1991-493 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 1i- f./ .ii / 9 gI
This is to certify that work requested to be done as shown by Permit No. 91-493
has been completed.
This structure may be occupied as a Septic Alteration
Location 15 Lynnfield Drive
Owner Mike Hevenor
By Order Town Board
TOWN OF QUEENSBURY
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Director of Bldg. do Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-493
WARREN COUNTY, NEW YORKfD
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PERMISSION is hereby granted to Mike Hevenor
OWNER of property located at 15 Lynnfield Drive Street, Road or Ave. rD
in the Town of Queensbury,To Construct or place a Septic Alteration pp
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
Same
2. CONTRACTOR or BUILDER'S Name
Steven Sanders v
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address y
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6. TYPE of Construction— (Please indicate by X)
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( )Wood Frame ( ) Masonry ( ) Steel ( )
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7. PLANS and Specifications 0
No.Septic alteration .to include: 330' of Tile field using #2 stone, 1' thickness as
per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 10, 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 10th Day of . Jul y 19 91
s
SIGNED BY C �U' .i / for the Town of Queensbury
Building and Zoning Ifispector
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41 j �r� u'� F QUEENSBUR s
TOWN/i F 2c� C�4VED
APPLICATION FOR SEP � SPOSAL PRmIT Permit # !et
/
411
JUL
10 1991 Fee Pail
Date: 2U/p,e) q/
BLDG. & CODE viewed��� o BY
LOCATION OF PROPERTY FOR INSTALLATION: /5` iyn ie//
• Owner's Name: )fl,IS& /4U�rr,
Owner's Mailing Address: /•C e7/ /2 veFvs�vs'/
Installer' s Name: /y �,� S�,r��rrf' Phone #: 7% -2//c5
Number of bedrooms (if residential ): d�
Total daily flow (residential-compute @ 150 gal . per bedroom) : 7�5b
Topography-Circle One: lat 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: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: iia.icipTO Well Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank / oc' gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 2TD feet//Total System Length 3,36 ' feet
Seepage Pit(s) : Number of / Size each: ft. x ft.
Size of Stone to be used: # / Depth or Thickness / feet
**************
HOLDING 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 the Town of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: &;:r t,/ G 4' DATE: ?/D- //
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:
\If c PI .
_own o/. Queenibur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
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NAME 14c,v PA C Y) Ifli kL
LOCAT ION 1 L n YikPki /)ri -e
DATE 7 //2 PERMIT NO./ / I / q�
SOIL TYPE - Sand` - Loam -I Clay _ ,
Percolation Test Required? YES' - ..12.)
Percolation rate - Min/Inch _ /
i /TYPE of SYSTEM:
Absorption field; total length ;>(} -•—
Length of each trench . kC)1 ) „,,,c,P
Depth of trenches -yaj -
Size of gravel --2_¢ /
SEEPAGE PITS{Number 01) I _____-
Size- X t,y-.�7 -
Graves e— �-i
PIPING: Mize Type
Bldg. to tank lit j=rTS y14J70
Tank to dist. box I L4_ ('Vz
Dist. box to field/pint -- r:/ -ni,:1- -
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
1Foundation to tan'? xC`J !L'
Foundation to abst`tttrption ft.-(--
Absorption to to line /0 ft.�
Separation of' pits 9 2/4-ft.
LOCATION OF SYS EM ON PROPERTY(circle one)
Front - Rear - eft side - Right side -
COMMENTS: V
if.- 16-"r: alqd-'7(j1 ' if
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SYSTEM USE APPROVED YES NO
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Building Ikspe,btor`'
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01/86 and vl
_Jouin of Q ee n i urcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R,D. 1 Box 98
. Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME A 4'
LOCATI N �a<6) 2L4T'x- i 9
9� / 4
DATE '7///9/ PERMIT NO. V(--- It7.47/
SOIL TYPE - Sand - Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
I
TYPE of SYSTEM: i
Absorption field, total length •(f
Length of each trench '
Depth of trenches ' 1 "
Size of gravel h f
SEEPAGE PITS{Number ofr'
Size- ft. X _ ft. ) ;E
Gravel size
PIPING: Size '' Type
Bldg. to tank 14 gtCi.J Li0 G /C--
Tank to dist. box • A
Dist. box to field/pit ,/
Openings sealed? YES / NO Partial
!i4
LOCATION/SEPARATIONS: !.''f .•
Foundation to tank ft: :--L'--'
' Foundation to absorption ft. .
. Absorption to lot line lift.
Separation of pits/ ‘ft.
LOCATION OF SYSTEM ON PROPERTYVcircle one)
Front - Rear - LeTt side - Rigl;t side -
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COMMENTS: f
„(11.,) •, , 1._.
1(ZOO 741—'I (-'.'°C-11214-)--.---'-.-1"-it.1 IL6/tit- -41. .
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SYSTEM USE APPROVED YFS- 'NO
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B4ildin4' Ifspector
01/86 and vl
z 0 „Zyri -Pie/e/:
-TOWN OF QUEENSSU
RECEIVED
JUL 10 1991
BLDG. & CODE E)EPT.
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5411 1?/-
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