1993-087 et" /
CERTIFICATE OF COMPLIANCE
TOWN OF .QUEENSBURY
WARREN COUNTY, NEW YORK
Date aio.k/./ 31) 19 '73
This is to certify that work requested to be done as shown by Permit No.93-087
has been completed.
This structure may be used as a 4,210tic. 4trstem
Location No&thwinds Lots 60 and 61, Laze/me Road
Owner Dania and Gunge DaeZZo4
9:-2-9 By Order of Town Board
TOWN:FOUEENSBURY
(De
Director of Building & Code Enforcement
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BUILDING PERMIT
TOWN OF QUEENSBURY -
No. 93-087
WARREN COUNTY, NEW YORK w
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PERMISSION is hereby granted to NORTHWINDS INC. ‘.°
OWNER of property located at Lots 60 & 61 Street, Road or Ave.
in the Town of Queensbury,To Construct or place a Septic system
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
Daniel & George Drellos
PO Box 224
Glens Falls NY 12801
2. CONTRACTOR or BUILDER'S Name to
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Sanitary Sewer
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3. CONTRACTOR or BUILDER'S Address
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4. ARCHITECT'S Name
5. ARCHITECT'S Address
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6. TYPE of Construction—(Please indicate by X)
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( )Wood Frame ( ) Masonry ( )Steel ( )
520
7. PLANS and Specifications
No. Septic system as approved plans for mobile home park and as per
application.
8. Proposed Use
Septic system for lots 60 and 61
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25.00
$ PERMIT FEE PAID —THIS PERMIT EXPIRES April 5 19 95 ci
(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.) to
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Dated at the Town of Queensbury this h Day f April 19 93 a
SIGNED BY for the Town of Queensbury
Building and Zoning In ctor
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j TOWN OF QUEENSBURY
APPLICATION FOR SEPTIC DISPOSAL PERMIT Permit # P -0 1Qg3
Fee Paid
.- 'r-) &q CODE DEPT_
Date: ii _ 9 93 Reviewed By
LOCATION OF PROPERTY FOR INSTALLATION: /i .JTfJ1Aii / ,c: itae _
Owner' s Name: , --N r rX____'- CR ';e OX e/4,--
Owner's Mailing Addr s: P d oX .22-cr c f -
Installer' s Name: 14,w l ' Lod__ Phone #: 712... - 7z r'7
Number of bedrooms (if residential ) : kr/fr
l Total daiy fl ow-(resi-dent a1-- edompu—t @—;:5llC=gal —p e r-bed-room):---N�f' — —
Topography-Circle One: Flat Rolling Steep Slope % of Slope
Ow
Soil Nature-Circle One: San, Loam Clay Other /Depth:
Ground Water-At What Depth? Feet
Bedrock or Impervious Material-At What Depth? 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
Separation: Water supply from any septic absorption feet
PROPOSED SYSTEM: Septic Tank 10000 gal . (Minimum size: 1,000 gal . )
Tile Field: Each Trench feet//Total System Length feet
Seepage Pit(s) : Number of 7,� / Size each: ft. x ft.
Size of Stone to be used: # L / Depth or Thickness feet
,A\ram, -`7,4)49 67,,'-6,.
' IZ _h!, i LI . . k
13 **************
- -'*- ITM,A-.60 1 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 t re erse side of this sheet and agree to abide
by these and all requirements o the own of Que bury Sanitary Sewage Disposal
Ordinance.
i ��, '22
SIGNATURE OF RESPONSIBLE PERSO r DATE:
I
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:
(-.4 A
TOHN OF QUEENSBURY 4
BUILDING & CODE ENFORCEMENT
531 Bay Road
Queensbury NY 12804
518-745-4447
SEPTIC DISPOSAL SYSTEM INSPECTION
Name 5.0,,F--,_01/li-
Location �t 6/‘/
Date l70 /, 6 Permit # 9-7-G7,7
SOIL TYPE: Sand'-Loam-Clay-
Results of Percolation Test-
(if applicable) Rate-Minute/Inch()-Jr'
TYPE OF SYSTEM:
ABSORPTION FIELD: Total Len t
Length of each trench,.- , l
Depth of t enc-hes""� , /u/ i i
/
Size of sto / '
SEEPAGE PITS: Number- '
Size - t. x 1 W- ft. Ioci_S7-c.).44,
Stone size "
PIPING: Size Type
Bldg. to Tank Pam; l%c 0 1&r-
Tank to Dist. Box 4" Selz 3
Dist. Box to Field/Pi,, Y-;-`' S-Dv.J'3 v-
Openings Sealed? s) No Partial
LOCATION/SEPARATIONS:
Foundation to Tank 1 iii/ feet
Foundation to Absorption ,Ii J,A- feet
Separation of Pits feet
Conforms as per Plot elan es No
LOCATION OF SYSTEM ON PROPB TY':
(circle one) '
It.
Front - Rear - ',de - R ght Side
Middle Front - '(,,Rea -
COMMENTS: 'ddle 1,
`—c t�`u„Le.
a POLL- (Ai °Kid-Ure A',o 0 pL1-74A0(
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SYSTEM USE APPROVED: YES NO
Arrived: q.%3 0
Departed: 1 0yf f
oaf
Building Inspector