Dist. -box to field/pi Lc Y/C/C --_ _ _
Openings sealed? DE.—.1 NO ` Partial
LOCATION/SEPA TIONS:\ /•
Foundation to/tank \ ( ft.
Foundation to absorption (,C7 ft:
Absorption)o lot line \ t'f<-ft.
Separation of pits \ /'), ft.
LOCATION OF SYSTEM-0 ROPE TY(circle one)
Front - Rear - Left side - Right side -
COMMENTSf
1i LOCf G AA L�
�� A� ' 1
e,/ ,--1P2A/V, .
SYSTEM USE APPROVED NO
i gl----
/';') -
�c-
Builiding fns eceor
• 01/86 and vl
- : \0 , .. ___
�/ F� p
�� S
!--_4 r-- (1_
- -- ---- --- - -
'--'b ;r.; o fg
-7-7-----4 /
C> j4' l°2 p
I.
T
--- . - r
vt
' .----)C-)1---`_\ - _
,\
V
' y1
O , \ ) ) _-�
vl �,
`� - - 0 G � -
if P
T --r,
• - - - - 1 _
f
, .
. .
, .
- - V ill >C1) 1 OWN1 OF 0.A.EENS UN! .
,rt 45 RECEIVED .
: ---5 -- .
JUN 2 8 1991
e . .
v-, 7..-, •_+-. .
_
m---. BLDG. & CODE DE T,
--,--k- •
..._ —
z c, v-,• ..6, -1%, , •
. .
• c--,
-..,.--VairiP.-_,--
.. -.>-,..,.
....."'5 ,....... •. ..(:-.----:........- 4.? .../L.le.7 1 >f%
L.. .. 'fi . .
E . . .. .
- "
. .
0 • ‘1 ' .
00 it.) -17,P --- ..../.
,g---.
t, i . ' .....
0 -k-D . • ic21-
(ir • ' ,,, ,
,cY ,
, -
( ,'-•D "? ,, C', I: -- o.,/ - 11 ./
- / 1,11) -I--
--- o ..* ' ` ' - -_,) Q . ,'..,:, " i 1,
,, ,
,.,,., 1 ,j
& 'tD'e .ci\ ' f.) n
_ , ....;,=:.--- ;,i-
-Y---.
• L? 1 i,----,A...'' '' ':: -;-.7,.: c.•i. 7,7 tr::,7;U R
- :6 • .
, - 0 I!.-'''f. :''. • • ' -- :-... i- ,:- : - ::-
.7 • . ..... ,
14 14$ ' . DATE A
• 0 % , .
- \
../ . . .
• liteit . , 1
. .
. .
. • • .-•
- , ,•..