1991-842 CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date .49". 49/41 ,51 919 17/
This is to certify that work requested to be done as shown by Permit No. 91-842.
has been completed.
This structure may be occupied as a Septic a1 tered on
Location 3 St Andrews Drive
Owner John Fisher
By Order Town Board
TOWN OF QUEENSBURY
Director of Bldg. do Code Enforcement
•
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-842
WARREN COUNTY, NEW YORK
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PERMISSION is hereby granted to John Fisher
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OWNER of property located at 3 St Andrews Drive 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 ,rl
approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. -'l
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1. OWNER'S Address is
Same
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2. CONTRACTOR or BUI LDER'S Name
Condon's Septic & Drain
3. CONTRACTOR or BUILDER'S Address t-h
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4. ARCHITECT'S Name to
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5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X) tL
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( )Wood Frame ( ) Masonry ( )Steel ( ) CD
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7. PLANS and Specifications p
No. Septic Alteration to include: 2 seepage pits each 8' x 8' using
#3 stone, Thickness 2' as per plot plan specifications and application
8. Proposed Use
Septic alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 6, 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 6th Day of / December 19 91
SIGNED BY for the Town of Queensbury
Building and Zoning'inspector
1
_ TO f, liF' QUEENSBURY 1
;sir APPLICATIOFJ F'1"� °TIC DISPOSAL PERMIT
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DATE: f)-- 3 - ti
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LOCATION OF PROPERTY FOR INSTALLATION . S ,j lj/t i z 'C�1S -DA 14- 41
Owner' s Name:, Oh1 i I /�
Address: S IhvbAc.0
Installer' s Name: ( ,,� (1.A S rr a. 1- h Telephone: 27&-•- ,c-f L
Number of bedrooms (residential only)
Total daily flow (compute @ 150 gal per bedroom), S
Topography: Circle one: Flat) Rolling Steep Slope % of Slope
Soil Nature: Circle one: San Loam Clay Other /Depth:
Ground Water: At what depth? l /� Feet
Bedrock or Impervious Material : At what depth? �d / F e
Percolation test: Circle one: not required) required RECEIVED
Rate - Min. Per Inch DEC 5 1991
Domestic water supply: Circle one: Municipal Well Other DEPT
If domestic water supply is a well : Ye,me
Separation: Water supply from any septic absorption feet.
a IX15f/iv
PROPOSED SYSTEM: Septic Tank/aad6f4- gal . (minimum size: 1,000 gal )
TILE FIELD: Each Trench feet/Total system length feet
SEEPAGE PIT(S): Number of 77 - /Size each feet
by ' feet
Size of stone to be used it. /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: 4; 647 — `
1
jowl System Inspections: •
A. all applications for septic system iastallacion, alceracion'or repair,
as required by the Town of Queensbury Sanitary Sevap• Ordinance. shall
be submitted co the Building Departaenc at least -24 hours before start
of construction and shall include a plot- plan showing:
1:) the proposed location of the system
2.) locacion and distance CO lot lines
3.) location and distance co structures
4.) location and distance co any water supply
5.) size and dimensions of all canks, distribution boxes.
tilt fields ant/or drywalls
B. No system shall be covered before -inspection and approval by the
uoilding Inspector. Failure to comply with this requirement may
rwsulc 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 co produce said plot plan at cilia. of inspection may
rusulc in an immediate work stoppage.
D. Should unforeseen problems during construction prevent proper inacalla-
cion. alteration or repair of an approved system, a new proposal must
be submitted co the Queunsbury Building Departmonc before further
coascruccion.
Town of Queensbury
BUILDTNC and CODES DEPARTMENT
• Bay and Haviland Roads
Queensbury, New York 12804
k.:auJrk :
Down of Queenibur,
BUILDING and ZONING DEPARTMENT
Bay and Haviland Road, R.D. 1 Box 98
Queensbury, New York 12801 •
SEPTIC DISPOSAL SYSTEM INSPECTION
NAME I/I.L a/
j9
LOCATION c�`" , o ley i2
DATE /. I / 9/ PERMIT NO. 9/Y-2—
SOIL TYPE 11POI- Loam - Clay -
Percolation Test Required? YES - NO
Percolation rate - Min/Inch
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TYPE of SYSTEM: i
Absorption field, total length f
Length of each trench /
Depth of trenches ' I 1
Size of gravel I
SEEPAGE PITS4Number of) _02 �
Size- g ft. X ' fti !j` I
Gravel size 3 1 /
PIPING: ze Type
Bldg. to tank 6 /S : -1.----
Tank to dist. box V k fUc
Dist. box to field/pit IVA it
Openings sealed? ES NO s4 Partial
LOCATION/SEPARATIONS: °fi . ',�
Foundation to tank e 5;__ ft.
Foundation to absorption a7 ',ft.
Absorption -to lot line pia fit.
Separation of pits J 0J3 ft
LOCATION OF SYSTEM 'ON P1OPERTY(cicle one)
(Eioni)- Rear - Left side - Right side -
COMMENTS ii t
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SYSTEM USE APPROVED & NO
B lding Inspector
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REVIEWED BY _ `r•r ‘''
DATE . Pr2-- 5 •