1991-695 S •
• 41.
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date (00 1l9-Q i I 19 �l
This is to certify that work requested to be done as shown by Permit No. 91-695
has been completed. `
This structure may be occupied as a septic system
Stewart Road
Location
MICHAEL JABAIJT
Owner
ai
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. & Code Enforcement
hl
BUILDING PERMIT
� A
TOWN OF QUEENSBURY
No. 91-695
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to MICHAEI JABAUT
OWNER of property located at Box 158 Stewart Road 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
RD#2 Box 158 Stewart Road
—
2. CONTRACTOR or BUILDER'S Name
Sanitary Sewer ,
n
rn
3. CONTRACTOR or BUILDER'S Address r—
PO Box 224
Glens Falls NY 12801
4. ARCHITECT'S Name PzI
O
X
Co
5. ARCHITECT'S Address cn
c-I-
Cu
cD
Cu
5
c+
6. TYPE of Construction— (Please indicate by X)
( I Wood Frame ( ) Masonry ( ) Steel ( )
7. PLANS and Specifications `
No. Septic alteration to include 1000 gallon septic tank, 200 feet of
tile field with #2 stone at 1 ft depth as per application and plot plan.
8. Proposed Use
Septic system
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES Septemher 30 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 ay f September 19 91 0
(/ cn
SIGNED BY for the Town of Queensbury
BuildingandiZoni /Inspector
i TOWN OF QUEENSBURY /D�f
APPLICATIOt ,FOR SEEM p 0 L PE I
��
DATE: 9-,3ro '' � • ILADN��.�°3 P� CODES DEPT.
LOCATION OF PROP RTY FOR INSTALLATION REVIEWED G d11`1
Owner' s Name:- 6 • E
Address: JOX
Installer' s Name:c ///f/ % C��%�� Telephone: 7 57)-Z
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom) g673
Topography: Circle one: ' Rolling Steep Slope % of Slope
Soil Nature: Circle one: San 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: 'unicipal Well Other
If domestic water supply is a wel
Separation: Water supply from any septic absorption feet.
PROPOSED SYSTEM: Septic Tank /Ooc gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench (51) 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
****************************
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: Jdr 9/
1
•
Sopti4 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 shoving:
1.) the proposed location of tho system
2.) location and distance to lot lines
3.) location and distance co structures
4.) location and distance co any water supply
5-.) size: and- dimens-ions-o-f all-canka,- distribution boxes,
till fields and/or drywalls
B. Nu system shall be covered before inspection and approval by the
Building Inspuctor. Failure to comply with this requirement may
rusulc in the uncovering of the system by the installer and a fine
of up co $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 say -
resulc in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installa-
tion, alteration or repair of an approved system, a new proposal must
bu submitted co the Quaunsbury Building Department before further
construction.
Town of Queensbury
• BUILDING and CODES DEPARTMENT
Bay and Haviland Roads
Queensbury, New York 12804
h.:niarks:
•
•
•
k •
—Amor— -
r
1
cc77 // _u
_loeun ol q�ueenibury
r/l 11 J BUILDING and ZONING DEPARTMENT �/
`j/ Bay and Haviland Road, R.D. 1 Box 98 .
Queensbury, New York 12801
SEPTIC DISPOSAL SYSTEM/ INSPECTION
NAME aC‘P 7 UG d 74
LOCATION ;I1 #'
DATE f0/9/ PERMIT NO. 9/-6 r
SOIL TYPE - Sand - Loam - Clay -
Percolation Test .Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM:
Absorption field;• total length 2-(DC)
Length of each trench $'cD
Depth of trenches ' 21" �(=j
Size of gravel 1 e"- ;'--Z—
SEEPAGE PITS4N 'umber of) • ' • �-7
Size- ftX1/rt�- _____---
Gravel 7./.1.-----\- i
c_ �PIPIN Size Type
Bldg. o tank A4 �'crh4o PvL
Tan to dist. box �( 9 V
ID' t. box to field/YES '-( 6UC-
gpenings sealed? NO Partial
LOCATION/SEPARATIONS:
Foundation to tank Zaft.
Foundation to absorpti•n y t.f--
.Absorption to lot line \ O l C-ft.
Separation of pits AJ/-Ift.
LOCATION OF SYSTEM ON PROPE Y • le one)
Front - Rear - Left side - ' ht side
COMMENTS: O le Tb CO C/&K_COM PILL-"2-io
c-i[Oil/ , �ti
S— ;L
---. /:.'6- . , .
SYSTEM USE APPROVED YE
s.
Bui ding nsp 'ctor
01/86 and vl
T (2-cr
ge '4
Pis
4 OCT 1991
13 Beepiyed
14, meat ow Ivry 4,
ckt,
-`leoze_tster0
\s
, .
bis'r
' 1- -
•