1991-845 4
CERTIFICATE OF COMPLIANCE
TOWN OF QUEENSBURY
WARREN COUNTY, NEW YORK
Date 4Oe .41-X 919 fi
;9,--JAA 0
This is to certify that work requested to be done as shown by Permit No. 91 84h
has been completed.
This structure may be occupied as a SepticAl terse on
i.n-ati O TW1fl Mountain Rd
Owner Tracey Tabor
By Order Town Board
ti
TOWN OF QUEENSBURY
•
Director of Bldg. do Code Enforcement
`ems
BUILDING PERMIT
TOWN OF QUEENSBURY
No. 91-845
WARREN COUNTY, NEW YORK
PERMISSION is hereby granted to Tracey Tabor
OWNER of property located at Twin Mountain Rd 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. �I
1. OWNER'S Address is
t
Same �I
2. CONTRACTOR or BUILDER'S Name
Ivan Bell
•
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 with #3 stone
1' Thickness as per plot plan specifications and application
8. Proposed Use
Septic Alteration
$ 25.00 PERMIT FEE PAID —THIS PERMIT EXPIRES December 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 9th ay of December 19 91
SIGNED BY for the Town of Queensbury
Building an oning Inspector
- _ 8
` j TOWN OF QUEENSBURYwVN OF QUEEN ;)• 4415-,
APPLICATION FOR SEPTIC DISPOSAL PERMIT,EOEIVED Permit #Fee Paid , -
DEC G 1991
Date: 11 .S 191 Reviewed By
G. & CODE DEPT,
LOCATION OF PROPERTY FOR INSTALLATION: / j/ I.i A., 9 vn 1 ct,' n ic/ •
Owner' s Name: 1-"" ( - J Te ,
Owner' s Mailing Address: 7 i ,',- au.,ria.n /`() 1. ze ,i5 5L1rCi
•
Installer' s Name: vo, ,t_ f3 L . Phone #: �]9F-41/ "
Number of bedrooms (if'residential ) 3 81
D '
Total daily flow (residential-compute @ 150 gal . per bedroom) : 950
Topography-Circle One: Gib Rolling Steep Slope % of Slope
Soil Nature-Circle One: Sand Loam Clay Other /Depth:
Ground Water-At What Depth? e7` G Feet
Bedrock or Impervious Material-At What Depth? - //I Feet
Percolation Test-Circle One: Not Required Required/Rate /i/,4 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 /VA feet
eX
PROPOSED SYSTEM: Septic Tank rood" gal . (Minimum size: 1,000 gal . )
Tile .Field: Each Trench 50 feet//Total System Length a, so feet
Seepage Pit(s): Number of 4/ / Size each: JV4- ft. x /VA ft.
Size of Stone to be used: # / Depth or Thickness / feet
**************
HOLDING TANK SYSTEM IF REQUIRED
No. of Tanks Size of Each /14 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: L DATE: /a /.5,/. /
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 plotplan 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:
Jouiva o� Queenitur, ���/I►
BUILDING and ZONING DEPARTMENT '
Bay.and Haviland Road, R.D. 1 Box 98 ' 0
Queensbury, New York 12801 11-`_
SEPTIC DISPOSAL SYSTEM .INSPECTION
NAME //TQI' p /g/ /I� •
J 1,60-ril7}--ArA,
LOCATION /7.(}(�� 4_02% G�f
DATE /2/f / 97 PERMIT NO. --2
SOIL TYPE - aS nd t Loam - Clay -
Percolation est Required? YES - 0
Percolation rate 7 Min/Inch
TYPE, of SYSTEM:
Absorption field, total length ]b`
Length of each trench 5-()
Depth of trenches • 7_�m; •
Size of gravel: " 1 ?,n_ 'j,.
SEEPAGE PITS{Number of) • ✓- _
Size- ft. X ' ft.
Gravel size /
PIPING: ',\ Size"• Type
Bldg. to tank mbri: J?C,
Tank to dist. box Ali:-
Dist. box to field/pit y PVC—
Openings sealed? ES,' NO Partial
LOCATION/SEPARATIONS.,'
Foundation to tank xx'5►0a ft.
Foundation to absorption 2 jft.
Absorption to lot killed, ()/ ft.
Separation of pits . ? 42Z.g-ft.
LOCATION OF SYSTEM° ON PROPERTY(circle one)
Front - Rear' Left side, - Right side -
COMMENTS:
is
'.A
ti
SYSTEM USE APPROVED E. NO
•
Building nsp `ctor _
•
01/86 and vl
•
b o NSA,
: {'P;va.r),
�d 199�- -. - -
•
1 ,. ,
•
•
... , . ..,_;,,,.. . „, - ', ',.1 ..• --,--. - '. - -.,!.''',-.- , — "--'•:. ' - . _
jb • rr
. - _•
;.. ;,
-i - - .•
� p
•
•
t•
! : _ I. rr CO• it r r j N:7rY r1 r.
• s J _ A Z{ s er
•
•
•
j_.
Pk n r 1-
{, •