Loading...
1991-835 _ -}e-. _ail(... 'v+.a- —!'f • Y` a -tr. a , ,-,__ _. rb a .... - .. CERTIFICATE OF COMPLIANCE TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK Date 0711I sf, 4" 19 9/ This is to certify that work requested to be done as shown by Permit No. 91-835 has been completed. This structure may be occupied as a Septic alteration Location SRO Dixon Road Owner Richard Chap By -Order Tow4 Board TOWN OF QUEENSBURY /17 Director of Bldg. at Code Enforcement BUILDING PERMIT 11) TOWN OF QUEENSBURY No. 91-835 WARREN COUNTY, NEW YORK • LO PERMISSION is hereby granted to Richard Chapman c)n OWNER of property located at 590 Dixon Road Street, Road or Ave. ro 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. w 1. OWNER'S Address is SAme =46 r) 2. CONTRACTOR or BUILDER'S Name Queensbury.:Sewer cn 3. CONTRACTOR or BUILDER'S Address O rz, x 0 4. ARCHITECT'S Name 5. ARCHITECT'S Address V) CD e+ 6. TYPE of Construction—(Please indicate by X) ( )Wood Frame ( 1 Masonry ( )Steel ( ) ei fD a 7. PLANS and Specifications O No.Septic alteration to include: 2 seepage pits each 8' x 8' using #3 stone, 2' thickness as per plot plan specifications and application 8. Proposed Use Septic Alteration $ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 2, 19 92 (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 thi d Day o/ December 19 91 SIGNED BY C /,G for the Town of Queensbury • Building and Zoning/Inspector lvj TOWN OF QUEENSBURY rt��P� �3F C,l! �� ,� p APPLICATION FOR SEPTIC DISPOSAL PERMIT ,,-FewrSb# 9/f REJEPeeDPaid itr 5 p r 2 1991 r l Date: 0 2 Reviewed By ! '0 LOCATION OF PROPFIY FQR INSTALLATION: ! /c--- a 714/ gEFil 1101 Owner' s.Name: IDYL.-� _ C� /( e id, Owner' s Mailing Address: 3c Di d 2 4,-). Installer' s Name: 621 coed,5(3 0, e- Lt.) Phone #: 7."--,,2 /7',(o Number of bedrooms (if residential ): 5 Total daily flow (residential-compute @ 150 gal . per bedroom) : Topography-Circle One: 4111, Rolling Steep Slope % of Slope Soil Nature-Circle One: Sa4) Loam Clay Other /Depth: Ground Water-At What Depth? Feet Bedrock or Impervious Material-At What Depth? Feet Percolation Test-Circle One: of Requir) Required/Rate Min. Per Inch Domestic Water Supply-Circle One: AialnIngto Well Other If domestic water supply is a 'well - • Separation: Water supply from any septic absorption feet PROPOSED SYSTEM: Septic Tank ''ozr gal . (Minimum size: 1,000 gal .') Tile Field: Each Trench feet//Total System Length feet Seepage Pit(s): Number of c.,Z / Size each: ft. x F ft. Size of Stone to be used: # -3 / Depth or Thickness 2 " 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: ',2 -// 1 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 th'e 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 drywel.ls. 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: nr) `town of oQueenibutry` BUILDING and ZONING DEPARTMENT Bay and Haviland Road, R.D. 1 Box 98 Queensbury, New York 12801 SEPTpIC DISPOSAL SYSTEM INSPECTION NAME C XNG YY\.AA,-, RGACk.`r) LOCATION , D arn� DATE izi-t PERMIT NO. CP C1 SOIL TYPE an - Loam - Clay - Percolation Test Required? YES - NO Percolation rate - Min/Inch , TYPE of SYSTEM: . Absorption field, total length Length of each trench Depth of trenches Size of gravel ) _ SEEPAGE PITS*Numb-.__ of) L Size- Oft. X ft. I / Gravel (ff0 a . PIPING: Sie Tye Bldg. to tank Tank to dist. box Dist. box to field/pit gvCJ Openings sealed? YES I4O . Partial LOCATION/SEPARATIONS: Foundation to tank '4,ft. Foundation to absorption ,#tft. ' Absorption to lot line / 3r6 f`t. Separation of pits LOCATION OF SYSTEM ON PROPERTY.(circle one) Front ea - Left side - Right side - COMMENTS: - J• • SYSTEM USE APPROVED 40 NO t . Bu ding •Insp ctor 01/86 and vl 1 , --=) 4 ----. , • -\ r- . . -g._ C • 0 \ 0 IN, 1,,, • ril rti ,„ :7 0 co Evt Cr )Nci,. -.__------- - "TP r 71 • ( ,I5P e'd 6 , 6 v i 0, 1,- a 4" . . . . \II 'ii