1991-766 ,1
•
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date C'.1v vZJ Oa 19 /
This is to certify that work requested to be done as shown by Permit No. 91 766
has been completed.
This "structure,may be occupied as a Septic Al teratI offl
Location33 Owen Avenue
Owner James Baker
By Order Town Board
TOWN OF QUEENSBURY
V
;:. Director,of Bldg. & Code Enforcement
•
•
9 a
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BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-766
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to James BAker
OWNER of property located at 33 Owen Avenue 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
Andy Scarpellino
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: 250' 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 October 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 th of October 19 91
/a/Y ^D.
SIGNED BY %"s i� ) for the Town of Queensbury
Building and Zoni ` Inspector
Allak
TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC D $ OS�'� PP 1EN$8u Permit # f 7&cP
RECEIVED Fee Paid des C�h
Date: de// /9?'7 OCT 3 0 1991 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: DLD0. . CODE DEFT
Owner's Name: :(/')c, 8 -/t Y'
Owner.'s Mailing Address: Ty Pit-dr
Installer's Name: /1/-�l r(rJff it/f/44 Phone #: 7G/0y-.5-;i 17)(
Number of bedrooms (if residential ): 3
Total daily flow (residential-compute @-150 gal . per. bedroom): 5--O
Topography-Circle One: Flat :Rolling Steep Slope % of Slope /0
Soil Nature-Circle One: Sand Loam Clay. Other /Depth:
Ground Water-At What Depth? . oC-I/ / Of . Feet
Bedrock or Impervious Material-At What Depth? 0A -- 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 we -
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: .Septic Tank WO- gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench 470 feet//Total System Length 015�O feet
Seepage Pit(s): Number of / Size each: ft. .x ft.
Size of Stone to be used: # 6 / Depth or Thickness / feet
**************
HOLDING TANK SYSTEM IF REQUIREp
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 Tow of Queensbury Sanitary Sewage Disposal
Ordinance.
SIGNATURE OF RESPONSIBLE PERSON: DATE: . (2j 3G 9/
Septic 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 showing:
1) 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
5) size and dimensions of all tanks, distribution boxes, tile fields
and/or drywells
B. No system shall be covered before inspection and approval by the Building
Inspector. 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 to produce said plot plan at time of inspection may result .
in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper installation,
alteration or repair of an approved system, a new proposal must be submitted
to the Queensbury Building Department before further construction.
Town of Queensbury
Building & Code Enforcement
Department
531 Bay Road
Queensbury NY 12804
Remarks:
A .- Alqi Ynk.. Ci&e4 .
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Jocun of /�
Queenitury M
• BUILDING and ZONING DEPARTMENT -
• Bay and Haviland Road, R.D. 1 Box 98
• Queensbury, New York 12801
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SEPT
IC
CDDISPOSAL SYSTEM INSPECTION -�
NAME �.J 1\ T l
1
LOCATION 33 (7)(,:NovA )411)"0-/A...Lk_31...__
DATE . /0/3()PERMIT NO. . C37 (' 2/0 Y
SOIL TYPE 7/Sine- Loam - Clay -
Percolatiori"Test Required? YES - NO
Percolation rate - Min/Inch
TYPE of SYSTEM: ,
Absorption field, total length z?,SC''.
Length of each trench ' ,-j G7
Depth of trenches j'/ 4.3 '
Size of gravel A,2 .
_
SEEPAGE PITS4Nvin*er of)
Size- ft. X I ft.
Gravel size . �, i
PIPING: 1 Size Type
Bldg. to tank I --- •
Tank to dist. box +¢P' S4-D
Dist. box to fief' /tit I�' it
Openings sealed? Y NO Partial
Y
LOCATION/SEPARATION :
Foundation to tank _ ft.
Foundation to absorp+ 1.-I
ion .3 5 ft.
Absorption to lot lin' 3'01-ft.
Separation of pits \ -- ft.
LOCATION OF_-_SYSTEM ON PROPERTY(circle one)
Front ear Left side -\Right side -
COMMENT f
J .\
j/ ::---.. -----' --- .
SYSTEM USE APPROVED/YES r 0
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'OWN OF QUEENSBUI.,
RECEIVED
OCT 3 01991
BLDG- & CODE DEPT.
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