1991-721 I
CERTIFICATE OF COMPLIANCE
•
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date �� f 3o 19 �£
This is to certify that work requested to be done as shown by Permit No. 91-721
has been completed.
This structure.may be occupied as a SepticAlteration
Location 5 s Place
Owner Arthur Treceno
By Order Town Board
TOWN OF QUEENSBURY
/-2) /
Director of Bldg. & Code.Enforcement
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-721
WARREN COUNTY, NEW YORK h
PERMISSION is hereby granted to Arthur Treceno1-1
~'
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OWNER of property located at 5 Ames Place Street, Road or Ave. 411.
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 ro
ro
V
3. CONTRACTOR or BUILDER'S Address
�t
4. ARCHITECT'S Name
5. ARCHITECT'S Address
DTI
ti ro
6. TYPE of Construction—(Please indicate by X) rn
( )Wood Frame ( ) Masonry ( )Steel ( ) I A+
ro
7. PLANS and Specifications Nrp
No. Septic Alteration to include: 187' of Tile Field using #2 Stone,
1' Thickness
8. Proposed Use CD�
Septic Alteration
0
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES October 9, 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 Day of :7 October 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning! spector
;;9r
TOWN OF QUEEI �i�j 'QUEENSBUR�
i � APPLICATIOX FOR SEPTIC DISPOSAL PE@QXIVED
DATE: /0—? —9( OCT 199
LOCATION OF PROPERTY FOR I, STALLATION BLDG. & GO E DEPT
Owner' s Name: 4tetYfitift /Acc rN D / 'EC
Address: A--(fe
� �
Installer' s Name: JAN) ,7 � �..c/ Telephone: 79 - 7J.c7
Number of bedrooms (residential o ly)
Total daily flow (compute @ 150 gal per bedroom) "/
22
Topography: Circle one: Flat Rolling Steep Slope % of Slope
Soil Nature: Circle one: Sand Loam Clay Other /Depth:
Ground Water: At what dept ? Feet
Bedrock or Impervious Material : At what depth? Feet
Percolation test: Circle one: <::;ot required required
Rate - Min. Per Inch
Domestic water supply: Circle oneigilliik Well Other
If domestic water supply is a wel
Separation: Water supply from any septic absorption feet.
E Ci'r 1u'
PROPOSED SYSTEM: Septic Tank /000 gal . (minimum size: 1,000 gal )
/ P 9
TILE FIELD: Each Trench 2/ -3 1- feet/Total system length -,e94:70feet
SEEPAGE PIT(S): Number of /Size each feet
by feet
Size of stone to be used #. /Depth or Thickness f 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 own of Queensb Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: i ; e C
1
:lepUic Sylti■ Inspections:
A. All applications for septic system instillation, alteration or repair,
as required by the Town of Queensbury Sanitary Sewage Ordinance, shall
bar 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 tho system
2.) location and distance to lot lines
3.) location and distance_ to structures
4.) location and distance co any water supply
5.) size and dimensions of all tanks, distribution boxes,
cile fields and/or drywalls
B. No system shall be covered before inspection and approval by the
Building Inspuccor. Failure to comply with this requirement may
rwsult 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 may
rusult 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 Qu.unsbury Building Department before further •
construction.
Town of Queensbury
BUILDING and CODES DEPARTMENT
• Bay and Haviland Roads
Quecnsbury, New York 12804
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kamarks:
•
•
•
_..
Jocun o� QueenJ4ury 71,1711
-
SUILDING and ZONING DEPARTMENT,'
Bay and Haviland Road, R.D. 1 Box 98 •
Queensbury, New York-12801
•
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME 6./%twi �/J4L4 4
LOCATION 641.14 -P�
DATE/O/3U/f/ PERMIT NO. /— /M /
SOIL TYPE - Sand - Loam - Clay -
.Percolation Test Required? YES - NO
Percolation rate - Min/Inch ,
i`
TYPE of SYSTEM: •Absorption field, total length j� "
Length of each trench („62,43t,
Depth of trenches (.>3 ' , n
Size of gravel' C-%;
SEEPAGE PITS4Nuinber of) • ,
Size- ft. X y ft.
Gravel size
PIPING: ` Size Type
Bldg. to tank :r[1
Tank to dist. box i/ (/
Dist. box to field/pikt 4 �'
Openings sealed?"' YE NO Partial
LOCATION/SEFARATIONS: '
Foundation to./tank ft.
Foundation to absorption ft.
Absorption to lot line l ft.
Separation of pits h, ft.
LOCATION SYSTEM ON PROPERTY(circle one)
Fin'£ ear - t side;`- Right side -
COMMENTS:
•
',
1
SYSTEM USE APPROVED CO NO
'/
B lding Ins'ector
01/86 and vl
LI` I
� J I
14 f�
a '1coOL
(\Doc, L
(a f- TOWN OF QUEENSBUR
RECEIVED
\l/ OCT 81991
BLDG. & CODE DEPT.