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1991-569 • . -„ 11 • !‘ • • ' • .„.- • CERTIFICATE OF COMPLIANCE , . • TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date if19 7- , This is to certify that work requested to be done as shown by Permit No. -• 91-569 has been completed. • This structure may be occupied as a Sopt.'.c Afteration Lot 150 Luzerae Rd ,Location Homestead VI-nage Owner • By Order Town Board • • TOWN OF QUEENSBURY r77• Director of of Bldg. & Code Enforcement . . • . . ,r , . . BUILDING PERMIT TOWN OF QUEENSBURY No. 91-569 c WARREN COUNTY, NEW YORK r. N PERMISSION is hereby granted to HOmestead Village1-1 OWNER of property located at Lot 150 LUzerne Rd 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 rD N approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. r' C- 1. OWNER'S Address is Du CD 2. CONTRACTOR or BUILDER'S Name Ivan Bell c ra 3. CONTRACTOR or BUILDER'S Address 4. ARCHITECT'S Name N fb 'O 5. ARCHITECT'S Address '—' e+ fD a O 6. TYPE of Construction—(Please indicate by X) ( I Wood Frame ( I Masonry ( )Steel ( ) 7. PLANS and Specifications No. Septic Alteration to include: 1000 Gal . Tank with 125' of Tile Field using #2 Stone as per plot plan specifications and application 8. Proposed Use Septic Alteration $ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES August 12, 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 12th Day of August 12 1991 SIGNED BY - 1%:z ' "L for the Town of Queensbury Building and Zoning In4ector # bj TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT , Permit # 9/1 5(q Fee Paid /lab— Date: ,' 0— o Revi 8VvA VY Qu'=amosuR, ✓ ,9 IREC E:lE7 LOCATION OF PROPERTY FOR INSTALLATION: 4 ci tr,-/4..0 /?tX 0-002 Owner's Name: .41 y,,s- 'e-cec/. `/,'lie o.. ,f- /5AUG 9 1991 '/ Owner' s Mailing Address: A 0 j-e,Y,,.,., l 9i,-c-cr'4-61l ,emonF WEPT; Installer' s Name: i i 14 /3-th Phone #: 7e,7,261W Number of bedrooms (if residential ): Total daily flow (residential-compute @ 150 gal . per bedroom) : .700 Topography-Circle One: i Rolling Steep Slope % of Slope Soil Nature-Circle One: Cr Loam Clay Other /Depth: Ground Water-At What Depth? Feet Bedrock or Impervious Material-At What Depth? o;W Feet Percolation Test-Circle One: Not Required Required/Rate,14 Min. Per Inch Domestic Water Supply-Circle One: �Ntaunicipa� Well Other If domestic water supply is a well - Separation: Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank rd©o gal . (Minimum size: 1,000 gal . ) Tile Field: Each Trench 92 , 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. SIGNATURE OF RESPONSIBLE PERSON: --. - DATE: a / y--Jy 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: • JQueeniLryown of BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTIC DISPOSAL SYSTEM INSPECTION NAME 44d, /Cr I LOCATION 7j(') DATE fb /9/ PERMIT NO. ��—,��✓ SOIL TYPE - Sand - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch TYPE of SYSTEM: Absorption field, total length / Length of each trench </_i- Depth of trenches '0 -� Size of gravel SEEPAGE PITS4Nuinber of) Size- ft. X ,/ ft. Gravel size i L - PIPING: Size Type Bldg. to tank �? . )' Tank to dist. Ijox„ '/ ' Dist. box to field/pit / ' f)/rj Openings sealed? YES NO Partial LOCATION/SEP#RATIONS: Foundation to tank /eft. Foundation to absorption.. ft. Absorption ::to lot line j n ft. SeparationOof pits 6. ft. LOCATION OF SYS OPERTY(circle one) Front - Rear - Left side Right side - COMMENTS:i` • • SYSTEM USE APPROVED NO (1- 62/4-€1-1' Bu , ding Inspector 01/86 and vl i —=__,r--�___- .,�..�•--,. �:.::.:.......-,r*•:—:. .=.: .-.j::s�:.�•:..-;.7:�1.a,r ~• _`;r;<-.-tom .;,.;..=.�. ..,,,�,:•�----, a�nn6���?,.�.;r�,,. qq;; 1 ,. 9 t0vK.y"i—a� RECEIVED • AUG 9 1991 /� J'J +d 6 c�r� �. J- C,ee i V G (,, . . ttDG. & coarE nr.p-1-_ • j • . LL Ct � ct � .4 ) 1 , . vci6