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1991-537 CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date / 19 ql This is to certify that work requested to be done as shownby Permit No. 91-537 has been completed. This structure may be occupied as a craptic al f:PrAtirm Location 18 Lady Slipper Drive Linda Power4 Owner By Order Town Board • TOWN OF QUEENSBURY L7/2 Director of Bldg. & Code Enforcement tr BUILDING PERMIT • TOWN OF QUEENSBURY No 91-537 WARREN COUNTY, NEW YORK PERMISSION is hereby granted to LINDA POWERS OWNER of property located at 18 Lady Slipper Drive Street, Road or Ave. 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. 1. OWNER'S Address is same 2. CONTRACTOR or BUILDER'S Name W.W. hlaille 3. CONTRACTOR or BUILDER'S Address r 0) 4. ARCHITECT'S Name 5. ARCHITECT'S Address ZO 6. TYPE of Construction— (Please indicate by X) cu ( )Wood Frame ( ) Masonry ( )Steel ( ) ¢ to J 7. PLANS and Specifications —• No. Septic alteration including 200 feet of tile field with #2 stone at 2' as per plot plan, specifications and application. -5 8. Proposed Use Septic system fD $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES July 29 19 93 to (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 29th Day41/ of, / July 19 91 in" �--� CSIGNED BY f>Gr for the Town of Queensbury p, Building and Zoning'in'spector 0 4/6 elleth V7� TOWN OF Qu ` , MvED S8UR APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # 9163"? JUL 2 51991 Fee Paid 5 / Date: v� .2c-' BLDG. & CODE DEPfTeviewed By LOCATION OF PROPERTY FOR INSTALLATION: /Y GAP/51/2;pets 17f Owner' s Name: L#No A ,d we iz S Owner' s Mailing Address: /V Lnoy -'/,'pej' L7/ . ??e-.1134,/y /1iy /may Installer' s Name: W, Ii' Ait/A Ztcq/9 T"-,v2 Phone #: Zgao©�nj Number of bedrooms (if residential ) : / Total daily flow (residential-compute @_150 gal . per bedroom): Topography-Circle One: Flat 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: Municipal Well Other /a te Av9 ,,/ If domestic water supply is a well - Separation: Water, supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank /o a G gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench s . feet//Total System Length ,20 e2 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: , z2e G�%4z16o_ DATE: 05- 9/ 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: .• _loom o, Queeni‘ury BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 ' j 'Oueensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME Lik-1Cs`OS A- ei LOCATION /�F (<c�SX ,rei DATE r7 / 3/ PERMIT NO. 9[53? SOIL TYPE �. Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length ZZ,a-n Length of each trench ,5,6 Depth of trenches ' ) _a Size of gravel 4/ SEEPAGE PITS-Number of) ' Size- ft. X ft. Gravel size , PIPING: Size `% Type Bldg. to tank ��v�,�"Lf / f(1_ Tank to dist. box Dist. box to field Openings sealed? YE r NO Partial LOCATION/SEPARATIONS: it Foundation to tank }' _)b�ft. Foundation to absorption �''`/� ft. • . Absorption to lot lime r ft. Separation of pits;/ \ ft. LOCATION • YST /ON PROPERY(circle one) Front Left side - RE ht. side - COMMENT • • SYSTEM USE APPROVED YES Bui ing In pector 01/86 and vl I 1<• . - . . 0 ; / .i. ",4": i . df.+ ___________>:, _, 1........._ 6 4 ------ '..4'.(-- • 4-6 - — .1.--s----.... —it .s— 1 • i i i d ,q Po tA) ,:, 0, 0 N Eli 11-4 LU‘... CT) e•-••• LU 7 z........_.' ..........,.... .,; p R ic - fes I / ' ' /9/'- 0 1.1.1 0 1 . 6 I 0 GN2 0 / 1 i ? °Cr = i i I '.-. I 1 • Z —) I g 1 -,, I -/',co fi-7 A I— .TiQr-ilfc 1 . I 0 ,_ 03 I • I „•, l',. 1 7.i e./ 1-1- ' i cll.": !,' t' •-7 ' /(.7.,' l'-i' :' • 1 3 l'..\ 1 - ' a L . i-Ys, % i•:,'-j".•'. • 1 I : & •• ; i t ' : \ 1.- ,,, .ci: I;1„ .--• ' • ' , ,. . ; 1 ..&- • i 1 72:."%." ILI,'"7: •.:,,": •.I . . 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