1991-494 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN -.COUNTY, NEW YORK
Date CT} 1 OJT.
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This is to certify that work requested to be done as shown by Permit No. 91®494
has been completed. \,
This structure may be occupied as a SepticAlteration
Location l `- fl®�0 Hill y �\
Owner James whiting
By Order Town Board
TOWN OF QUEENSBURY
(-2
Director of Bldg. do Code Enforcement
7
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-494
WARREN COUNTY, NEW YORK 'I
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PERMISSION is hereby granted to James Whiting
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OWNER of property located at 1616 Moon Hill Rd Street, Road or Ave.
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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.
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1. OWNER'S Address is
Same O'
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2. CONTRACTOR or BUILDER'S Name 0
Condon's Septic & Drain Service
3. CONTRACTOR or BUILDER'S Address a
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4. ARCHITECT'S Name
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5. ARCHITECT'S Address CD
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6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications
No Septic Alteration to include:1000 gal . Tank to replace old metal
tank 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 Day off , % _lul-y 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning Inspector
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4j TOWN OF QUEi ", i
APPLICATION FOR SEPTIC DISP41 p # )1— 299
' 0 Paid .5, c4)
q a 1991
Date: Q` I l l .kiG & CO0TCe Val' .ewed By
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LOCATION OF PROPERTY FOR INSTALLATION: /68 2 /720011) J]ii
Owner' s Name: I ) i 4 LS V rl 64/lv
Owner' s Mailing Address: /6 /( MOO it) 1-11/1 X11 4V7
Installer' s Name: (110n)1641) S :ci Z.r sc,4-b/ lni S5 Phone #: V 1%D - 'cf?
Number of bedrooms (if residential ): • _3
Total daily flow (residential-compute @ 150 gal . per bedroom) : L/ID
Topography-Circle One: 4490 Rolling Steep Slope % of Slope
Soil. Nature-Circle One: and Loam Clay Other _ /Depth:
Ground Water-At What Depth? /v`/) Feet
Bedrock or Impervious Material-At What Depth? /0/ Feet
Percolation Test-Circle One: Not Required Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: Municipal � ` Other
If domestic water supply is a well -
Separation: Water supply from any septic absorption Z Z feet
dvO1Y -r6 QEplaCt c /7D / e kl' rehaK
PROPOSED SYSTEM: Septic Tank/OGG gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length 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.
TOWijkiiiTURF OF R SPONSIBLk P � Orykde-)"_, DATE: 7 —?—?/
3UILD7 rNr '1 CODES WRIST.
REVIEW:. 3 Y f--<'
DATE 1/41/?.)
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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:
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