1991-617 g
CERTIFICATE OF COMPLIANCE •
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 14091,- '9 9/
This is to certify that work requested to be done as shown by Permit No. 91 617
has been completed.
This structure may be occupied as a Septic alteration
37 liicrest Drive
Location
Berna. Rahi l l
Owner
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-617 •.
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Bernard Rahi l 1
OWNER of property located at 37 Wincrest 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
Sanitary Sewer
3. CONTRACTOR or BUILDER'S Address
4. ARCHITECT'S Name
5. ARCHITECT'S Address
6. TYPE of Construction—(Please indicate by X)
( )Wood Frame ( ) Masonry ( I Steel ( )
7. PLANS and Specifications
Septic alteration to include: 3 Seepage pits each 8' x 8' using #3 stone
2' Thickness as per plot plan specifications and application
8. Proposed Use
Septic alteration
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$ 25.00 PERMIT FEE PAID—THIS PERMIT EXPIRES August 27, 19 q3
(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 h y Qf August 19 91
SIGNED BY — ,GU' / for the Town of Queensbury
Building and Zon Og Inspector
TOWN OF QUEENSBURY
41Virl ({_ APPLICATION FOR SEPTIC D ISPOtAtiVERMIIUEENSBUN
RECEIVED.
DATE: Co' 7 - 9"( AUG 2 7 1991 °
LOCATION OF PROPERTY FOR INSTALLATION N3 1 4/,' C, e jr
a & 'ODE DEP1
Owner's Name: / e..t xinn
Address: 1
Installer' s Name:_11;4-4/7 . � . Telephone: 792, 7)s'
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) el 0!)
Topography:___Ci r_cl-e_ one.° t 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: of required required
Rate - Min. Per Inch
Domestic water supply: Circle one: Well Other
If domestic water supply is a. we ":'
Separation: Water supply from any septic absorption feet.
(Aer Jr w")
PROPOSED SYSTEM: Septic Tank gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of � /Size each feet
by feet
Size of stone to be used # ) /Depth or Thickness feet
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HOLDING TANK. SYSTEM IF REQUIRED
NO. of Tanks Size of Each Gal .
• *Alarm system and associated electrical work to be inspected by an approved
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: ATE:
piic System Inspections,:
A. All applications for septic system installation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
be submiccad to the Building Department at leasc• 24 hours before start
of construction and shall include a plot plan showing:.
1.) the proposed location of the system
2.) location and distance co lot lines
3.) location and distance co structures
4.) location and distance to any water supply
5.) size and dimensions of all tanks, distribution boxes,
cild fields anal%or drywalls -
B. No system shall be covered before inspection and approval by the
Building Inspuctor. 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 co produce said plot -plan at cime of inspection may
rusulc in an immeediace work stoppage.
D. Should unforeseen problems during construction prevent proper installa—
tion, alteration or rupuir of an 'approved system, a new proposal must
bo submitted co the Queensbury Building Department before further
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queansbury, New York 12804
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kuniarks: :.
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(-7 / IL
• . Jown o f Queeniur , /91
BUILDING and ZONING DEPARTMENT
'Bay and Haviland Road, R.D. 1 Box 98 . •
,Oueensbury, New York 12801 .
SEPTIC DISPOSAL. SYSTEM INSPECTION
NAME ‘LdeAr it e1.ahl
LOCATION .3 7 (.!/ 0..„1.1- 2
DATE 0—q/ PERMIT NO. ' 9/-6 7
SOIL TYPE - Sand - Loam - 'Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: :---�
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Absorption field, total len th ---`-
Length of eaci t er nch V - --
Depth of.tr'enches ' /"`f ":;
Size of graveI ' -. . _
SEEPAGE PITS{Number of) ' .
Size- % ft. X ': ft'.
Gravel size .7a)
PIPING: Siz Type
Bldg. to tank EX s y-(,v(,
Tank to dist. box _1 P1 - __PVC__ ___ ___` _ _
Dist. box to field/pig/ :.j PVC—
Openings sealed? tillipp, NO Partial
LOCATION/SEPARATIONS.
Foundation to tank/ z 3',iA E ft.
' Foundation to abso ption 2
ift.J.1(kr .
Absorption to lot line t6.4 _ ft.
Separation of pi ft.
LOCATION OF SYSTEM ON PROPE TY(circle one)
Front - ear - Left side - R ht .side - '
COMMENTS: •
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SYSTEM USE. APPROVED' Y--) NO-.
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Building Ins ector
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TOVV OF •
BUlq
REVIEWED BY
DATE 3 77 /
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