1991-689 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date vi/ .Di.e40 `,�P/} 34 19 9/
This is to certify that work requested to be done as shown by Permit No. 91-689
has been completed.
This structure may be occupied as a Sep l:3 Alteration
Location 107 Aviation Rd
Owner Brian Phelps
By Order Town Board
TOWN OF QUEENSBURY
Director.of Bldg. & Code Enforcement
•
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-689
WARREN COUNTY, NEW YORK V
03
1-6
PERMISSION is hereby granted to Brian Phelps
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OWNER of property located at 107 Aviation 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
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance.
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1. OWNER'S Address is
Same
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2. CONTRACTOR or BUILDER'S Name
Ivan Bell
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name O
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) rD
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( )Wood Frame ( I Masonry ( )Steel ( )
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7. PLANS and Specifications
No. Septic Alteration to include: 200' of Tile Field using #2 stone
1' thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT_FEE PAID —THIS PERMIT EXPIRES September 27, 1993
(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 of Se tember 19 91
SIGNED BY /P' , i/1 1 for the Town of Queensbury
Building and Zoning In ctor"—
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vs, TOWN OF QUEEN,S,BUR,Y=
APPLICATION FOR SEPTIC DISPOSAL PERMfT • Permit # /4,9
Fee Paid e S
SEpw (5199
Date: 5,/ot 2 6 9 f GODS Do v'i ewed B
pCa. & C
LOCATION OF PROPERTY FOR INSTALLATION:// /0 ? i Oy, / cl
Owner' s Name:. ��� ; 4h /3vl.t.���
Owner' s Mailing Address: w 7 hve7h-opt
Installer' s Name: s,4y4 5611 Phone #: 79 69 /
Number of bedrooms (if residential ) : . ,
Total daily flow (residential-compute @ 150 gal . per bedroom) : c/o'o
Topography-Circle One: •4111, Rolling Steep Slope % of Slope
Soil Nature-Circle One: . an). :Loam Clay Other /Depth:
Ground Water-At What Depth? je Feet
Bedrock or Impervious Material-At What Depth? yJA Feet
Percolation Test-Circle One.: No.t Required Required/Rate AlMin. Per. Inch
Domestic Water Supply-Circle One: Municipa . Well Other
If domestic water supply is a we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 9 p >�oo gal . (Minimum size: 1,000 gal . )
Tile Field: Each. Trench sv • feet//Total System Length a o,o feet
Seepage Pit(s): Number of "7,4 . / Size each: ft. x ft.
Size of Stone to be used: # 2 / Depth or Thickness / feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks y/ 1 • Size of Each y1y 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: sr,,, DATE: 5.4p f zG r/
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�
� Septic System Inspections:
A ` l op l�cations for Septic system installation',
alteration or repair,
A. "' the of OueenSbVry Sanitary Sewage Ordinance, shall
` as req«/ reube duY» �t�e' Building Department at least 24 hours before atamt
of construction and Shall include a plot plan showing:
l 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
5size and dimensions of al=-�-tanks,. distribution boxes, tile fields
�Dd/�r drvwell3
' _
B. No system shall be covered before inspection and approval
by the
Building
ult in the
with thts requirement may res
Inspector. Failur6 to ` '
uncovering of the system by h
installer and a fine of up to $250.00.
the construction
C. '
C ' approved copy Of the plot plan shall be available on � cons ru
r' �^te. Faflure to produce said plot plan at time of inspection may result
i' in- an immediate work stoppage.
` t inStalla�fU�
Shou7d unforeseen problems during construction pre vent proper "
d t �w proposal must b� submitted
alteration Dr repair Of an approve s u o p _
` i7di Department B �hef0re furth�r construction. ,
` to� the Ou�enSbury u ng .
,
� Town of Oueensbury "
' Building & Code Enforcement
Department , '
531 Bay Road
Oueensbury NY I2804
'
r - ' Remarks: ,
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Jown o/ Queeniurcy
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME / (
LOCATION /D 7
DATE 9/3i7ii PERMIT NO. c1 -�W
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 7W
Depth of trenches '4L
Size of gravel S 2
SEEPAGE PITS-(Number of)
Size- ft. X ft.
Gravel size
PIPING: Size Type
Bldg. to tank �L
Tank to dist. box L " L
Dist. box to field/pit <1 " C_
Openings sealed? YES NO Partial
LOCATION/SEPARATIONS:
Foundation to tank jd ft.
Foundation to absorption `,b ft.
Absorption to lot line gjft.
Separation of pits ft.
LOCATION e SYSTEM ON PROPERTY(circle one)
Front -` - Left side - Right side -
COMMENTS:
SYSTEM USE APPROVED lak> NO
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