1991-670 •
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date September 25 19 91
This is to certify that work requested to be done as shown by Permit No. 91-670
has been completed.
seumge alteration
This stricture may be occupied as a
Location 80 Old Faroe Road
Ljrnda Crayford
Owner
By Order Town Board
TOWN OF QUEENSBURY
r
-D
Director of Bldg. & Code Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-670 =t
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Linda Crawford
OWNER of property located at 80 Old Forge 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
Queensbury 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 ( )Steel ( )
7. PLANS and Specifications
No. Septic Alteration to include: 2 seepage pits each 6' x 8' using
#2 stone as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES September 20, 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 20th Day ff September 19 91
SIGNED BY for the Town of Queensbury
Building and Zogai Inspector
cs
TOWN OF QUEENSBURY APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # 6,;(f U
Fee Paid
Date: ,,5a7 7 1 ( Reviewed B
LOCATION OF PROPE Y FOR INSTALLATION: 1
Owner's Name: OZ & CODE DEPT,
Owner' s Mailing Address: 0j;/)
Installer' s Name: Phone #:
/7-2S T f
Number of bedrooms (if residential ):
Total daily flow (residential-compute @ 150 gal . per bedroom) : e. /S7---6
Topography-Circle One: 4100 Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sa d Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? Feet
Percolation Test-Circle One: 'ot Require. Required/Rate Min. Per Inch
Domestic Water Supply-Circle One: `unicipal Well Other
If domestic water supply is a we -
.Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank -1 -gal . (Minimum size: 1,000 gal .)
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of / Size each: C., ft. x " ft.
Size of Stone to be used: # 2 ( / 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: � 1 (- 9/
•
own of Queeniury
ILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
) :730 .
SEPTIC DISPOSAL SYSTEM)---r.s% INSPECTION
NAME ��Y .G 'r n d p
t
LOCATION ).8--, (0 0,� �,civc _.-
DATE 61 /DS' PERMIT NO. 9 ( _ ( 7O
SOIL TYPE ` San Loam - Clay -
Percolation Test Required? YES - NO ,
Percolation rate - Min/,Inch
TYPE of SYSTEM: /
Absorption field, tot l length f
Length of each trench,
Depth of trenches ' 6 !
Size of gravel ,. 4 �(
SEEPA
Size- 5PIft{Nuinbe6r of)ft. zie RAS/6sr�e- .
Gravel size . ,j .L df '4
PIPING: Siz" Type
Bldg. to tank gif'i-
Tank to dist. box Y'' 's;
Dist. box to field/•' le £
Openings sealed? ?1 NO Partial
LOCATION/SEPARATIO
Foundation to tan;kid %
e vi- ,eft.
Foundation to absorption p?2 'ft.
Absorption to lc& line /0 fit.
Separation of its /4 ft.
LOCATION OF SYSTEM ON PROPERTY(circle one)
Re - Left side - Right side -
COMMENTS:
/////
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SYSTEM USE APPROVE YE
Buil ' In ector
01/86 and vl
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\..1 SEP 1 ) 1991
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